| chronic diarrhea associated with clostridium difficile in children. | clostridium difficile toxin was associated with chronic diarrhea without classic symptoms of colitis in seven children (age range, 7 weeks to 7 years). all patients had received antibiotics. six of the seven were treated with vancomycin hydrochloride and demonstrated improvement. after treatment, four patients suffered relapses, and three required further therapy. one patient had four relapses. during all clinical relapses, toxin reappeared in the stool; recovery was always associated with its d ... | 1983 | 6823927 |
| differentiation of clostridium difficile toxin from clostridium botulinum toxin by the mouse lethality test. | the mouse lethality test is the most sensitive method for confirming the diagnosis of infant botulism. both clostridium difficile and clostridium botulinum produce heat-labile toxins which are lethal for mice and can be found in the feces of infants. these two toxins can be distinguished from one another in this assay when both are present in the same fecal specimen because they appear to be immunologically distinct toxins. | 1983 | 6824325 |
| relapse of antibiotic associated colitis: endogenous persistence of clostridium difficile during vancomycin therapy. | this study reports 24 patients with antibiotic associated colitis due to clostridium difficile. fifteen patients were treated with vancomycin due to the severity of the colitis and in eight of these a clinical relapse of the colitis occurred after vancomycin therapy was stopped. bacteriological investigations of these patients indicated that c difficile was able to persist in stool samples during vancomycin therapy in the absence of detectable cytotoxin. this was in contrast with the seven patie ... | 1983 | 6826104 |
| outbreaks of diarrhea associated with clostridium difficile and its toxin in day-care centers: evidence of person-to-person spread. | clostridium difficile was associated with five outbreaks of diarrhea occurring in three day-care centers caring for children less than 2 years of age during a three and one-half-month period; two centers had one outbreak of diarrhea, and one had three outbreaks. the frequency of isolation of c. difficile and its toxin was determined in stool specimens from 65 children attending the three day-care centers. twelve of 21 (57%) children who had diarrhea excreted c. difficile and its toxin, whereas o ... | 1983 | 6827409 |
| the use of cie for the detection of clostridium difficile toxin in stool filtrates: laboratory and clinical correlation. | two cie procedures (cie-1, cie-2) for the detection of clostridium difficile in diarrheal stools were evaluated by comparison to cytotoxin assay and culture results and by comparison to a clinical likelihood of c. difficile-induced diarrhea. using a combination of toxin assay and culture results for reference, the cie-1 and cie-2 procedures had sensitivities of 33% and 47%, specificities of 89% and 91%, and positive predictive values of 42% and 54%, respectively. using clinical likelihood for re ... | 1983 | 6829506 |
| the non-value of counterimmunoelectrophoresis for the direct rapid detection of clostridium difficile toxin in stool filtrates. | | 1983 | 6829507 |
| clostridium difficile colitis unassociated with antibiotic therapy. | | 1983 | 6831181 |
| double-contrast enema in antibiotic-related pseudomembranous colitis. | pseudomembranous colitis (pmc) is a potentially fatal disease often associated with antibiotic therapy. the condition is now known to be due to an enterotoxin produced by clostridium difficile. diagnosis is based on the endoscopic finding of the typical pseudomembranes, stool culture, and assay of the stools for the specific toxin. radiography with double-contrast medium (dce), which can be performed in patients not critically ill, often yields pathognomonic findings and permits early diagnosis. | 1983 | 6832539 |
| norleucine-tyrosine broth for rapid identification of clostridium difficile by gas-liquid chromatography. | a new medium, norleucine-tyrosine (nt) broth, was developed for rapid identification of clostridium difficile on the basis of caproic acid and p-cresol production. the nt broth consists of 0.5% trypticase (bbl microbiology systems, cockeysville, md.), 0.5% yeast extract (difco laboratories, detroit), 0.2% l-norleucine and 0.2% l-tyrosine (wt/vol; final concentrations), and a mixture of salts. the procedure for demonstrating caproic acid and p-cresol production involves extracting nt broth cultur ... | 1983 | 6833488 |
| clostridium difficile toxin associated with chronic diarrhea and failure to gain weight. | two young children are described in whom chronic diarrhea associated with the presence of clostridium difficile toxin responded to treatment with oral vancomycin. c. difficile infection should be considered in the evaluation of young children with diarrhea who fail to gain weight, even in the absence of prior antibiotic treatment. | 1983 | 6839628 |
| pseudomembranous colitis in clostridium difficile-monoassociated rats. | germfree rats were monoassociated with either a toxin-producing strain of clostridium difficile (tox+) or a variant of this strain (toxr) which produced much less toxin (1/10,000) in vivo and in vitro. monoassociation of germfree rats with c. difficile tox+ resulted in mortality (17%) and in pathology to the small and large intestines, livers, and lungs. cecal filtrates from the tox+-monoassociated rats were cytotoxic for tissue culture cells. the cytotoxicity of cecal filtrates could be blocked ... | 1983 | 6840842 |
