| clostridium difficile infection in hospitalized patients at a czech tertiary center: analysis of epidemiology, clinical features, and risk factors of fulminant course. | clostridium difficile infection (cdi) has been increasing in incidence, with significant morbidity and mortality, and is subject to geographical and institutional variability. we aimed to characterize epidemiology and clinical manifestations of cdi in a czech tertiary care center and to identify risk factors of fulminant course. | 2014 | 24942955 |
| [epidemiology of clostridium difficile-associated disease (cdad) in salamanca]. | clostridium difficile infection is considered a major cause of nosocomial diarrhoea in developed countries and is increasingly becoming more important as an etiologic agent of community diarrhoea, also in patients without risk factors. | 2014 | 24940894 |
| recovery of the gut microbiome following fecal microbiota transplantation. | clostridium difficile infection is one of the most common health care-associated infections, and up to 40% of patients suffer from recurrence of disease following standard antibiotic therapy. recently, fecal microbiota transplantation (fmt) has been successfully used to treat recurrent c. difficile infection. it is hypothesized that fmt aids in recovery of a microbiota capable of colonization resistance to c. difficile. however, it is not fully understood how this occurs. here we investigated ch ... | 2014 | 24939885 |
| decreasing clostridium difficile infections by an antimicrobial stewardship program that reduces moxifloxacin use. | clostridium difficile infections (cdi) in hospitalized patients are known to be closely related to antibiotic exposure. although several substances can cause cdi, the risk differs between individual agents. in vienna and other eastern parts of austria, cdi ribotype 027 is currently highly prevalent. this ribotype has the characteristic of intrinsic moxifloxacin resistance. therefore, we hypothesized that moxifloxacin restriction can decrease the number of cdi cases in hospitalized patients. our ... | 2014 | 24936597 |
| tryptophan catabolism restricts ifn-γ-expressing neutrophils and clostridium difficile immunopathology. | the interplay between clostridium difficile and the host's metabolome is believed to influence the severity of infection. however, the mechanism for this phenomenon remains unclear. in this study, we model one of these metabolic pathways by focusing on tryptophan metabolism in the host. we found that inhibition of tryptophan catabolism in ido1-knockout mice led to increased mucosal destruction, cecal hemorrhage, and increased production of ifn-γ in response to c. difficile infection, but no sign ... | 2014 | 24935925 |
| antibiotic overuse and clostridium difficile: a teachable moment. | | 2014 | 24935617 |
| nosocomial transmission of c. difficile in english hospitals from patients with symptomatic infection. | recent evidence suggests that less than one-quarter of patients with symptomatic nosocomial clostridium difficile infections (cdi) are linked to other in-patients. however, this evidence was limited to one geographic area. we aimed to investigate the level of symptomatic cdi transmission in hospitals located across england from 2008 to 2012. | 2014 | 24932484 |
| survey of c. difficile-specific infection control policies in local long-term care facilities. | the incidence and severity of clostridium difficile infection (cdi) has been increasing and long-term care facility (ltcf) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. infection control policies are crucial for controlling cdi, but there are currently no regulatory guidelines in the united states. therefore, we evaluated infection control policies in local ltcfs to define the cdi-specific policies and the administrative and staff understanding of cdi, ... | 2014 | 24932422 |
| fate of clostridium difficile during wastewater treatment and incidence in southern ontario watersheds. | to investigate the prevalence of clostridium difficile encountered during sewage treatment and in water sources into which treated effluent was directly or indirectly discharged. | 2014 | 24930867 |
| multilocus sequence typing analysis and antibiotic resistance of clostridium difficile strains isolated from retail meat and humans in belgium. | clostridium difficile has been isolated from food animals and meat, specially ground pork and ground beef. the recovered isolates were closely related to c. difficile human strains, indicating that animals and food are possible transmission routes of human c. difficile infection. the main objective of this study was to characterize c. difficile isolates from retail meat and to compare with human isolates recovered from hospital patients in belgium. raw meat (beef and pork) was obtained from the ... | 2014 | 24929733 |
| clostridium difficile infection in solid organ transplant recipients. | clostridium difficile infection (cdi) is one of the most common healthcare-associated infections, and the threat associated with cdi continues to grow in all patient populations. there is increasing evidence that cdi has a substantial impact on the morbidity and mortality in solid organ transplant (sot) recipients. furthermore, new diagnostic and treatment options and strategies for cdi have emerged over the last decade. the purpose of this review is to provide a general understanding of cdi and ... | 2014 | 24927151 |
| intravenous immunoglobulin in the treatment of severe clostridium difficile colitis. | intravenous immunoglobulin (ivig) has been utilized in patients with recurrent and refractory clostridium difficile colitis. it is increasingly being used in patients with initial clinical presentation of severe colitis. herein, we report a case of severe c. difficile colitis successfully treated with ivig with a review of the medical literature to identify the optimal timing and clinical characteristics for this treatment strategy. | 2014 | 24926170 |
| staggered and tapered antibiotic withdrawal with administration of kefir for recurrent clostridium difficile infection. | daily administration of the probiotic kefir given in combination with a staggered and tapered antibiotic withdrawal regimen may resolve recurrent clostridium difficile infection as effectively as fecal microbiota transplantation. | 2014 | 24917658 |
