| genetic relatedness between japanese and european isolates of clostridium difficile originating from piglets and their risk associated with human health. | clostridium difficile colonization in pig intestine has been a public health concern. we analyzed c. difficile prevalence among piglets in japan to clarify their origin and extent of the associated risk by using molecular and microbiological methods for both swine and human clinical isolates and foreign isolates. c. difficile was isolated from 120 neonatal piglet fecal samples. toxin gene profile, antimicrobial susceptibilities, pcr ribotype, and multiple-locus variable-number tandem-repeat anal ... | 2014 | 25339943 |
| precision microbiome reconstitution restores bile acid mediated resistance to clostridium difficile. | the gastrointestinal tracts of mammals are colonized by hundreds of microbial species that contribute to health, including colonization resistance against intestinal pathogens. many antibiotics destroy intestinal microbial communities and increase susceptibility to intestinal pathogens. among these, clostridium difficile, a major cause of antibiotic-induced diarrhoea, greatly increases morbidity and mortality in hospitalized patients. which intestinal bacteria provide resistance to c. difficile ... | 2015 | 25337874 |
| discrepancies between surveillance definition and the clinical incidence of clostridium difficile infection in a veterans affairs long-term care facility. | | 2014 | 25333446 |
| differences in hospital-associated multidrug-resistant organisms and clostridium difficile rates using 2-day versus 3-day definitions. | we surveyed infection prevention programs in 16 hospitals for hospital-associated methicillin-resistant staphylococcus aureus (mrsa), vancomycin-resistant enterococci, extended-spectrum β-lactamase, and multidrug-resistant acinetobacter acquisition, as well as hospital-associated mrsa bacteremia and clostridium difficile infection based on defining events as occurring >2 days versus >3 days after admission. the former resulted in significantly higher median rates, ranging from 6.76% to 45.07% hi ... | 2014 | 25333439 |
| evaluation of a sporicidal peracetic acid/hydrogen peroxide-based daily disinfectant cleaner. | oxycide daily disinfectant cleaner, a novel peracetic acid/hydrogen peroxide-based sporicidal disinfectant, was as effective as sodium hypochlorite for in vitro killing of clostridium difficile spores, methicillin-resistant staphylococcus aureus, and vancomcyin-resistant enterococci. oxycide was minimally affected by organic load and was effective in reducing pathogen contamination in isolation rooms. | 2014 | 25333438 |
| attributable inpatient costs of recurrent clostridium difficile infections. | to determine the attributable inpatient costs of recurrent clostridium difficile infections (cdis). | 2014 | 25333435 |
| probiotics for antibiotic-associated diarrhoea (paad): a prospective observational study of antibiotic-associated diarrhoea (including clostridium difficile-associated diarrhoea) in care homes. | antibiotic prescribing rates in care homes are higher than in the general population. antibiotics disrupt the normal gut flora, sometimes causing antibiotic-associated diarrhoea (aad). clostridium difficile (hall and o'toole 1935) prévot 1938 is the most commonly identified cause of aad. little is known either about the frequency or type of antibiotics prescribed in care homes or about the incidence and aetiology of aad in this setting. | 2014 | 25331573 |
| interleukin-22 and cd160 play additive roles in the host mucosal response to clostridium difficile infection in mice. | our previous work has shown the significant up-regulation of il22 and increased phosphorylation of signal transducer and activator of transcription 3 (stat3) as part of the mucosal inflammatory response to clostridium difficile infection in mice. others have shown that phosphorylation of stat3 at mucosal surfaces includes interleukin-22 (il-22) and cd160-mediated components. the current study sought to determine the potential role(s) of il-22 and/or cd160 in the mucosal response to c. difficile ... | 2015 | 25327211 |
| [fecal microbiota transplantation: first case report in chile and review]. | clostridium difficile (cd) infection is increasing in frequency and severity in in-hospital and outpatient clinical settings, with a recurrence that can reach 30% after first episode. the recurrences are usually treated with longer courses of metronidazole or vancomycin. other treatments have been used, such as probiotics, fidaxomicin, rifaximin, immunoglobulins and monoclonal antibodies against toxins a and b. fecal microbiota transplantation (fmt) has emerged as a promising strategy in this gr ... | 2014 | 25327204 |
| nationwide surveillance study of clostridium difficile in australian neonatal pigs shows high prevalence and heterogeneity of pcr ribotypes. | clostridium difficile is an important enteric pathogen of humans and the cause of diarrhea and enteritis in neonatal pigs. outside australia, prevalence in piglets can be up to 73%, with a single pcr ribotype (rt), 078, predominating. we investigated the prevalence and genotype of c. difficile in australian pig herds. rectal swabs (n = 229) were collected from piglets aged <7 days from 21 farms across australia. selective culture for c. difficile was performed and isolates characterized by pcr f ... | 2015 | 25326297 |
| oral, capsulized, frozen fecal microbiota transplantation for relapsing clostridium difficile infection. | fecal microbiota transplantation (fmt) has been shown to be effective in treating relapsing or refractory clostridium difficile infection, but practical barriers and safety concerns have prevented its widespread use. | 2014 | 25322359 |
| clostridium difficile in retail baskets, trolleys, conveyor belts, and plastic bags in saudi arabia. | to determine clostridium difficile (c. difficile) prevalence on retail surfaces and shoppers plastic bags. | 2014 | 25316477 |
| antibiotic resistance patterns and pcr-ribotyping of clostridium difficile strains isolated from swine and dogs in italy. | recent studies suggest animals, in particular farm and companion animals, as possible reservoir for clostridium difficile human pathogenic strains. the aim of this study was to give a first characterization of c. difficile isolates from italian swine and dogs. in total, 10 different pcr-ribotypes were identified among porcine strains and six among canine strains. the predominant type found among porcine strains was 078 (50%), whereas the most frequently detected among canine strains was the non- ... | 2015 | 25316022 |