| antagonism of toxigenic clostridium difficile by nontoxigenic c. difficile. | cefoxitin-treated hamsters were first colonized with a nontoxigenic strain of clostridium difficile, and then a toxigenic strain of c. difficile was administered. toxigenic c. difficile was suppressed to a mean cecal population level of less than 0.2% of that found in control animals given only toxigenic c. difficile after cefoxitin treatment. colonization with nontoxigenic c. difficile before toxigenic c. difficile was associated with 93% survival, as opposed to 21% survival of the control anim ... | 1983 | 6842009 |
| comparison of bacterial isolation, cytotoxicity assay, and counterimmunoelectrophoresis for the detection of clostridium difficile and its toxin. | | 1983 | 6842010 |
| diarrhoea associated with clostridium difficile in a hospital population. | the incidence of disease associated with clostridium difficile was investigated in a general hospital population over a period of six months. in 26 (14.5%) of 179 patients studied, c. difficile was either isolated or faecal cytotoxin was detected. the incidence of other enteropathogenic bacteria, except aeromonas hydrophila, was low. faecal cytotoxin was not detected in nine patients (35%), and non-cytotoxigenic strains of c. difficile were isolated from these patients. in seven patients, a sele ... | 1983 | 6843465 |
| isolation of clostridium difficile from pigs. | | 1983 | 6845597 |
| foodborne transmission of clostridium difficile. | | 1983 | 6847849 |
| study of diarrhea in critically ill patients. | there has been an impression that diarrhea occurs commonly in seriously ill patients treated in icus. in view of the sparsity of published work on the problem, we embarked on a prospective study of all patients admitted to the icu for more than 48 h over a 12-month period. three factors were examined in detail: nasogastric feeding, cimetidine administration, and antibiotic treatment. other factors also were considered, notably the nature of the underlying illness and the spread of a possible inf ... | 1983 | 6848311 |
| absorption of oral vancomycin - possible associated toxicity. | we report a case of an anephric child who accumulated significant concentrations of vancomycin during oral therapy for clostridium difficile pseudomembranous colitis. sustained serum vancomycin levels of 34 microgram/ml and csf level of 4.2 microgram/ml were documented during an unexplained clinical syndrome of fever and encephalopathy. discontinuation of drug and performance of hemodialysis reduced serum concentrations to 24 microgram/ml and were associated with rapid resolution of symptoms. pa ... | 1983 | 6853034 |
| evaluation of the usefulness of counterimmunoelectrophoresis for diagnosis of clostridium difficile-associated colitis in clinical specimens. | results of counterimmunoelectrophoresis (cie) were compared with those of isolation of clostridium difficile and assay for cytotoxicity in hela cells. on the basis of 471 stool specimens, cie exhibited a sensitivity of 38% and a specificity of 88% as compared with the cytotoxin assay. the predictive value of a reactive cie results is low (17%), whereas the predictive value of a nonreactive cie result is significant (96%) and therefore warrants its use as a screening test. in addition, stool filt ... | 1983 | 6853688 |
| enzyme-linked immunosorbent assay (elisa) for antibodies to clostridium difficile toxins in patients with pseudomembranous colitis and antibiotic-associated diarrhoea. | enzyme-linked immunosorbent assay (elisa) was established with purified toxins from clostridium difficile as antigen to measure antibody response in patients with pseudomembranous colitis (pmc) and prolonged antibiotic-associated diarrhoea (aad). positive elisa titres were defined in a control population. antibodies of igg class against toxin b were demonstrated in 6/88 (7%) control sera and in 31/61 (51%) sera from 11/19 (58%) patients. antibodies of iga class were found in one patient while an ... | 1983 | 6854035 |
| splenic abscess due to clostridium difficile. | | 1983 | 6854068 |
| [studies on clostridium difficile and antimicrobial associated diarrhea or colitis]. | clostridium difficile has been implicated as the major cause of antimicrobial associated colitis or diarrhea. c. difficile was found in stools from 21 of 120 healthy subjects. c. difficile was found in stools from 8 of 9 patients with antimicrobial associated pseudomembranous colitis and in stools from 16 of 96 patients with antimicrobial associated diarrhea. the cytopathic toxin to hela cell neutralized by antitoxin to c. difficile was found in stools from all patients with antimicrobial associ ... | 1983 | 6854944 |
| an outbreak of clostridium difficile necrotizing enterocolitis: a case for oral vancomycin therapy? | during a 2-month period, 13 infants in this neonatal intensive care unit developed necrotizing enterocolitis, increasing the prevalence in inborns from 5.2 to 20.5/1,000 live births. fifty-seven perinatal and neonatal factors, many of which have previously been associated with necrotizing enterocolitis, were compared between the infants with necrotizing enterocolitis and 17 unaffected inborn control infants admitted concurrently. clostridium difficile cytotoxin was detected in the stools of 12 a ... | 1983 | 6856405 |