| occurrence of clostridium difficile infections due to pcr ribotype 027 in bucharest, romania. | little is known about prevailing ribotypes of clostridium difficile infection in romania where cdi is not a mandatory notifiable disease. | 2014 | 24916866 |
| structural, spectroscopic and functional investigation into fe-substituted mnsod from human pathogen clostridium difficile. | clostridium difficile, which inhabits the human digestive tract, is an etiological agent that causes pseudomembranous colitis and antibiotic-associated diarrhea. the oxidative stress tightly relates to its virulence, which highlights the function of its superoxide dismutase (sod). the sod from clostridium difficile (sodcd) is a mn/fe cambialistic sod with mnsodcd exhibiting an optimal activity while fe-sub-mnsodcd showing 10-fold less activity. to explain why the fe-loaded protein exhibits a muc ... | 2014 | 24915901 |
| hospital clostridium difficile infection testing rates: is "don't ask, don't tell" at play? | | 2014 | 24915231 |
| pediatric clostridium difficile infection: 6-year active surveillance in a defined patient population. | | 2014 | 24915227 |
| the prediction of complicated clostridium difficile infections in children. | we validated proposed definitions for severe clostridium difficile infection (cdi) in adults for prediction of complicated cdi in children. complicated cdi occurred in 9 of 202 cases. definitions for severe cdi in adults showed poor measures for discrimination of complicated cdi in children, which calls into question the usefulness of such definitions in pediatric cohorts. | 2014 | 24915226 |
| protein expression, characterization, crystallization and preliminary x-ray crystallographic analysis of a fic protein from clostridium difficile. | fic domains in proteins are found in abundance in nature from the simplest prokaryotes to animals. interestingly, fic domains found in two virulence factors of gram-negative bacteria have recently been demonstrated to catalyse the transfer of the amp moiety from atp to small host gtpases. this post-translational modification has attracted considerable interest and a role for adenylylation in pathology and physiology is emerging. this work was aimed at the structural characterization of a newly i ... | 2014 | 24915103 |
| clostridium difficile infection in the hematopoietic unit: a meta-analysis of published studies. | hematopoietic stem cell transplant (hsct) recipients are at high risk of contracting clostridium difficile infection (cdi). we systematically searched the pubmed and embase databases through march 2014 and performed a random-effects meta-analysis to estimate the prevalence and trends of cdi over time. among 48 eligible articles that included 12,025 patients at risk, we estimated that 7.9% (95% confidence interval [ci], 6.5% to 9.5%) of hsct patients are diagnosed with cdi during the peri-transpl ... | 2014 | 24914822 |
| hematologic diseases: high risk of clostridium difficile associated diarrhea. | to investigate the incidence and clinical outcome of clostridium difficile (c. difficile) associated diarrhea (cdad) in patients with hematologic disease. | 2014 | 24914383 |
| antibiotics for treatment of clostridium difficile infection in hospitalized patients with inflammatory bowel disease. | patients with inflammatory bowel disease (ibd), namely ulcerative colitis (uc) and crohn's disease (cd), have worse outcomes with clostridium difficile infection (cdi), including increased readmissions, colectomy, and death. oral vancomycin is recommended for the treatment of severe cdi, while metronidazole is the standard of care for nonsevere infection. we aimed to assess treatment outcomes of cdi in ibd. we conducted a retrospective observational study of inpatients with cdi and ibd from janu ... | 2014 | 24913174 |
| multidisciplinary analysis of a nontoxigenic clostridium difficile strain with stable resistance to metronidazole. | stable resistance to metronidazole in a nontoxigenic clostridium difficile strain was investigated at both the genomic and proteomic levels. alterations in the metabolic pathway involving the pyruvate-ferredoxin oxidoreductase were found, suggesting that reduction of metronidazole, required for its activity, may be less efficient in this strain. proteomic studies also showed a cellular response to oxidative stress. | 2014 | 24913157 |
| initiation of sporulation in clostridium difficile: a twist on the classic model. | the formation of dormant endospores is a complex morphological process that permits long-term survival in inhospitable environments for many gram-positive bacteria. sporulation for the anaerobic gastrointestinal pathogen clostridium difficile is necessary for survival outside of the gastrointestinal tract of its host. while the developmental stages of spore formation are largely conserved among endospore-forming bacteria, the genus clostridium appears to be missing a number of conserved regulato ... | 2014 | 24910370 |
| clostridium difficile infection among immunocompromised patients in rio de janeiro, brazil and detection of moxifloxacin resistance in a ribotype 014 strain. | clostridium difficile is a gram-positive spore forming anaerobic bacterium, often associated with nosocomial diarrhea and pseudomembranous colitis. the acquisition of this organism occurs primarily in hospitals through accidental ingestion of spores, and its establishment and proliferation in the colon results from the removal of members of the normal intestinal flora during or after antibiotic therapy. in this study, stool samples from patients admitted to the university hospital clementino fra ... | 2014 | 24907488 |