| clostridium difficile infection: update on diagnosis, epidemiology, and treatment strategies. | clostridium difficile infection (cdi) has increased in incidence and severity over the past quarter century, and is now considered a major cause of healthcare-associated infections. | 2014 | 25314344 |
| persistence and toxin production by clostridium difficile within human intestinal organoids result in disruption of epithelial paracellular barrier function. | clostridium difficile is the leading cause of infectious nosocomial diarrhea. the pathogenesis of c. difficile infection (cdi) results from the interactions between the pathogen, intestinal epithelium, host immune system, and gastrointestinal microbiota. previous studies of the host-pathogen interaction in cdi have utilized either simple cell monolayers or in vivo models. while much has been learned by utilizing these approaches, little is known about the direct interaction of the bacterium with ... | 2015 | 25312952 |
| clostridium difficile infection: a review of the literature. | clostridium difficile is a gram-positive, strictly anaerobic, spore-forming bacterium. it is the most common cause of antibiotic-associated diarrhea in hospitals and other healthcare facilities and is of significant concern because of the increasing morbidity and mortality rates as well as increased health care costs. spectrum of presentation of clostridium difficile infection ranges from mild, self-limiting diarrhea, to serious diarrhea, pseudomembranous colitis and life-threatening fulminant c ... | 2014 | 25312190 |
| infant botulism: is there an association with thiamine deficiency? | infant botulism is an acute life-threatening condition and diagnosis is frequently delayed. therefore, the best time window to administer specific antibodies, at present the only etiology-based therapy, is often missed, entailing long periods of hospitalization in the picu. here we present a 3-month-old boy with infant botulism and respiratory failure, who quickly and favorably responded to thiamine supplementation. from the feces we isolated clostridium botulinum serotype a2. in addition to pro ... | 2014 | 25311602 |
| structural and functional changes in the gut microbiota associated to clostridium difficile infection. | antibiotic therapy is a causative agent of severe disturbances in microbial communities. in healthy individuals, the gut microbiota prevents infection by harmful microorganisms through direct inhibition (releasing antimicrobial compounds), competition, or stimulation of the host's immune defenses. however, widespread antibiotic use has resulted in short- and long-term shifts in the gut microbiota structure, leading to a loss in colonization resistance in some cases. consequently, some patients d ... | 2014 | 25309515 |
| a search for clostridium difficile ribotypes 027 and 078 in brazil. | toxigenic strains of clostridium difficile may be disseminating. here we prospectively screened patients with nosocomial diarrhoea in two hospitals in brazil. to identify c. difficile polymerase chain reaction ribotypes 027/078 strains, we used high resolution melting and multiplex polymerase chain reaction. among 116 screened patients, 11 were positive for c. difficile. the polymerase chain reaction ribotypes 027/078 strains were not identified in this study. | 2014 | 25307680 |
| clostridium difficile sortase recognizes a (s/p)pxtg sequence motif and can accommodate diaminopimelic acid as a substrate for transpeptidation. | covalent attachment of surface proteins to the cell wall of gram-positive bacteria requires a sortase-mediated transpeptidation reaction. in almost all gram-positive bacteria, the housekeeping sortase, sortase a, recognizes the canonical recognition sequence lpxtg (x=any amino acid). the human pathogen clostridium difficile carries a single putative sortase gene (cd2718) but neither transpeptidation activity nor specificity of cd2718 has been investigated. we produced recombinant cd2718 and exam ... | 2014 | 25305382 |
| performance assessment of the bd max cdiff assay in comparison to xpert c. difficile assay in a setting with very low prevalence of toxigenic clostridium difficile pcr ribotype 027. | in a clinical setting with low prevalence of 'epidemic' pcr ribotype 027, the bd max cdiff assay was found to be a suitable alternative to the xpert c. difficile assay for the detection of toxigenic clostridium difficile in samples which are reflex pcr tested after obtaining a discrepant immunoassay result. there was no significant difference between the sensitivities and specificities of both commercial molecular assays. | 2014 | 25305151 |
| longitudinal trends and cross-sectional analysis of english national hospital antibacterial use over 5 years (2008-13): working towards hospital prescribing quality measures. | there is global concern that antimicrobial resistance is a major threat to healthcare. antimicrobial use is a primary driver of resistance but little information exists about the variation in antimicrobial use in individual hospitals in england over time or comparative use between hospitals. the objective of this study was to collate, analyse and report issue data from pharmacy records of 158 national health service (nhs) acute hospitals. | 2015 | 25304646 |
| the evaluation of clostridium difficile infection (cdi) in a community hospital. | clostridium difficile is a serious reemerging pathogen in europe and north america. c. difficile infection (cdi) has been of concern over the last decade in view of its significant morbidity and mortality, as well as the high health care costs involved with each case. although multiple risk factors are known to be associated with cdi, a number of patients develop severe infection even in the absence of known risk factors. cdi is diagnosed by the detection of the toxin a/b in stools by enzyme imm ... | 2016 | 25301221 |
| a case of imported clostridium difficile pcr-ribotype 027 infection within the czech republic which has a high prevalence of c. difficile ribotype 176. | the first case of clostridium difficile rt027 infection in the czech republic (cz) was identified. the patient had been hospitalised in germany prior to moving to cz. multiple-locus variable number tandem repeat analysis revealed a genetic relatedness between the patient's isolate and rt027 isolate collected in the german hospital. | 2014 | 25300750 |