| antibiotic-associated diarrhoea and pseudomembranous colitis caused by clostridium difficile. a review of 40 cases. | we found antibiotic-associated diarrhoea (aad) and pseudomembranous colitis caused by clostridium difficile in 19% of patients with diarrhoea related to antibiotic therapy or with diarrhoea for which no other cause could be found. ampicillin, cephalosporins and co-trimoxazole appear to be the agents most commonly associated with this complication. the clinical presentation of aad falls into two categories: (i) an early-onset type characterized by severe diarrhoea with watery stools which may con ... | 1983 | 6857419 |
| [clostridium difficile in the feces in acute diarrhea, irritable colon and ulcerative colitis]. | | 1983 | 6857791 |
| role of clostridium difficile and campylobacter jejuni in relapses of inflammatory bowel disease. | findings from recent studies on the role of clostridium difficile and campylobacter jejuni in exacerbations of inflammatory bowel disease are in conflict. we examined stool specimens from 32 patients who had inflammatory bowel disease in relapse for the presence of c difficile and c difficile cytotoxin. in the last 19 cases stool specimens were also cultured for c jejuni. c difficile was identified in one patient who was receiving antimicrobial therapy. in no patient was c difficile cytotoxin de ... | 1983 | 6858121 |
| [clostridium difficile - enterocolitis as a nosocomial problem]. | | 1983 | 6862991 |
| influence of age, sex, and diet on asymptomatic colonization of infants with clostridium difficile. | a total of 40% of 107 stool samples from infants 1 to 52 weeks of age were found to contain clostridium difficile antigens, detected by counterimmunoelectrophoresis. within the group tested, there was no detectable variation by age or sex. infants fed formula were nearly four times more likely to carry c. difficile than were those exclusively breast fed (62 versus 16%), whereas breast-fed infants also receiving formula or solids had an intermediate rate of colonization (35%). the distributions w ... | 1983 | 6863502 |
| [antibiotics and diarrhea, "clostridium difficile"]. | | 1983 | 6867526 |
| transferable resistance to clindamycin, erythromycin, and tetracycline in clostridium difficile. | resistance to clindamycin, erythromycin, and streptogramins in clostridium difficile could be transferred to a susceptible strain by mixed culture at low frequencies (1 x 10(-8) to 4 - 10(-8) per donor cell). transfer of tetracycline resistance occurred at frequencies of 3 x 10(-7) to 5 x 10(-7). no plasmid dna involved in these transfers could be detected. | 1983 | 6870225 |
| active and passive immunization to protect against antibiotic associated caecitis in hamsters. | the administration of clindamycin to hamsters induces a lethal enterocolitis as a consequence of toxins produced in the alimentary tract by clostridium difficile. the lethal and cytopathic effects of c. difficile toxins are neutralized in vitro by c. sordellii antitoxin and hamsters may be protected against clindamycin induction of caecitis by passive immunization using c. sordellii antitoxin. to examine active immunization using c. difficile and c. sordellii toxoids, groups of male and female s ... | 1983 | 6873474 |
| bacteriophage and bacteriocin typing scheme for clostridium difficile. | the study of the epidemiology of infection with clostridium difficile would be aided by a way to type individual bacterial isolates. we therefore sought bacteriophages for use in typing. with mitomycin c exposure (3 micrograms/ml), filtrates from 10 strains of c. difficile had plaque-forming lytic activity on other c. difficile strains. individual phage were passaged and made into high-titer stock preparations for typing. electron microscopy revealed tailed phage particles from one such preparat ... | 1983 | 6874905 |
| usefulness of counterimmunoelectrophoresis for detecting toxin of clostridium difficile. | | 1983 | 6881095 |
| clostridium difficile and inflammatory bowel disease. | | 1983 | 6885673 |
| isolation rate and toxigenic potential of clostridium difficile isolates from patients with cystic fibrosis. | | 1983 | 6886480 |
| serum antibody response to toxins a and b of clostridium difficile. | an enzyme-linked immunosorbent assay (elisa) for the detection of antibodies to toxins a and b of clostridium difficile was developed. serum samples from 340 patients were tested for determination of the age-related prevalence of antitoxin. antibody to toxin a was present in 64% of patients more than two years old and antibody to toxin b in 66% of patients more than six months old. a strongly positive elisa value correlated with the presence of cytotoxicity-neutralizing antibody (p less than 0.0 ... | 1983 | 6886489 |
| failure to detect clostridium difficile in foods. | | 1983 | 6886496 |
| a selective broth for clostridium difficile. | a selective broth for the isolation of clostridium difficile from stool specimens is described. the broth contains gentamicin, cycloserine and cefoxitin (gcc broth) and gives rapid presumptive evidence of the presence of c. difficile using gas-liquid chromatography. the broth may also be used for the detection of cytotoxin. final recovery of c. difficile was significantly improved with an increase in isolation rate of 20% in patients in whom fecal cytotoxin could be detected and 125% in patients ... | 1983 | 6888964 |