| haemorrhagic toxin and lethal toxin from clostridium sordellii strain vpi9048: molecular characterization and comparative analysis of substrate specificity of the large clostridial glucosylating toxins. | large clostridial glucosylating toxins (lcgts) are produced by toxigenic strains of clostridium difficile, clostridium perfringens, clostridium novyi and clostridium sordellii. while most c. sordellii strains solely produce lethal toxin (tcsl), c. sordellii strain vpi9048 co-produces both hemorrhagic toxin (tcsh) and tcsl. here, the sequences of tcsh-9048 and tcsl-9048 are provided, showing that both toxins retain conserved lcgt features and that tcsl and tcsh are highly related to toxin a (tcda ... | 2014 | 24905543 |
| rhode island clostridium difficile infection trends and laboratory id events ranking. | | 2014 | 24905379 |
| [development of gastrointestinal infectious diseases between 2000 and 2012]. | infectious gastroenterological diseases are of increasing medical and health-economic significance. | 2014 | 24905106 |
| study of the frequency of clostridium difficile tcda, tcdb, cdta and cdtb genes in feces of calves in south west of iran. | clostridium difficile (c. difficile) is a gram-positive, toxin-producing bacillus which is an intestinal pathogen in both humans and animals and causes a range of digestive disorders including inflammation of the bowel, abdominal pain, fever and diarrhea. c. difficile toxins include enterotoxin (toxin a), cytotoxin (toxin b) and a binary toxin. two large protein toxins a and b are encoded by separate genes, tcda and tcdb. clostridium difficile infection (cdi) mainly caused by the activity of the ... | 2014 | 24903619 |
| severe clostridium difficile infection: incidence and risk factors at a tertiary care university hospital in vienna, austria. | clostridium difficile infection (cdi) is the major cause of hospital-acquired bacterial diarrhoea. the incidence of cdi has been increasing in canada, the us and europe and severe cases are becoming more common. | 2014 | 24903143 |
| clostridium difficile infection in liver transplant recipients: a retrospective study of rates, risk factors and outcomes. | clostridium difficile infection (cdi) occurs in 3-7% of liver transplant recipients (ltr). however, few data exist on the recent epidemiology, predictors and outcomes of cdi in ltr. a cohort study was performed including ltr from 2000 to 2010 at a tertiary care hospital in detroit. cdi was defined as diarrhea with a stool c. difficile positive test. data analyzed included demographics, comorbidities, length of stay (los), severity of cdi, rates of recurrence (<12 weeks), relapse (<4 weeks) and o ... | 2014 | 24902610 |
| clostridium difficile: case report and concise review of fecal microbiota transplantation. | | 2013 | 24902394 |
| pyknotic cell death induced by clostridium difficile tcdb: chromatin condensation and nuclear blister are induced independently of the glucosyltransferase activity. | tcda and tcdb are the main pathogenicity factors of clostridium difficile-associated diseases. both toxins inhibit rho gtpases, and consequently, apoptosis is induced in the affected cells. we found that tcdb at higher concentrations exhibits cytotoxic effects that are independent on rho glucosylation. tcdb and the glucosyltransferase-deficient mutant tcdb d286/288n induced pyknotic cell death which was associated with chromatin condensation and reduced h3 phosphorylation. affected cells showed ... | 2014 | 24898616 |
| an antimicrobial stewardship program's real-world experience with fidaxomicin for treatment of clostridium difficile infection: a case series. | to evaluate real-world clinical and economic outcomes in patients with clostridium difficile infection (cdi) treated with fidaxomicin. | 2014 | 24898525 |
| risk factors for recurrent clostridium difficile infection (cdi) hospitalization among hospitalized patients with an initial cdi episode: a retrospective cohort study. | recurrent clostridium difficile infection (rcdi) is observed in up to 25% of patients with an initial cdi episode (icdi). we assessed risk factors for rcdi among patients hospitalized with icdi. | 2014 | 24898123 |
| risk factors for recurrence, complications and mortality in clostridium difficile infection: a systematic review. | clostridium difficile infection (cdi) can lead to complications, recurrence, and death. numerous studies have assessed risk factors for these unfavourable outcomes, but systematic reviews or meta-analyses published so far were limited in scope or in quality. | 2014 | 24897375 |
| outcomes from rectal vancomycin therapy in patients with clostridium difficile infection. | | 2014 | 24896763 |
| national trends and inpatient outcomes of inflammatory bowel disease patients with concomitant chronic liver disease. | there is little information on the frequency of chronic liver disease among hospitalized patients with inflammatory bowel disease (ibd). in this study, we seek to define the common etiologies contributing to chronic liver disease among ibd patients and to identify potential risk factors predictive of increased mortality in this population. | 2014 | 24895841 |
| clinical characteristics of relapses and re-infections in clostridium difficile infection. | the purpose of this study was to identify factors associated with relapses or re-infections in patients with recurring clostridium difficile infections (cdis). from september 2008 to january 2012, cases with two or more isolates from consecutive cdi episodes were included. pcr-ribotyping and multilocus variable-number tandem-repeat analysis were performed using paired isolates. among 473 patients, 68 (14.4%) experienced one to five recurrences. fifty-one of these with two or more isolates from c ... | 2014 | 24894547 |
| carriage and acquisition rates of clostridium difficile in hospitalized horses, including molecular characterization, multilocus sequence typing and antimicrobial susceptibility of bacterial isolates. | clostridium difficile has been identified as a significant agent of diarrhoea and enterocolitis in both foals and adult horses. hospitalization, antibiotic therapy or changes in diet may contribute to the development of c. difficile infection. horses admitted to a care unit are therefore at greater risk of being colonized. the aim of this study was to investigate the carriage of c. difficile in hospitalized horses and the possible influence of some risk factors in colonization. during a seven-mo ... | 2014 | 24894133 |