| prevalence and risk factors of clostridium difficile infection in patients hospitalized for flare of inflammatory bowel disease: a retrospective assessment. | recent studies have identified a high frequency of clostridium difficile infections in patients with active inflammatory bowel disease. | 2014 | 25294795 |
| [developments in the treatment of inflammatory bowel disease: 2014 overview]. | the way we treat inflammatory bowel disease is rapidly changing. biologics have accounted for the biggest change in recent years, and they are being used on a more regular basis, on more indications and at earlier stages. however, primary response failure and, above all, secondary response failure and cost represent serious limitations for their use. combination immunosuppressant therapy, individualization depending on levels and response, increasing compliance and a more suitable choice of case ... | 2014 | 25294262 |
| the past 10 years of gastroenterology and hepatology-reflections and predictions. | in november 2004, the very first issue of this journal featured articles on the pathogenesis of ulcerative colitis, mechanisms leading to chronic pancreatitis, and treatment of recurrent clostridium-difficile-associated diarrhoea. although those topics might seem familiar, much has changed in the intervening years in our understanding, diagnosis and treatment of many different diseases across the field of gastroenterology and hepatology. nonetheless, many challenges remain. here, we have asked f ... | 2014 | 25291429 |
| fecal microbiota transplantation: a new old kid on the block for the management of gut microbiota-related disease. | gut microbiota is deeply involved in the regulation of both health and disease within our body. the restoration of a healthy gut microbiota is, therefore, a main clinical target in the management of diseases associated with its disruption. fecal microbiota transplantation (fmt) is an old therapy that has recently been rediscovered, having proved a clear efficacy against recurrent clostridium difficile infection. by restoring the altered gut microbiota in a substantial and durable manner, fmt is ... | 2014 | 25291136 |
| giardia duodenalis infection reduces granulocyte infiltration in an in vivo model of bacterial toxin-induced colitis and attenuates inflammation in human intestinal tissue. | giardia duodenalis (syn. g. intestinalis, g. lamblia) is a predominant cause of waterborne diarrheal disease that may lead to post-infectious functional gastrointestinal disorders. although giardia-infected individuals could carry as much as 106 trophozoites per centimetre of gut, their intestinal mucosa is devoid of overt signs of inflammation. recent studies have shown that in endemic countries where bacterial infectious diseases are common, giardia infections can protect against the developme ... | 2014 | 25289678 |
| mini-review: epidemiology and zoonotic potential of multiresistant bacteria and clostridium difficile in livestock and food. | information on the epidemiology of multiresistant bacteria (mrb) with zoonotic potential is growing but still remains quite incomplete. this narrative mini-review provides a general overview of the epidemiology of the most important zoonotic mrb in cattle, swine and poultry in europe. | 2014 | 25285265 |
| clostridium difficile in the community: time to clean up? | | 2014 | 25284189 |
| synthetic polymers active against clostridium difficile vegetative cell growth and spore outgrowth. | nylon-3 polymers (poly-β-peptides) have been investigated as synthetic mimics of host-defense peptides in recent years. these polymers are attractive because they are much easier to synthesize than are the peptides themselves, and the polymers resist proteolysis. here we describe in vitro analysis of selected nylon-3 copolymers against clostridium difficile, an important nosocomial pathogen that causes highly infectious diarrheal disease. the best polymers match the human host-defense peptide ll ... | 2014 | 25279431 |
| reply to "use of adenosine triphosphate bioluminescence assays to measure cleaning: the role of spores and clostridium difficile infection rates". | | 2014 | 25278414 |
| hospital roommates and development of health care-onset clostridium difficile infection. | there is potential for person-to-person transmission in clostridium difficile outbreak settings. a limited number of studies have examined the role of hospital roommates in the development of nosocomial infections. this retrospective cohort study evaluated room cooccupancy and duration of exposure to roommates as predictors of health care-onset c difficile infection (cdi). among roommates of patients with cdi, duration of room cooccupancy was significantly longer in those developing cdi. | 2014 | 25278404 |
| the rise in clostridium difficile infection incidence among hospitalized adults in the united states: 2001-2010. | clostridium difficile infection (cdi) incidence is a growing concern. this study provides national estimates of cdi over 10 years and identifies trends in mortality and hospital length of stay (los) among hospitalized adults with cdi. | 2014 | 25278388 |
| phenotypic and genotypic analysis of clostridium difficile isolates: a single-center study. | clostridium difficile infections (cdi) are a growing concern in north america, because of their increasing incidence and severity. using integrated approaches, we correlated pathogen genotypes and host clinical characteristics for 46 c. difficile infections in a tertiary care medical center during a 6-month interval from january to june 2010. multilocus sequence typing (mlst) demonstrated 21 known and 2 novel sequence types (sts), suggesting that the institution's c. difficile strains are geneti ... | 2014 | 25275005 |
| faecal transplantation and infectious diseases practitioners. | | 2014 | 25274397 |