| bacitracin therapy in antibiotic-associated pseudomembranous colitis. | two patients with antibiotic-associated pseudomembranous colitis, and stool positive for clostridium difficile cytotoxin were successfully treated with oral bacitracin. one patient had previously suffered two relapses of pseudomembranous colitis following successful treatment with vancomycin and one patient was allergic to vancomycin. bacitracin appears to be a reasonable choice to treat patients with antibiotic-associated colitis who are allergic to vancomycin. further studies comparing vancomy ... | 1980 | 6903494 |
| [2 cases of colitis caused by clostridium difficile during antibiotic therapy]. | defined the most important clinical, endoscopic and pathological aspects of antibiotic-associated colitis, the aa. examine the clostridium difficile as the etiological agent. the range of examination has been limited to two cases of pseudomembranous colitis, a diagnostic and a therapeutic evaluation is suggested for patients with aad and pmc. furthermore the importance of a strictly observance of hospital hygienic rules in the prevention of such pathological cases is strongly stressed. | 1982 | 6927221 |
| antibacterial activities of a new stabilized thienamycin, n-formimidoyl thienamycin, in comparison with other antibiotics. | the in vitro activity of a new crystalline derivative of thienamycin, n-formimidoyl thienamycin (mk0787), was tested against 46 laboratory reference strains and 2,158 clinical isolates of gram-positive and -negative bacteria, including anaerobes, and compared with cefoxitin, cefaxolin, carbenicillin, and amikacin. mk0787 was significantly more active than the reference antibiotics against most bacteria tests. mk0787 was 16- to 500-fold more active than the other antibiotics against staphylococcu ... | 1980 | 6931548 |
| antibiotic associated colitis and clostridium difficile. a symposium held at the swedish medical society, stockholm, sweden, august 23, 1979. | | 1980 | 6937943 |
| experimental studies of antibiotic associated colitis. | clostridium difficile has been implicated as the major cause of antibiotic-associated pseudomembranous colitis. the laboratory diagnostic test of choice is a tissue culture assay that demonstrates the presence of a cytopathic toxin neutralized by antitoxin to clostridium sordelli. this toxin is found in stools from patients with antibiotic-associated pseudomembranous colitis and in stools from patients with antibiotic-associated diarrhea. neutralization of toxin by antitoxin to c. sordelli appea ... | 1980 | 6937944 |
| diagnosis of clostridium difficile-associated enterocolitis in sweden. laboratory and epidemiological aspects. | over a 32-week period 1979, 256 fecal samples from 132 patients with antibiotic-associated enterocolitis were analyzed for the presence of c. difficile bacteria and/or toxin. the toxin test was positive in 35 patients (27%) and the bacterium was present in 14 patients (11%). seventy-three patients with enterocolitis were investigated with regard to age, sex, antibiotic therapy, and clinical symptoms by analysis of their records. a positive toxin titre had an apparent predictive value of 69% for ... | 1980 | 6937945 |
| characterization of clostridium difficile and its differentiation from clostridium sporogenes by automatic head-space gas chromatography. | although 47 strains of clostridium difficile and clostridium sporogenes were studied by gas chromatography. acidic and neutral volatile products, formed after 96 h of incubation in glucose-containing peptone yeast-extract medium, were chromatographed. all strains produced appreciable amounts of fatty acids, which were tentatively identified by gas chromatographic retention data. chromatograms obtained when analysing diethyl ether extracts of culture media of all 47 strains were virtually identic ... | 1980 | 6937946 |
| the experimental pathogenesis of antibiotic related colitis. | findings from several countries now closely associate clostridium difficile and its toxin with pmc. in fact, testing for the toxin by means of tissue culture assay is being used more and more to define the proportion of patients with clinically significant antibiotic associated colitis. reproduction of a similar entity in hamsters appears to fulfil the koch-henle postulates, establishing c. difficile as the cause of the syndrome. antibiotic treatment creates susceptibility to infection rather th ... | 1980 | 6937947 |
| in vitro susceptibility of anaerobic bacteria to nitroimidazoles. | the in vitro susceptibility of 355 swedish clinical isolates of anaerobic bacteria to three nitroimidazole drugs was determined by the agar dilution method. the drugs were metronidazole, tinidazole and ornidazole. in addition the in vitro susceptibility of 32 strains of clostridium difficile to metronidazole was determined. gram-negative rods and clostridia were inhibited by 4 microgram/ml or less of all three compounds except one strain of c. difficile, which was not inhibited by 16 microgram/m ... | 1981 | 6941455 |