| clostridium difficile infection (cdi) in solid organ and hematopoietic stem cell transplant recipients. | patients undergoing solid organ and stem cell transplantation are at increased risk of clostridium difficile infection (cdi) compared with nontransplant patients. cdi may be associated with significant morbidity in this population including prolonged hospitalization, increased hospital charges, and complications in the transplanted organ. a combination of host factors, including both b-cell and t-cell immunosuppression, in addition to traditional risk factors for cdi such as broad-spectrum antib ... | 2014 | 24893981 |
| herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. | patients with small intestine bacterial overgrowth (sibo) have chronic intestinal and extraintestinal symptomatology which adversely affects their quality of life. present treatment of sibo is limited to oral antibiotics with variable success. a growing number of patients are interested in using complementary and alternative therapies for their gastrointestinal health. the objective was to determine the remission rate of sibo using either the antibiotic rifaximin or herbals in a tertiary care re ... | 2014 | 24891990 |
| clinical impact of clostridium difficile colonization. | clostridium difficile can cause antibiotic-associated diarrhea in hospitalized patients. asymptomatic colonization by c. difficile is common during the neonatal period and early infancy, ranging from 21% to 48%, and in childhood. the colonization rate of c. difficile in adult hospitalized patients shows geographic variation, ranging from 4.4% to 23.2%. asymptomatic carriage in neonates caused no further disease in many studies, whereas adult patients colonized with toxigenic c. difficile were pro ... | 2015 | 24890755 |
| fidaxomicin inhibits clostridium difficile toxin a-mediated enteritis in the mouse ileum. | clostridium difficile infection (cdi) is a common, debilitating infection with high morbidity and mortality. c. difficile causes diarrhea and intestinal inflammation by releasing two toxins, toxin a and toxin b. the macrolide antibiotic fidaxomicin was recently shown to be effective in treating cdi, and its beneficial effect was associated with fewer recurrent infections in cdi patients. since other macrolides possess anti-inflammatory properties, we examined the possibility that fidaxomicin alt ... | 2014 | 24890583 |
| fecal microbiota transplant for treatment of clostridium difficile infection in immunocompromised patients. | patients who are immunocompromised (ic) are at increased risk of clostridium difficile infection (cdi), which has increased to epidemic proportions over the past decade. fecal microbiota transplantation (fmt) appears effective for the treatment of cdi, although there is concern that ic patients may be at increased risk of having adverse events (aes) related to fmt. this study describes the multicenter experience of fmt in ic patients. | 2014 | 24890442 |
| deciphering meta-analytic results: a mini-review of probiotics for the prevention of paediatric antibiotic-associated diarrhoea and clostridium difficile infections. | meta-analyses are used to evaluate pooled effects of a wide variety of investigational agents, but the interpretation of the results into clinical practices may be difficult. this mini-review offers a three-step process to enable healthcare providers to decipher pooled meta-analysis estimates into results that are useful for therapeutic decisions. as an example of how meta-analyses should be interpreted, a recent meta-analysis of probiotics for the prevention of paediatric antibiotic-associated ... | 2015 | 24889895 |
| patience is a virtue: an argument for delayed surgical intervention in fulminant clostridium difficile colitis. | recently, the incidence and severity of clostridium difficile infection (cdi) has increased. in cases of fulminant infection, surgery is a viable therapeutic option but associated with high mortality. we sought to examine factors associated with mortality in a large sample of patients with severe cdi that underwent surgery. a retrospective study was conducted in patients with severe cdi undergoing colectomy. demographics, risk factors, comorbidities, clinical and laboratory data, and time betwee ... | 2014 | 24887802 |
| detection of clostridium difficile infection clusters, using the temporal scan statistic, in a community hospital in southern ontario, canada, 2006-2011. | in hospitals, clostridium difficile infection (cdi) surveillance relies on unvalidated guidelines or threshold criteria to identify outbreaks. this can result in false-positive and -negative cluster alarms. the application of statistical methods to identify and understand cdi clusters may be a useful alternative or complement to standard surveillance techniques. the objectives of this study were to investigate the utility of the temporal scan statistic for detecting cdi clusters and determine if ... | 2014 | 24885351 |
| appendicectomy and clostridium difficile infection: is there a link? | clostridium difficile infection (cdi) is a gradually emerging healthcare problem in the western world, occurring predominantly from the de-arrangement of the gut microbiota and the widespread use of antibiotics. recently, it has been proposed that the presence or absence of the appendix could be a factor influencing the occurrence and/or the severity of cdi. we performed a review of the literature, aiming to identify and interpret in an accumulative way the results of the published clinical stud ... | 2014 | 24883147 |
| [contamination of healthcare workers hands with clostridium difficile spores after caring for patients with c. difficile infection.] | | 2014 | 24878917 |
| fatal spontaneous clostridium septicum gas gangrene: a possible association with iatrogenic gastric acid suppression. | the long-term use of proton pump inhibitors has been linked to an increased risk for the development of gastric polyps, hip fractures, pneumonia, and clostridium difficile colitis. there is evidence that chronic acid suppression from long-term use of proton pump inhibitors poses some risk for the development of c difficile-associated diarrhea by decreasing the elimination of pathogenic microbes before reaching the lower gastrointestinal tract. here we present a case of a 51-year-old woman with a ... | 2014 | 24878026 |