| recombinant clostridium difficile toxin b induces endoplasmic reticulum stress in mouse colonal carcinoma cells. | clostridium difficile is the main cause of antibiotic-associated diarrhea and pseudomembranous colitis in humans and animals. its pathogenicity is primarily linked to the secretion of two exotoxins (tcda and tcdb). although great progress in the toxic mechanism of tcda and tcdb has been achieved, there are many conflicting reports about the apoptotic mechanism. more importantly, apoptotic endoplasmic reticulum (er) stress has been reported in cells treated with shiga toxins-another kind of cytot ... | 2014 | 25274332 |
| faecal microbiota transplantation--the austrian approach. | the intestinal microbiome is essential for maintaining human health and defending against intestinal pathogens. alterations of the intestinal microbiota, also termed dysbiosis, play a pivotal role in the pathogenesis of various human diseases. faecal microbiota transplantation (fmt) is aimed at correcting these alterations by delivering faecal microorganisms from a healthy person to the intestines of a patient. at present, recurrent clostridium difficile infection is the only indication supporte ... | 2014 | 25274251 |
| community and hospital acquired clostridium difficile in south australia - ribotyping of isolates and a comparison of laboratory detection methods. | a total of 274 samples were screened for toxigenic clostridium difficile using a combination of several commercially available assays, and positive isolates ribotyped. a two-step algorithm assisted in demonstrating an increased prevalence of c. difficile infection in south australia of 9·8%, most of which were ribotypes 014 and 052. a glutamate dehydrogenase assay followed by the detection of genes associated with toxin production was the most sensitive and specific algorithm for screening for t ... | 2015 | 25274056 |
| the potential beneficial role of faecal microbiota transplantation in diseases other than clostridium difficile infection. | this review gives an outline of the indications for faecal microbiota transplantation (fmt) for diseases other than clostridium difficile (c. difficile) infection. the remarkable efficacy of fmt against c. difficile infection has already been demonstrated. the use of fmt for other diseases, such as inflammatory bowel disease (ibd), irritable bowel syndrome (ibs), and metabolic syndrome, is now being evaluated. the currently available data suggest that fmt might be beneficial for ibd (including u ... | 2014 | 25274035 |
| practical implementation of faecal transplantation. | clostridium difficile infection is a leading cause of antibiotic-related and healthcare-related diarrhoea. in the past decade, faecal microbiota transplantation or transfer has attracted increasing interest as an effective treatment strategy for severe recurrent c. difficile infection, with a global success rate of >80%. however, experience with this procedure is limited by a lack of randomized trials supporting its efficacy and the lack of standardization of the procedure. this review will addr ... | 2014 | 25273614 |
| faecal microbiota transplantation: from practice to legislation before considering industrialization. | recurrent clostridium difficile infections constitute an important medical concern. evidence has been provided showing that faecal microbiota transplantation is a more efficient treatment than antibiotics. serious side effects are unusual, and acceptability is not an obstacle. nevertheless, protocols are heterogeneous with respect to the selection of donors and the methodology used for the faecal transplantation. regulations by both the food and drug administration and the french authorities con ... | 2014 | 25273480 |
| 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 | 25271845 |
| [can the antibiotic prescription practice in a hospital be influenced by in-house guidelines? an interventional study at the university hospital halle (saale), germany]. | in-house guidelines are an essential tool of antibiotic stewardship (abs) programs to guide antimicrobial therapy. we studied the effect of in-house guidelines adapted to the local pathogen and resistance epidemiology on prescribing behavior. | 2014 | 25271804 |
| characterization of clostridium difficile isolates from human fecal samples and retail meat from pennsylvania. | a study was conducted to determine the prevalence of clostridium difficile and characterize c. difficile isolates from human stool and retail grocery meat samples. human stool samples (n=317) were obtained from a clinical laboratory and meat samples (n=303) were collected from 8 retail grocery stores from october 2011 through september 2012 from centre county of pennsylvania and were examined for c. difficile. c. difficile was isolated from 16.7% of stool samples (n=317) and 6.9%, 11.5%, 14.5%, ... | 2014 | 25269079 |
| clostridium difficile and pediatric inflammatory bowel disease: a prospective, comparative, multicenter, espghan study. | clostridium difficile infection is associated with pediatric inflammatory bowel disease (ibd) in several ways. we sought to investigate c. difficile infection in pediatric patients with ibd in comparison with a group of children with celiac disease and to evaluate ibd disease course of c. difficile infected patients. | 2014 | 25268634 |
| clostridium difficile is emerging in romania: a story of 027 ribotype and excessive antibiotic consumption. | | 2014 | 25267968 |
| beneficial effect of oral tigecycline treatment on clostridium difficile infection in gnotobiotic piglets. | the efficacy of oral tigecycline treatment (2 mg/kg of body weight for 7 days) of clostridium difficile infection (cdi) was evaluated in the gnotobiotic pig model, and its effect on human gut microflora transplanted into the gnotobiotic pig was determined. tigecycline oral treatment improved survival, clinical signs, and lesion severity and markedly decreased concentrations of firmicutes but did not promote cdi. our data showed that oral tigecycline treatment has a potential beneficial effect on ... | 2014 | 25267665 |
| clostridium difficile carriage in hospitalized cancer patients: a prospective investigation in eastern china. | clostridium difficile carriage has been considered as a potential source for the deadly infection, but its role in cancer patients is still unclear. we aimed to identify the clinical and immunological factors that are related to c. difficile carriage in chinese cancer patients. | 2014 | 25267108 |