| the role of anaerobes in human infections. | anaerobic bacteria have been shown to play a role in infection of all types in humans. certain infections are notable for the prominent role played by anaerobes; included are brain abscess, chronic sinusitis and otitis media, oral and dental infections, neck space infections, bite infections, lung abscess, aspiration pneumonia, empyema, intra-abdominal infections of all types (notably peritonitis, intra-abdominal abscess, and liver abscess), abdominal surgical wound infections, female genital tr ... | 1981 | 6941463 |
| a clinical and aetiological study of adult patients hospitalised for acute diarrhoeal disease. | sixty adult patients with diarrhoea discharged from the infectious disease unit, auckland hospital in the 15 months from 1 january 1980 were reviewed. thirty had diarrhoea due to enteric organisms (campylobacter fetus 8, shigella 6, salmonella typhi 4, salmonella typhimurium 4, clostridium difficile causing pseudomembranous colitis 3). other diagnoses included ulcerative colitis and a colonic carcinoma. eighteen had no specific diagnosis. combinations of admission fever, faecal leucocytes and le ... | 1982 | 6952128 |
| clostridium difficile-associated colitis: cross infection in predisposed patients with renal failure. | four men with renal failure developed clostridium difficile-associated diarrhoea while being cared for in the same ward at about the same time. cross infection appeared to play a role. all patients had received antibiotics; three were treated for chest infections and one for a urinary tract infection. the antibiotics implicated were cefoxitin alone in two patients, cefoperazone alone in one patient and cloxacillin, cefoperazone and amoxycillin in the last patient. two patients had received immun ... | 1982 | 6953368 |
| reactive arthritis due to clostridium difficile. | | 1982 | 6953381 |
| susceptibilities of anaerobic bacteria to n-formimidoyl thienamycin (mk0787) and to other antibiotics. | the susceptibilities of 462 clinical anaerobic bacterial isolates to n-formimidoyl thienamycin and 16 other currently available and investigational antibiotics were determined by the agar dilution technique. n-formimidoyl thienamycin was significantly more active than the reference antibiotics against most organisms tested, especially bacteroides sp., including clindamycin-resistant strains. all 462 isolates were inhibited by 4 micrograms of n-formimidoyl thienamycin per ml, and no resistant str ... | 1982 | 6956247 |
| contamination and crossinfection with clostridium difficile in an intensive care unit. | an outbreak of pseudomembranous colitis in an intensive care unit is described. this resulted in environmental contamination by clostridium difficile. the outbreak could be traced to one patient who received several antibiotics over the preceding three months. a search was conducted for asymptomatic carriers among patient and staff but none were found. aquisition of c. difficile from inanimate environmental sources was the most probable means of transmission of the organism. its persistence in t ... | 1982 | 6956292 |
| reactive arthritis associated with clostridium difficile. | a case of reactive arthritis in a patient with a previously documented history of reiter's syndrome is described. the precipitating agent appears to have been clostridium difficile. high levels of toxin were demonstrable in the faeces and neutralising antitoxin was detected in the patient's serum but not synovial fluid. resolution of the polyarthropathy was slow despite successful eradication of the c. difficile with a course of vancomycin. | 1982 | 6960877 |
| clostridium difficile and antibiotic associated diarrhoea in sweden. | distribution of age and sex among patients with clostridium difficile enterocolitis shows an increased ratio female: male (3:1) in age group 20 to 40 years and a corresponding 2:1 ratio in patients over 70 years of age, the latter group constituting 45% of 505 patients investigated. being the only laboratory in sweden performing cytotoxin-assay from cases of c. difficile enterocolitis during 1979-1981, we have observed that the frequencies with which clindamycin/lincomycin are associated with c. ... | 1982 | 6962998 |
| clostridium difficile-associated cecitis in guinea pigs exposed to penicillin. | penicillin treatment resulted in lethal hemorrhagic cecitis in seven of eight guinea pigs. cecal contents at necropsy from all seven animals contained a cytopathic toxin which was neutralized by clostridium sordellii and c difficile antitoxins. bacteriologic cultural examinations of these specimens yielded penicillin-sensitive strains of c difficile which produced a similar or identical cytotoxin in vitro. stools obtained before penicillin administration and cecal contents from control animals l ... | 1980 | 6969561 |
| evaluation of eight cephalosporins in hamster colitis model. | eight commonly used cephalosporins were evaluated in the hamster colitis mode. they were all found to cause hemorrhagic cecitis and death within 10 days of being given as subcutaneous or oral challenges. necropsy findings were indistinguishable from clindamycin-induced cecitis. bacteria-free cecal filtrate obtained from hamsters dying of cephalosporin-induced cecitis contained toxin similar or identical to hat produced by clostridium difficile isolated from the cecum of a hamster. daily oral adm ... | 1981 | 6973951 |