| genes encoding toxin of clostridium difficile in children with and without diarrhea. | the presence of gene 16s rrna and genes encoding toxin a (tcda), toxin b (tcdb), and binary toxin (cdta/cdtb) of clostridium difficile in stool samples from children with (110) and without (150) diarrhea was determined by using a taqman system. fifty-seven (21.9%) out of 260 stool samples harbored the 16s rrna gene. the genetic profile of tcda+/tcdb- and cdta+/cdtb+ was verified in one c. difficile-positive diarrhea sample and of tcda+/tcdb+ in three c. difficile-positive nondiarrhea samples. th ... | 2014 | 24876992 |
| risk of aki with gentamicin as surgical prophylaxis. | in 2009, the scottish government issued a target to reduce clostridium difficile infection by 30% in 2 years. consequently, scottish hospitals changed from cephalosporins to gentamicin for surgical antibiotic prophylaxis. this study examined rates of postoperative aki before and after this policy change. the study population comprised 12,482 adults undergoing surgery (orthopedic, urology, vascular, gastrointestinal, and gynecology) with antibiotic prophylaxis between october 1, 2006, and septemb ... | 2014 | 24876113 |
| results from the first 12 months of the national surveillance of healthcare associated outbreaks in germany, 2011/2012. | in august 2011, the german protection against infection act was amended, mandating the reporting of healthcare associated infection (hai) outbreak notifications by all healthcare workers in germany via local public health authorities and federal states to the robert koch institute (rki). | 2014 | 24875674 |
| recent evolution of antibiotic resistance in the anaerobes as compared to previous decades. | evolution of antibiotic resistance in the anaerobes was reviewed using recent data covering 2000-2013 as compared to previous years. all studies reported growing moxifloxacin resistance in bacteroides/parabacteroides spp. in europe and usa and in clostridium difficile in europe. in half or more studies, the resistance rates in bacteroides/parabacteroides spp. to amoxicillin-clavulanate or ampicillin-sulbactam and clindamycin rose. in some studies, an increase in resistance was found in bacteroid ... | 2015 | 24875330 |
| cags and acs evidence based reviews in surgery. is a diverting loop ileostomy and colonic lavage an alternative to colectomy for the treatment of severe clostridium difficile-associated disease? | the term “evidence-based medicine” was first coined by sackett and colleagues as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”1 the key to practising evidencebased medicine is applying the best current knowledge to decisions in individual patients. medical knowledge is continually and rapidly expanding. for clinicians to practise evidence-based medicine, they must have the skills to read and interpret the medic ... | 2014 | 24869615 |
| [clostridium difficile infecion--diagnostics, prevention and treatment]. | clostridium difficile is the most common cause of an antibiotic-associated diarrhoea. frequency of clostridium difficile infections (cdi) increased in the last decade. this study presents current preventive measure i.e. hand washing, disposable gloves. additionally, the article presents diagnostic methods: detection glutamine dehydrogenase (gdh), toxins a and b, cytotoxicity neutralization test, polymerase chain reaction methods (pcr) i.e. nucleic acid amplification test (naat) and stool culture ... | 2014 | 24868904 |
| association between clostridium difficile infection and antimicrobial usage in a large group of english hospitals. | this study aimed to determine the association between the reduction in the number of clostridium difficile infection (cdi) cases reported by the english national health service (nhs) hospitals and concurrent antimicrobial use. | 2014 | 24868578 |
| evaluation of dedicated infectious diseases pharmacists on antimicrobial stewardship teams. | patient care improvements and cost savings achieved by a large integrated health system through the implementation of antimicrobial stewardship programs (asps) at two hospitals are reported. | 2014 | 24865759 |
| effect of treatment variation on outcomes in patients with clostridium difficile. | new guidelines for the treatment of clostridium difficile-associated diarrhea were published by the infectious disease society of america (idsa) in 2010, however, there has been no literature evaluating the effectiveness of these guidelines. the purpose of this study was to examine the clinical outcomes of clostridium difficile infection including death, c difficile infection recurrence, toxic megacolon, and surgery between patients who received guideline-concordant therapy vs guideline-discorda ... | 2014 | 24862310 |
| surgical management of severe colitis in the intensive care unit. | severe colitis, an umbrella encompassing several entities, is one of the most common acute gastrointestinal disorders resulting in critical illness. clostridium difficile infection is responsible for the majority of nosocomial diarrhea with fulminant c difficile colitis (cdc) carrying a high mortality. optimal outcomes can be achieved by early identification and treatment of fulminant cdc, with appropriate surgical intervention when indicated. ischemic colitis, on the other hand, is uncommon wit ... | 2015 | 24859995 |
| fecal transplant for treatment of toxic megacolon associated with clostridium difficile colitis in a patient with duchenne muscular dystrophy. | clostridium difficile (c diff) colitis infection is the most common cause of nosocomial infectious diarrhea and the prevalence is increasing worldwide. toxic megacolon is a severe complication of c diff colitis associated with high mortality. gastrointestinal (gi) comorbidity and impaired smooth muscle contraction are risk factors for the development of c diff-associated toxic megacolon. we present a case of fulminant c diff colitis with toxic megacolon in a patient with duchenne muscular dystro ... | 2016 | 24858336 |