| fulminant clostridium difficile colitis: comparing computed tomography with histopathology: are they concordant? | a total abdominal colectomy (tac) is recommended for fulminant clostridium difficile colitis (fcdc) because intraoperative assessment of diseased segments is inaccurate. to determine whether computerized tomography (ct) provides an accurate assessment of disease, we examined the concordance between ct and histopathologic colitis distribution in patients undergoing tac for fcdc. the ileocolon was divided into seven distinct segments. of 20 patients meeting criteria, the median interval between pr ... | 2014 | 25264661 |
| carriage of clostridium difficile in free-living south american coati (nasua nasua) in brazil. | the objective of this study was to isolate and characterize clostridium difficile strains in stool samples from a wild urban mammal, a south american coati (nasua nasua) in brazil. forty-six free-living n. nasua were trapped, and stool samples were collected. c. difficile was isolated from three (6.5%) sampled animals, two strains were toxigenic (a+b+cdt-, pcr ribotype 014/020 and 106) and one was non toxigenic (a-b-cdt-, pcr ribotype 053). the present work confirms that ring-tailed coati (n. na ... | 2014 | 25263534 |
| adverse reactions associated with oral and parenteral use of cephalosporins: a retrospective population-based analysis. | few studies have provided population-based, route-specific data on allergy to cephalosporin or incidence of serious adverse drug reactions (adrs). | 2015 | 25262461 |
| core elements of hospital antibiotic stewardship programs from the centers for disease control and prevention. | the proven benefits of antibiotic stewardship programs (asps) for optimizing antibiotic use and minimizing adverse events, such as clostridium difficile and antibiotic resistance, have prompted the centers for disease control and prevention (cdc) to recommend that all hospitals have an asp. this article summarizes core elements of hospital antibiotic stewardship programs, a recently released cdc document focused on defining the infrastructure and practices of coordinated multidisciplinary progra ... | 2014 | 25261548 |
| β-lactam/β-lactamase inhibitors versus carbapenems for the treatment of sepsis: systematic review and meta-analysis of randomized controlled trials. | data on the relative efficacy of β-lactam/β-lactamase inhibitors (bl/blis) versus carbapenems are scant. | 2015 | 25261419 |
| hand hygiene is crucial to combat clostridium difficile. | patients with clostridium difficile infection (cdi) can contaminate the environment with spores that are able to survive for months. a previous room occupant with cdi is a significant risk factor for developing the infection. room cleaning with commonly used disinfectants will not kill spores. sodium hypochlorite and hydrogen peroxide are effective but correct concentration and contact time are important. hand hygiene is a crucial element in preventing infection. in the uk, there is a clear reco ... | 2014 | 25258234 |
| a case of clostridium difficile infection complicated by acute respiratory distress syndrome treated with fecal microbiota transplantation. | acute respiratory distress syndrome is a life-threatening disorder caused mainly by pneumonia. clostridium difficile infection (cdi) is a common nosocomial diarrheal disease. disruption of normal intestinal flora by antibiotics is the main risk factor for cdi. the use of broad-spectrum antibiotics for serious medical conditions can make it difficult to treat cdi complicated by acute respiratory distress syndrome. fecal microbiota transplantation is a highly effective treatment in patients with r ... | 2014 | 25253977 |
| gastrointestinal microbiota-mediated control of enteric pathogens. | the gastrointestinal (gi) microbiota is a complex community of microorganisms residing within the mammalian gastrointestinal tract. the gi microbiota is vital to the development of the host immune system and plays a crucial role in human health and disease. the composition of the gi microbiota differs immensely among individuals yet specific shifts in composition and diversity have been linked to inflammatory bowel disease, obesity, atopy, and susceptibility to infection. in this review, we desc ... | 2014 | 25251855 |
| prevention of health care-associated infections. | health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. over the past decade, a downward trend in health care-associated infections has occurred nationwide. basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic techniqu ... | 2014 | 25251230 |
| enterococci, clostridium difficile and esbl-producing bacteria: epidemiology, clinical impact and prevention in icu patients. | most hospital-acquired infections arise from colonising bacteria. intensive care patients and immunocompromised individuals are at highest risk for microbial invasion and subsequent infection due to multiple invasive procedures in addition to frequent application of chemotherapeutics and presence of poor microperfusion leading to mucosal disruption. in this narrative review, we summarise the literature on bacterial colonisation in intensive care patients, in particular the epidemiology, the clin ... | 2014 | 25250957 |
| exogenous phosphatidylcholine supplementation improves intestinal barrier defense against clostridium difficile toxin. | the incidence and severity of clostridium difficile colitis have increased dramatically in the last decade. disease severity is related to c. difficile virulence factors, including toxins a and b, as well as the patient's immune status. the intestinal mucus is an important component of innate barrier function in the intestine. phosphatidylcholine (pc) is a key constituent of the intestinal mucus barrier, and exogenous pc administration has had therapeutic efficacy in patients with ulcerative col ... | 2014 | 25250596 |
| similar proportions of stool specimens from hospitalized children with and without diarrhea test positive for clostridium difficile. | many laboratories use polymerase chain reaction (pcr)-based assays to detect the clostridium difficile toxin b gene (tcdb) in stool. however, pcr testing experience in pediatric patients is limited. we compared the detection of c. difficile by pcr in hospitalized children with and without diarrhea. | 2015 | 25247582 |