| antibiotic-associated hemorrhagic colitis. | pseudomembranous colitis arising from clostridium difficile super-infection after treatment with various antibiotics is a well-defined portion of the pathological spectrum of antibiotic related bowel injury. we have observed two patients with hemorrhagic colitis associated with the use of penicillin derivatives. the colitis was characterized by predominant right-sided involvement, sparing of the rectum and distal colon, absence of pseudomembrane formation, and presence of marked hemorrhage in th ... | 1982 | 6979926 |
| implantation of bacteria from the digestive tract of man and various animals into gnotobiotic mice. | fourteen microbial strains isolated from conventional rats were inoculated into axenic rats and mice receiving identical diets. the populations of these organisms which became established in the feces of gnotobiotic adult recipient rats and mice were quite similar. the only major difference was that one strain, belonging to the genus clostridium, disappeared from the feces of gnotobiotic mice, whereas this strain became established in gnotobiotic rats. most of the strictly anaerobic strains were ... | 1980 | 7001883 |
| bacteria newly recognized as nosocomial pathogens. | bacteria recently recognized as nosocomial pathogens generally fall into three categories: those that grow slowly, those that are fastidious in their nutritional or atmospheric requirements and those that resemble commensals. each characteristic has contributed to the delay in perceiving their importance. mycobacterium chelonei and myco. fortuitum--which grow slowly, although characterized as "rapid-growing" mycobacteria--cause sternal osteomyelitis, pericarditis and endocarditis after cardiac s ... | 1981 | 7008590 |
| interaction of cytopathogenic toxin from clostridium difficile with cells in tissue culture. | partially purified cytopathogenic toxin from clostridium difficile induced morphological changes in five cell lines in tissue culture. the relative sensitivity scale of the cell lines was human lung and intestinal fibroblasts greater than chinese hamster ovary cells much greater than mouse adrenal cells greater than mouse neuroblastoma cells. the cytopathogenic effect did not occur in toxin-treated lung fibroblasts incubated at 0 degree c. pre-incubation of lung fibroblasts with 2,4-dinitropheno ... | 1980 | 7010532 |
| therapeutic trials of antibiotic associated colitis. | since september 1977 we have seen 63 patients with clostridium difficile and a faecal toxin, but only 33 had histological evidence of pseudomembranous colitis. we have conducted separate double blind trials of an antibiotic, vancomycin and an anion-exchange resin, colestipol, in patients with post-operative diarrhoea. vancomycin was extremely effective at eradicating the organism and its faecal toxin. these changes were associated with a marked symptomatic improvement. colestipol proved ineffect ... | 1980 | 7010533 |
| [role of clostridium and its toxin in pseudo-membranous colitis (author's transl)]. | at present many authors consider that pseudo-membranous colitis is of bacterial origin. the main pathogenic agent is clostridium difficile. it is not easy to isolate this organism in the stool, selective media are under study. it liberates a lipo-glycoprotein exotoxin during lysis. it is only partially purified, its structure is not fully elucidated. its molecular weight is not yet precisely determined. it consists of several polymerised polypeptide fragments of molecular weight 50 000. it is a ... | 1981 | 7011118 |
| [detection of "clostridium difficile" on minimal and selective medium and by immunofluorescence antibody staining (author's transl)]. | a minimal and selective medium containing 5 aminoacids, 3 vitamins, a low sugar concentration and 2 antibiotics (cefoxitin at 16 microgram/ml and streptomycin at 500 microgram/ml) is described for isolation of clostridium difficile from the gut. comparable results were obtained with this medium and using spore isolation by the sodium thioglycolate-lysozyme technique. an antiserum specific to c. difficile was prepared and used for detection by immunofluorescent antibody staining. this is a very s ... | 1981 | 7015956 |
| pseudomembranous (antibiotic-associated) colitis. | we have come to understand the cause of antibiotic-associated pseudomembranous colitis (pmc) only in the last decade. clostridium difficile produces the intestinal dysfunction and the characteristic finding of exudative plaques on the mucosa by elaborating a toxin in the colon. this report reviews the development of our knowledge of this disease and the rapid adoption of a rational therapy once the cause was specified. c. difficile or its toxin can be cultured or isolated from the stools of 90% ... | 1981 | 7016935 |
| rapid detection and presumptive identification of clostridium difficile by p-cresol production on a selective medium. | a modification of a selective medium for clostridium difficile is described. the ability of cl difficile to produce p-cresol from p-hydroxy phenyl acetic acid provides a means for the rapid, sensitive detection and presumptive identification of this species in faecal cultures. | 1981 | 7019263 |
| enzyme immunoassay for the detection of clostridium difficile antigen. | | 1981 | 7026694 |