| lactobacillus acidophilus modulates the virulence of clostridium difficile. | clostridium difficile is a spore-forming, toxin-producing, anaerobic bacterium that colonizes the human gastrointestinal tract. this pathogen causes antibiotic-associated diarrhea and colitis in animals and humans. antibiotic-associated diseases may be treated with probiotics, and interest is increasing in such uses of probiotics. this study investigated the effect of lactobacillus strains on the quorum-sensing signals and toxin production of c. difficile. in addition, an in vivo experiment was ... | 2014 | 24856984 |
| species and genus level resolution analysis of gut microbiota in clostridium difficile patients following fecal microbiota transplantation. | clostridium difficile is an opportunistic human intestinal pathogen, and c. difficile infection (cdi) is one of the main causes of antibiotic-induced diarrhea and colitis. one successful approach to combat cdi, particularly recurrent form of cdi, is through transplantation of fecal microbiota from a healthy donor to the infected patient. in this study we investigated the distal gut microbial communities of three cdi patients before and after fecal microbiota transplantation, and we compared thes ... | 2014 | 24855561 |
| clinical and economic consequences of vancomycin and fidaxomicin for the treatment of clostridium difficile infection in canada. | clostridium difficile infection (cdi) represents a public health problem with increasing incidence and severity. | 2014 | 24855476 |
| timing and type of surgical treatment of clostridium difficile-associated disease: a practice management guideline from the eastern association for the surgery of trauma. | clostridium difficile infection is the leading cause of nosocomial diarrhea in the united states; however, few patients will develop fulminant c. difficile-associated disease (cdad), necessitating an urgent operative intervention. mortality for patients who require operative intervention is very high, up to 80% in some series. since there is no consensus in the literature regarding the best operative treatment for this disease, we sought to answer the following:pico [population, intervention, co ... | 2014 | 24854320 |
| puerperal retroperitoneal abscess caused by clostridium difficile: case report and review of the literature. | retroperitoneal infection can be lethal. optimal management is still elusive to describe because of the small number of case reports. we presented here a case of retroperitoneal abscess caused by clostridium difficile arising in the puerperal period. | 2014 | 24853835 |
| fecal microbiota transplantation in children with recurrent clostridium difficile infection. | clostridium difficile eradication using fecal microbiota transplantation (fmt) has been successful in adults but little information is available in pediatrics. we report 6 pediatric patients with refractory c. difficile cured by fmt with no recurrences to date. our results demonstrate that fmt can be an effective treatment for refractory c. difficile infection in pediatrics. long-term safety and efficacy need to be studied. | 2014 | 24853539 |
| serum bacterial toxins are related to the progression of inflammatory bowel disease. | inflammatory bowel disease (ibd), including crohn's disease (cd) and ulcerative colitis (uc), is an autoimmune disease. disorder of intestinal microbes is thought to play a critical role in the pathogenesis of ibd. detection of bacterial toxins could become a new approach to judge the situation of this disease. | 2014 | 24853095 |
| asymptomatic clostridium difficile colonization as a reservoir for clostridium difficile infection. | clostridium difficile (cd) infection (cdi) is the leading cause of healthcare associated diarrhea despite intense hospital infection prevention programs. a substantial proportion of the population is asymptomatically colonized with cd, and evidence is mounting that these individuals serve as a reservoir for cdi. the purpose of this review is to discuss the mechanisms by which individuals may harbor toxigenic cd but remain asymptomatic, the evidence that asymptomatically colonized individuals ser ... | 2014 | 24848084 |
| [clostridium difficile infections: update on new european recommendations]. | clostridium difficile infections: update on new european recommandations while metronidazole and vancomycin have been the only drug options to date for the treatment of c. difficile infection, new therapeutic approaches with promising results have recently emerged for the treatment of the first episode and relapses. fidaxomicin is a new macrocyclic antibiotic more active against c. difficile and with a narrow spectrum allowing preservation of the intestinal microbiota. while having the same effi ... | 2014 | 24843988 |
| managing clostridium difficile in inflammatory bowel disease (ibd). | clostridium difficile (c. difficile) infection has emerged as a significant clinical challenge for patients suffering from inflammatory bowel disease (ibd). c. difficile can both precipitate and worsen flares of ibd, contributing to emergent colectomies and mortality. advances in the management of c. difficile infection in ibd include recommendations for testing for this infection in the setting of clinical flare and hospitalization, improved diagnostic testing, identification of high rates of c ... | 2014 | 24838421 |
| a high-throughput small-molecule screen to identify a novel chemical inhibitor of clostridium difficile. | clostridium difficile, a highly drug-resistant gram-positive, spore-forming bacterium, remains a leading cause of hospital-acquired diarrhoea and antibiotic-associated colitis. clinically, only a handful of antibiotics are used for treating c. difficile infection (cdi), suggesting a necessity for the development of new treatment options. here we performed a high-throughput screen of 2000 drug-like compounds for inhibition of c. difficile. from this screen, one compound, 5-nitro-1,10-phenanthroli ... | 2014 | 24837414 |