| molecular characterization of toxigenic clostridium difficile in a northern italian hospital. | clostridium difficile is responsible for more than 90 % of cases of antibiotic-associated diarrhea and pseudomembranous colitis. the most important virulence factors are two toxins called enterotoxin a and cytotoxin b; some c. difficile strains contain the c. difficile binary toxin (cdt). the aim of our study was to prospectively analyze c. difficile clinical isolates in a single center to determine the molecular features of collected strains. among the 252 isolates, 217 were a + b + (86.1 %), 3 ... | 2015 | 25245958 |
| extraintestinal clostridium difficile infections: a single-center experience. | to evaluate the clinical burden of extraintestinal clostridium difficile infection (cdi) seen at a single institution and to characterize the management and outcomes of these rare infections. | 2014 | 25245597 |
| a survey of prescriber perceptions about the prevention of stress-related mucosal bleeding in the intensive care unit. | practices vary between institutions and amongst prescribers regarding when to initiate stress ulcer prophylaxis (sup), which agent to choose (including doses and frequencies) and rationale, and decisions about escalation or discontinuation of therapy. the purpose of this survey is to evaluate the perceptions of prescribers about risk assessment of stress-related mucosal bleeding (srmb) and practice patterns of sup. | 2014 | 25243327 |
| the roles of host and pathogen factors and the innate immune response in the pathogenesis of clostridium difficile infection. | clostridium difficile (c. difficile) is the most common cause of nosocomial antibiotic-associated diarrhea and the etiologic agent of pseudomembranous colitis. the clinical manifestation of c. difficile infection (cdi) is highly variable, from asymptomatic carriage, to mild self-limiting diarrhea, to the more severe pseudomembranous colitis. furthermore, in extreme cases, colonic inflammation and tissue damage can lead to toxic megacolon, a condition requiring surgical intervention. c. difficile ... | 2015 | 25242213 |
| biofilms of clostridium species. | the biofilm is a microbial community embedded in a synthesized matrix and is the main bacterial way of life. a biofilm adheres on surfaces or is found on interfaces. it protects bacteria from the environment, toxic molecules and may have a role in virulence. clostridium species are spread throughout both environments and hosts, but their biofilms have not been extensively described in comparison with other bacterial species. in this review we describe all biofilms formed by clostridium species d ... | 2014 | 25242197 |
| antimicrobial susceptibility patterns of clostridium difficile strains belonging to different polymerase chain reaction ribotypes isolated in poland in 2012. | in the beginning of 2012, a study was conducted to obtain an overview of clostridium difficile infections (cdis) in polish hospitals. the collection of 83 toxigenic c. difficile isolates obtained from this hospital-based survey was used to identify antimicrobial susceptibility patterns. among the c. difficile isolates analyzed, 48 (57.8%) belonged to pcr ribotype 027, 21 (25.3%) to its closely related pcr ribotype 176, and 14 (16.9%) to different pcr ribotypes. seventy one (85.5%) isolates were ... | 2015 | 25242196 |
| clostridium difficile infection after cardiac surgery: prevalence, morbidity, mortality, and resource utilization. | despite increasing efforts to prevent infection, the prevalence of hospital-associated clostridium difficile infections (cdi) is increasing. heightened awareness prompted this study of the prevalence and morbidity associated with cdi after cardiac surgery. | 2014 | 25242055 |
| evaluation of the illumigene c. difficile assay for toxigenic clostridium difficile detection: a prospective study of 302 consecutive clinical fecal samples. | toxigenic clostridium difficile is a major pathogen causing nosocomial diarrhea. consequently, rapid detection of toxigenic c. difficile is very important in clinical laboratories. the illumigene c. difficile dna amplification assay (illumigene; meridian bioscience, inc.) is a rapid method that detects the toxin a gene (tcda) by loop-mediated isothermal amplification. in the present study, we evaluated the diagnostic performance of the illumigene assay using 302 consecutive stool specimens in co ... | 2014 | 25241189 |
| isolation and characterization of a new clostridium difficile ribotype during a prospective study in a hospital in italy. | | 2015 | 25240292 |
| investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with clostridium difficile infection. | antimicrobial exposure remains an important risk factor for developing clostridium difficile infection (cdi). efficient method to identify antibiotics associated with cdi is important for formulating strategies to curtail their use. as a prelude to a more extensive agency for healthcare research and quality-funded project (evaluation & research on antimicrobial stewardship's effect on clostridium difficile), we undertook an exploratory evaluation to determine a resource-efficient method for iden ... | 2014 | 25239720 |
| an interleukin-4 polymorphism is associated with susceptibility to clostridium difficile infection in patients with inflammatory bowel disease: results of a retrospective cohort study. | clinical studies have suggested that patients with inflammatory bowel disease (ibd) are at greater risk for developing clostridium difficile infection (cdi). the purpose of this study was to identify single-nucleotide polymorphisms (snps) associated with cdi among ibd patients. | 2014 | 25239315 |
| stimulation of innate immunity by in vivo cyclic di-gmp synthesis using adenovirus. | the bacterial second messenger cyclic di-gmp (c-di-gmp) stimulates inflammation by initiating innate immune cell recruitment and triggering the release of proinflammatory cytokines and chemokines. these properties make c-di-gmp a promising candidate for use as a vaccine adjuvant, and numerous studies have demonstrated that administration of purified c-di-gmp with different antigens increases protection against infection in animal models. here, we have developed a novel approach to produce c-di-g ... | 2014 | 25230938 |
| antimicrobial stewardship-qualitative and quantitative outcomes: the role of measurement. | overuse and misuse of antibiotics have contributed to the growing problem of antimicrobial resistance and serious side effects including clostridium difficile infection. the centers for disease control and prevention estimates that more than 2 million people are infected by multidrug-resistant organisms every year. they propose that promoting antimicrobial stewardship programs (asp) is an essential component to combat this growing threat. one of the major barriers in implementing effective asp i ... | 2014 | 25230602 |