| pseudomembranous colitis in renal transplant recipients; plain film findings. | the plain abdominal film findings in nine renal transplant patients with pseudomembranous colitis were characteristic of but not specific for this entity and most commonly showed "thumb-printing" reflecting submucosal edema (five patients) and a persisting localized segmental ileus in the colon (five patients). based on the plain film findings, the differential diagnosis will include the acute stages of ulcerative colitis, granulomatous colitis, ischemic colitis and other inflammatory colitides, ... | 1981 | 7028758 |
| rapid detection of clostridium difficile toxin in human feces. | fifty fecal specimens were tested by three methods, bacterial isolation, counterimmunoelectrophoresis, and tissue culture, for clostridium difficile and its toxin. ten specimens (20%) were positive by all three methods. an additional eight specimens were toxin positive only by counterimmunoelectrophoresis. although counterimmunoelectrophoresis and tissue culture are of equivalent sensitivity, the additional dilution necessary for tissue culture assay may be critical when only small concentration ... | 1980 | 7031079 |
| simplified procedure for the routine isolation of clostridium difficile from faeces. | the use of alcohol, at a final concentration of 50%, as a selective procedure for the isolation of clostridium difficile was compared to a selective medium containing 250 microgram /ml of cycloserine and 10 microgram /ml of cefoxitin. of 266 faecal samples 82 were shown to be positive by one or other method. seventy-seven (94%) of these were detected by the selective agar (sa) and 72 (88%) by the alcohol procedure (ap). ten samples (12%) were positive only by sa and five samples (6%) by ap only ... | 1981 | 7031097 |
| simple method for isolation and presumptive identification of clostridium difficile. | clostridium difficile can be isolated from stools and presumptively identified by inoculating the stools onto cccba and the culture looked at under ultra violet light where the golden-yellow fluorescent colonies show up against a dark background. the colonies are then identified by testing them using the api zym system and the results further confirmed by testing the culture for toxin production using the tissue culture technique employing cl. sordellii antitoxin. | 1981 | 7032146 |
| bacillus pumilus in the induction of clindamycin-associated enterocolitis in guinea pigs. | antibiotic-associated enterocolitis was induced in guinea pigs by the intraperitoneal injection of clindamycin. the colonic and cecal mucosa and feces of acutely ill animals were cultured under aerobic and anaerobic conditions on 5% sheep blood agar plates and on a selective and differential medium for clostridium difficile. all morphologically distinct colony types were isolated in pure culture and identified. a sterile cell-free filtrate of each isolate was tested for ability to induce morphol ... | 1982 | 7033138 |
| clostridium difficile colitis associated with cancer chemotherapy. | administration of cancer chemotherapeutic agents to humans and animals is frequently complicated by diarrhea and enterocolitis. clostridium difficile and its toxin were found in the stools of two patients with colitis after chemotherapy for malignant neoplasms. diarrhea in both patients resolved with oral vancomycin hydrochloride therapy. clostridium difficile was also isolated from several fomites within the room of one of these patients and also from the hands of his nurses. based on these two ... | 1982 | 7036924 |
| infectious gastroenteritis in bone-marrow-transplant recipients. | we prospectively evaluated infections with several gastrointestinal pathogens in patients undergoing bone-marrow transplantation, in an attempt to correlate infection with morbidity and mortality. thirty-one of 78 patients (40 per cent) were infected with one or more of the following enteric pathogens during the study: adenovirus (12 infections), rotavirus (nine), coxsackievirus (four), or clostridium difficile (12). several patients were infected with more than one pathogen. infection correlate ... | 1982 | 7038501 |
| randomized controlled trial of colestipol in antibiotic-associated colitis. | thirty-eight patients with severe antibiotic-associated postoperative diarrhoea were entered into a randomized controlled trial to compare colestipol (an ion exchange resin) in 17 patients with placebo (sherbet) in 21 patients. clostridium difficile or its toxin was present before treatment in 12 of the colestipol group, compared with only 5 in the placebo group. because of the low incidence of cl. difficile or its toxin, the placebo group data from 22 patients receiving placebo in a previous tr ... | 1982 | 7039758 |
| antibiotic-associated diarrhoea and methicillin-resistant staphylococcus aureus. | methicillin-resistant staphylococcus aureus was thought to be the cause of 10 cases of antibiotic-associated diarrhoea observed over a 12-month period at the royal melbourne hospital. each patient had significant underlying disease, and all had been treated with multiple, broad-spectrum antibiotic agents. the diagnosis was made on the distinctive gram-stain appearance of faecal smears, the heavy predominant growth of methicillin-resistant staph. aureus from stool cultures, and the absence of oth ... | 1982 | 7048039 |