| the effect of pharmacy restriction of clindamycin on clostridium difficile infection rates in an orthopedics ward. | a high consumption of clindamycin was noted in an orthopedics ward with high rates of clostridium difficile infection (cdi). we restricted clindamycin for the entire ward. a reduction of 88% in cdi (1.07 to 0.12 × 1,000 patients-days, p = .056) and 84% for all-cause diarrhea (2.40 to 0.38 × 1,000 patients-days, p = .021) was achieved. clindamycin was reduced 92.61% without an increase in other antibiotics. we identified high consumption of clindamycin as a risk factor for cdi. | 2014 | 24837129 |
| risk factors associated with clostridium difficile infection severity in hospitalized patients. | | 2014 | 24837124 |
| hospital clostridium difficile outbreak linked to laundry machine malfunction. | clostridium difficile is a gram-positive, spore-forming anaerobic bacillus that is associated with diarrheal disease. c difficile is shed in the feces of affected individuals and its spores can survive on surfaces for prolonged periods of time. these spores can contaminate a hospital environment by spread through health care workers and suboptimal environmental cleaning practices. we report an outbreak of health care facility-onset c difficile infection that was eventually linked to contaminated ... | 2014 | 24837118 |
| implementation and impact of ultraviolet environmental disinfection in an acute care setting. | multiple-drug-resistant organisms (mdros) and clostridium difficile (cd) are significant problems in health care. evidence suggests that these organisms are transmitted to patients by the contaminated environment. | 2014 | 24837107 |
| prevalence and in-hospital mortality trends of infections among patients with cirrhosis: a nationwide study of hospitalised patients in the united states. | data on bacterial infections in hospitalised patients in the us with cirrhosis are derived largely from single centre data. countrywide data in this population are lacking. | 2014 | 24832591 |
| transanal minimally invasive surgery for benign and malignant rectal neoplasia. | transanal minimally invasive surgery (tamis), an alternative technique to transanal endoscopic microsurgery, was developed in 2009. herein, we describe our initial experience using tamis for benign and malignant rectal neoplasia. | 2014 | 24832238 |
| intestinal microbiota transplantation: a case of crohn's colitis with superimposed clostridium difficile infection. | | 2013 | 24831911 |
| a different kind of "allogeneic transplant": successful fecal microbiota transplant for recurrent and refractory clostridium difficile infection in a patient with relapsed aggressive b-cell lymphoma. | | 2015 | 24828871 |
| fecal microbiota transplantation in treating clostridium difficile infection. | clostridium difficile infection (cdi) is an increasingly common and severe international health problem. customary treatment of this infection, usually with antibiotics, is often ineffective and its recurrence is common. in recent years the treatment of recurrent or refractory cdi by the transfer of stool from an uninfected person, so called fecal "microbiota transplantation" has become recognized as effective and generally safe. the effectiveness of this novel treatment is incompletely defined ... | 2014 | 24825534 |
| fulminant clostridium difficile enteritis causing abdominal compartment syndrome. | clostridium difficile infection of the small bowel, or c. difficile enteritis (cde), is an uncommon condition. cases reported previously have been described in patients with inflammatory bowel disease (ibd), compromised immune systems, or a history of colectomy or small bowel surgery. | 2014 | 24824419 |
| analysis of clostridium difficile infections after cardiac surgery: epidemiologic and economic implications from national data. | clostridium difficile infections (cdis) have increased during the past 2 decades, especially among cardiac surgical patients, who share many of the comorbidity risk factors for cdi. our objectives were to use a large national database to identify the regional-, hospital-, patient-, and procedure-level risk factors for cdi; and determine mortality, resource usage, and cost of cdis in cardiac surgery. | 2014 | 24823282 |
| mechanism of action and epitopes of clostridium difficile toxin b-neutralizing antibody bezlotoxumab revealed by x-ray crystallography. | the symptoms of clostridium difficile infections are caused by two exotoxins, tcda and tcdb, which target host colonocytes by binding to unknown cell surface receptors, at least in part via their combined repetitive oligopeptide (crop) domains. a combination of the anti-tcda antibody actoxumab and the anti-tcdb antibody bezlotoxumab is currently under development for the prevention of recurrent c. difficile infections. we demonstrate here through various biophysical approaches that bezlotoxumab ... | 2014 | 24821719 |
| [saccharomyces cerevisiae fungemia in an elderly patient following probiotic treatment]. | saccharomyces cerevisiae, known as baker's yeast, is also used as a probiotic agent to treat gastroenteritis by modulating the endogenous flora and immune system. however, since there have been increasing reports of fungemia due to s.cerevisiae and its subspecies s.boulardii, it is recommended that probiotics should be cautiously used in immunosuppressed patients, people with underlying diseases and low-birth weight babies. to emphasize this phenomenon, in this report, a case of s.cerevisiae fun ... | 2014 | 24819274 |
| antimicrobial prophylaxis for colorectal surgery. | research shows that administration of prophylactic antibiotics before colorectal surgery prevents postoperative surgical wound infection. the best antibiotic choice, timing of administration and route of administration remain undetermined. | 2014 | 24817514 |
| identification and characterization of glycoproteins on the spore surface of clostridium difficile. | in this study, we identify a major spore surface protein, bcla, and provide evidence that this protein is glycosylated. following extraction of the spore surface, solubilized proteins were separated by one-dimensional page and stained with glycostain to reveal a reactive high-molecular-mass region of approximately 600 kda. tandem mass spectrometry analysis of in-gel digests showed this band to contain peptides corresponding to a putative exosporangial glycoprotein (bcla3) and identified a number ... | 2014 | 24816601 |