| clostridium difficile-induced colitis in mice is independent of leukotrienes. | clostridium difficile is the major cause of antibiotic-associated diarrhea and pseudomembranous colitis in healthcare settings. however, the host factors involved in the intestinal inflammatory response and pathogenesis of c. difficile infection (cdi) are largely unknown. here we investigated the role of leukotrienes (lts), a group of pro-inflammatory lipid mediators, in cdi. notably, the neutrophil chemoattractant ltb4, but not cysteinyl (cys) lts, was induced in the intestine of c57bl/6 mice i ... | 2014 | 25230329 |
| [pharmaceutical intervention in duration of antimicrobial treatment at hospital ambit]. | to estimate the acceptance of the pharmaceutical intervention in controlling duration of antimicrobial therapy and to evaluate their impact on optimizing the treatment. | 2014 | 25229371 |
| evaluation of three enzyme immunoassays and a nucleic acid amplification test for the diagnosis of clostridium difficile-associated diarrhea at a university hospital in brazil. | despite the known importance of clostridium difficile as a nosocomial pathogen, few studies regarding clostridium difficile infection (cdi) in brazil have been conducted. to date, the diagnostic tests that are available on the brazilian market for the diagnosis of cdi have not been evaluated. the aim of this study was to compare the performances of four commercial methods for the diagnosis of cdi in patients from a university hospital in brazil. | 2014 | 25229284 |
| clostridium difficile ribotype 027 is most prevalent among inpatients admitted from long-term care facilities. | intestinal inflammation was evaluated using faecal lactoferrin and ribotype in 196 hospitalized adults with clostridium difficile infection to determine the impact of ribotype 027 in long-term care facilities (ltcfs). ltcf residents (n=28) had greater antibiotic use (p=0.049) and more ribotype 027 infection [odds ratio (or): 4.87; 95% confidence interval (ci): 2.02-11.74; p<0.01], compared to those admitted from home. patients infected with ribotype 027 strains had worse six-month mortality (or: ... | 2014 | 25228227 |
| fecal microbiota transplantation: an interest in ibd? | fecal microbiota transplantation (fmt) is a targeted microbiome-based therapy that has garnered a great deal of attention from the scientific, clinical, and lay communities. an increasing number of studies have demonstrated that fmt is a highly effective therapy for recurrent/refractory clostridium difficile infection and appears safe in the short term. uncontrolled reports suggest the possibility of benefit in a select group of ibd patients, but there is quite limited information so far. fmt fo ... | 2014 | 25227298 |
| host immunity to clostridium difficile pcr ribotype 017 strains. | clostridium difficile is an important nosocomial pathogen and the leading cause of antibiotic-associated diarrhea. multilocus sequence typing indicates that c. difficile strains belong to five distinct genetic clades encompassing several pcr ribotypes (rt). since their emergence in 2003, hypervirulent rt027 strains have been a major focus of research; in contrast, our current understanding of rt017-mediated disease pathogenesis lags far behind. in this study, we aimed to characterize host immuni ... | 2014 | 25225246 |
| clostridium difficile infection induced by pregabalin-associated agranulocytosis. | a 33-year-old man who had recently undergone surgery for cervical spondylotic myelopathy was prescribed pregabalin for neuralgia, and the dose was increased to 600 mg/day during hospitalization. however, the patient was diagnosed with a clostridium difficile infection on day 34 after admission. a complete blood count showed agranulocytosis (neutrophil count: 105/μl). we did not observe any changes in vital signs, a relative increase in band cells, or intestinal edema. the patient's agranulocytos ... | 2014 | 25224205 |
| polymerase chain reaction ribotyping of clostridium difficile isolates in qatar: a hospital-based study. | clostridium difficile infection (cdi) is not generally reported to public health authorities in the middle east and its true prevalence remains largely unknown. the aims of this study were to determine the prevalence of cdi and its associated ribotypes among c. difficile isolates in qatar. influence of age and correlation with other risk factors e.g. proton pump inhibitor use, antibiotic use, existence of chronic conditions, etc was also investigated for cdi positive patients. | 2014 | 25223337 |
| host recognition of clostridium difficile and the innate immune response. | clostridium difficile is a gram-positive, spore forming bacillus and the most common cause of antibiotic-associated diarrhea in the united states. clinical outcomes of c. difficile infection (cdi) range from asymptomatic colonization to pseudomembranous colitis, sepsis and death. disease is primarily mediated by the action of the rho-glucosylating toxins a and b, which induce potent pro-inflammatory signaling within the host. the role of this inflammatory response during infection is just beginn ... | 2014 | 25223264 |
| pseudomembranous colitis due to clostridium difficile. | | 2014 | 25223126 |
| lessons learned from implementing clostridium difficile-focused antibiotic stewardship interventions. | to determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset clostridium difficile infection (cdi) rates. | 2014 | 25222903 |
| racial and ethnic disparities in healthcare-associated infections in the united states, 2009-2011. | little is known about racial and ethnic disparities in the occurrence of healthcare-associated infections (hais) in hospitalized patients. | 2014 | 25222888 |
| risk factors and management of refractory or recurrent clostridium difficile infection in ileal pouch patients. | clostridium difficile infection (cdi) is increasingly recognized in patients with ulcerative colitis with ileal pouch-anal anastomosis (ipaa). the aim of this study was to identify clinical risk factors for treatment-refractory or recurrent cdi in patients with ipaa. | 2014 | 25222656 |
| recombination drives evolution of the clostridium difficile 16s-23s rrna intergenic spacer region. | pcr-ribotyping, a typing method based on size variation in 16s-23s rrna intergenic spacer region (isr), has been used widely for molecular epidemiological investigations of c. difficile infections. in the present study, we describe the sequence diversity of isrs from 43 c. difficile strains, representing different pcr-ribotypes and suggest homologous recombination as a possible mechanism driving the evolution of 16s-23s rrna isrs. isrs of 45 different lengths (ranging from 185 bp to 564 bp) were ... | 2014 | 25222120 |
| [faecal microbiota transplantation in france: what applicable law?]. | the transplantation of gut microbiota addresses a critical gap in the treatment of recurrent severe clostridium difficile infection, and clinical trials are ongoing throughout the world for other potential broader clinical indications. as the fecal flora inoculum has currently no legal status under european law, we consider it provisionally a sui generis biological drug rather than a human tissue transplantation, with major implications in terms of legal liability in france. the inoculum obeys a ... | 2014 | 25220232 |
| risk factors of clostridium difficile infections among patients in a university hospital in shanghai, china. | clostridium difficile infection (cdi) is an increasing concern in china. however, the risk factors of cdi are rarely reported in the chinese population. a prospective observational study was therefore conducted among patients with hospital-acquired c. difficile diarrhoea and the risk factors of cdi in a retrospective case-control study. the cdi patients were compared with the non-cdi diarrhoeal patients and those without diarrhoea, respectively. the recurrent cdi patients were compared with the ... | 2014 | 25219941 |
| [clostridium difficile isolation in children hospitalized with diarrhea]. | clostridium difficile is the leading cause of nosocomial and antibiotic-associated diarrhea in adults, and its incidence has substantially risen over the last few years. the prevalence of this infection in children is difficult to assess due to the high rates of colonization in this setting. | 2015 | 25217386 |
| hand-hygiene compliance does not predict rates of resistant infections in critically ill surgical patients. | our institution had a major outbreak of multi-drug-resistant acinetobacter (mdra) in its general surgical and trauma intensive care units (icus) in 2011, requiring implementation of an aggressive infection-control response. we hypothesized that poor hand-hygiene compliance (hhc) may have contributed to the outbreak of mdra. a response to the outbreak including aggressive environmental cleaning, cohorting, and increased hand hygiene compliance monitoring may have led to an increase in hhc after t ... | 2014 | 25215463 |
| pseudomembranous colitis: not always caused by clostridium difficile. | although classically pseudomembranous colitis is caused by clostridium difficile, it can result from several etiologies. certain medications, chemical injury, collagenous colitis, inflammatory bowel disease, ischemia, and other infectious pathogens can reportedly cause mucosal injury and subsequent pseudomembrane formation. we present the case of a middle-aged woman with vascular disease who was incorrectly diagnosed with refractory c. difficile infection due to the presence of pseudomembranes. ... | 2014 | 25214850 |
| diagnosis and management of common gastrointestinal tract infectious diseases in ulcerative colitis and crohn's disease patients. | management of inflammatory bowel disease (ibd), including ulcerative colitis and crohn's disease, stretches beyond control of flares. some infections of the gastrointestinal tract are more commonly seen in patients with ibd. work from the human microbiome project has been instrumental in our understanding of the interplay between the vast gut microbiota and host immune responses. patients with ibd may be more prone to infectious complications based on their underlying inflammatory disease and va ... | 2014 | 25208106 |
| molecular epidemiology of clostridium difficile for clinical practice. | during the last decade, the world has witnessed numerous outbreaks of clostridium difficile infections (cdi) in healthcare settings. increasing incidence rates of cdi have been mainly attributed to the successful global spread of a more virulent strain of c. difficile - namely pcr-ribotype 027. more recent studies, however, point to the emergence of other ribotypes as the main cause of the continuing epidemic. this review summarises the current literature on the molecular epidemiology of c. diff ... | 2014 | 25207831 |
| impact of clostridium difficile infection on inflammatory bowel disease outcome: a review. | although a considerable number of studies support a substantial increase in incidence, severity, and healthcare costs for clostridium difficile infection (cdi) in inflammatory bowel disease (ibd), only few evaluate its impact on ibd outcome. medline and several other electronic databases from january 1993 to october 2013 were searched in order to identify potentially relevant literature. most of the studies showed that ibd patients with cdi present a greater proportion of worse outcomes than tho ... | 2014 | 25206277 |
| point-of-care testing for clostridium difficile infection: a real-world feasibility study of a rapid molecular test in two hospital settings. | in the developed world, clostridium difficile infection (cdi) is the most important cause of nosocomial infectious diarrhea. in addition to providing epidemiological data and helping to indicate that a local outbreak may be occurring, laboratory tests are used to augment clinical decisions on individual patients. very rarely do diagnostic tests provide results at the point of decision making; in the intervening period between requesting investigations on a patient with suspected cdi and return o ... | 2014 | 25205503 |
| fidaxomicin: a novel macrolide antibiotic for clostridium difficile infection. | to review the chemistry, pharmacology, microbiology, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, drug interactions, dosing, and administration of fidaxomicin (fdx). | 2014 | 25203410 |
| shared hoppers: a novel risk factor for the transmission of clostridium difficile. | | 2014 | 25203194 |