| statins use and risk of mortality in patient with clostridium difficile infection. | current evidence suggests that statins may improve outcome in infectious diseases. this study aims to assess whether statins use is associated with reduced risk of 30-day mortality in clostridium difficile infection (cdi). using the computerized database of clalit, the largest healthcare provider in israel, we identified a cohort of adult subjects (age ≥40 years) who tested positive on a c. difficile toxin assay performed between january 2011 and december 2012. subjects were defined as current s ... | 2014 | 24816303 |
| funding healthcare-associated infection research: a systematic analysis of uk research investments, 1997-2010. | healthcare-associated infections (hcais) are a cause of high health and economic burden in the uk. the number of hcai research studies funded in the uk, and the associated amount of investment, has not previously been analysed. | 2014 | 24815767 |
| hospital-acquired clostridium difficile infections: estimating all-cause mortality and length of stay. | clostridium difficile is a health care-associated infection of increasing importance. the purpose of this study was to estimate the time until death from any cause and time until release among patients with c. difficile, comparing the burden of those in the intensive care unit (icu) with those in the general hospital population. | 2014 | 24815305 |
| colonic marbling in clostridium difficile pancolitis. | | 2014 | 24814091 |
| expert panel evaluation of health information technology effects on adverse events. | adverse events (aes) among hospitalized patients occur frequently and result in significant sequelae. federal policy is incentivizing health information technology (hit) use, although research demonstrating safety benefits from hit is mixed. our objective was to evaluate the potential effects of hit on reducing 21 different inpatient aes. identifying aes most likely to be reduced by hit can inform the design of future studies evaluating its effectiveness. | 2014 | 24813820 |
| clinical characteristics and outcome of patients with clostridium difficile infection diagnosed by pcr versus a three-step algorithm. | clinical features of clostridium difficile infections (cdi) detected by pcr, but not by conventional methods, are poorly understood. we compared the clinical features of cdi cases detected by pcr only and cases detected by both pcr and a three-step algorithm. we performed a retrospective cohort study of patients fulfilling a standardized definition over a 13-month period. stool specimens were tested in parallel by pcr and an algorithm based on enzyme immunoassay and cytotoxicity assay (eia/cca). ... | 2014 | 24813402 |
| towards point of care testing for c. difficile infection by volatile profiling, using the combination of a short multi-capillary gas chromatography column with metal oxide sensor detection. | rapid volatile profiling of stool sample headspace was achieved using a combination of short multi-capillary chromatography column (smcc), highly sensitive heated metal oxide semiconductor (mos) sensor and artificial neural network (ann) software. for direct analysis of biological samples this prototype offers alternatives to conventional gc detectors and electronic nose technology. the performance was compared to an identical instrument incorporating a long single capillary column (lscc). the a ... | 2014 | 27212803 |
| response to p. destrez concerning g.j. hughes et al.: impact of cleaning and other interventions on the reduction of hospital-acquired clostridium difficile infections in two hospitals in england assessed using a breakpoint model. | | 2014 | 24811116 |
| clostridium difficile as a cause of healthcare-associated diarrhoea among children in auckland, new zealand: clinical and molecular epidemiology. | we aimed to determine the incidence of clostridium difficile infection (cdi), the molecular epidemiology of circulating c. difficile strains and risk factors for cdi among hospitalised children in the auckland region. a cross-sectional study was undertaken of hospitalised children <15 years of age in two hospitals investigated for healthcare-associated diarrhoea between november 2011 and june 2012. stool specimens were analysed for the presence of c. difficile using a two-step testing algorithm ... | 2014 | 24810967 |
| clostridium difficile spores: a major threat to the hospital environment. | clostridium difficile is a gram-positive, anaerobic spore former and is an important nosocomial and community-acquired pathogenic bacterium. c. difficile infections (cdi) are a leading cause of infections worldwide with elevated rates of morbidity. despite the fact that two major virulence factors, the enterotoxin tcda and the cytotoxin tcdb, are essential in the development of cdi, c. difficile spores are the main vehicle of infection, and persistence and transmission of cdi and are thought to ... | 2014 | 24810347 |
| relative incidences and outcomes of clostridium difficile infection following transplantation of unrelated cord blood, unrelated bone marrow, and related peripheral blood in adult patients: a single institute study. | clostridium difficile is a major cause of nosocomial diarrhea. the incidence and prognosis of c. difficile-associated diarrhea (cdad) has not yet been assessed in adult patients after unrelated cord blood transplantation (ucbt). | 2014 | 24810244 |
| a review of the economics of treating clostridium difficile infection. | clostridium difficile infection (cdi) is a costly result of antibiotic use, responsible for an estimated 14,000 deaths annually in the usa according to the centers for disease control and prevention. annual costs attributable to cdi are in excess of $us 1 billion. this review summarizes appropriate utilization of prevention and treatment methods for cdi that have the potential to reduce the economic and humanistic costs of the disease. some cost-effective strategies to prevent cdi include screen ... | 2014 | 24807468 |