| antibiotic-associated pseudomembranous colitis: an epidemiologic investigation of a cluster of cases. | ten cases of antibiotic-associated colitis (aac) were identified at a hospital in washington, d.c., from march 17 to may 9, 1979. no geographic clustering of cases was found, nor was an association with increased use of antibiotics demonstrated. exposure to aminoglycosides, cephalosporins, and clindamycin was associated with aac, as was a history of enemas in the seven days before the onset of illness (p=0.045). this association was strengthened when gastrointestinal procedures-defined as (1) th ... | 1982 | 7054330 |
| office-based management of diarrhea. | diarrhea of unknown cause is a particularly challenging diagnostic problem as it may be trivial and self-limiting or the presenting symptom of a life-threatening disorder. antibiotic-associated diarrhea is a frequent complication of antimicrobial therapy, especially in the elderly. the more severe form, pseudomembranous colitis, is now known to be caused by a toxin produced in the colon by clostridium difficile. | 1982 | 7056472 |
| trimethoprim/sulfamethoxazole-associated pseudomembranous colitis. | a case of tmp/smx-associated pseudomembranous colitis is described in a patient being treated for a urinary tract infection. pseudomembranes are visualized on proctosigmoidoscopy, and stool cultures identified clostridium difficile as the causative organism. the patient was treated successfully with oral vancomycin. a review of this infrequently reported adverse reaction to tmp/smx is presented, emphasizing etiology and treatment. | 1982 | 7060459 |
| metronidazole: an alternate therapy for antibiotic-associated colitis. | the results of treatment of 13 consecutive cases of antibiotic-associated pseudomembranous colitis with oral metronidazole are described. the diagnosis was made by typical sigmoidoscopic appearance with a confirming characteristic colonic biopsy specimen and/or stools positive for clostridium difficile cytotoxin. all patients responded with the disappearance of diarrhea between 1 and 5 days. two patients experienced relapse when the therapy was discontinued. our experience with metronidazole sho ... | 1982 | 7060906 |
| counterimmunoelectrophoresis vs. cytotoxicity assay for the detection of clostridium difficile toxin. | | 1982 | 7061887 |
| is clostridium difficile pathogenic in infants? | | 1982 | 7062169 |
| clostridium difficile toxin in asymptomatic neonates. | clostridium difficile toxin was detected in the feces of 10.5% of normal newborn infants and 55% of neonates in the intensive care unit. none of the normal infants and less than one-third of those in the nicu had any signs of enteric illness. vaginal delivery and breast-feeding were associated with increased rates of toxin carriage. although toxin was not detected during antibiotic therapy, it could be found in 85% of infants two weeks or more, and for at least an additional two months, followin ... | 1982 | 7062179 |
| the prevalence of clostridium difficile and toxin in a nursery population: a comparison between patients with necrotizing enterocolitis and an asymptomatic group. | during a period when certain neonates in our nursery developed necrotizing enterocolitis, we studied stool specimens from a population of symptomatic and asymptomatic patients for the presence of clostridium difficile and its toxin. the presence of the organism among nursery personnel and in the nursery environment was also evaluated. results showed that five symptomatic neonates and 17 asymptomatic neonates in a population of 37 patients studied in our neonatal intensive care and intermediate c ... | 1982 | 7062180 |
| morphologic and functional effects of clostridium difficile enterotoxin in tissue culture. | the effects of the clostridium difficile toxin were examined in hela and mouse adrenal tumor (mat) cells. cytotoxicity was evaluated by vital dye exclusion and 51cr release. in both hela and mat cells, c. difficile toxin caused rounding of virtually 100% of cells. this rounding was distinguishable from rounding produced by the escherichia coli heat-labile enterotoxin (lt): (1) lt was inactive in hela cells; (2) in mat cells, c. difficile toxin produced uniformly rounded cells, while lt-rounded c ... | 1982 | 7066760 |
| isolation of clostridium difficile from patients with inactive crohn's disease. | based upon studies of patients with inflammatory bowel disease, clostridium difficile and an associated cytotoxin have been proposed as contributory factors in relapse of disease. these studies have not included a comprehensive search for other bacterial pathogens. fifty patients with crohn's disease were investigated to determine if selected enteric pathogens colonize the bowel and if they play a role in the activity of the disease. clostridium difficile was recovered from 8% of patients, all w ... | 1982 | 7067956 |
| ulcerative colitis and crohn's disease tissue cytotoxins. | bowel-wall tissue filtrates from patients with inflammatory bowel disease produce cytopathic effects in tissue culture. the cytopathic effects inducers have been reported to have the characteristics of a small rna virus. clostridium difficile toxin also produces cytopathic effects and has been found in the stools of patients with crohn's disease and ulcerative colitis. the present study concerns the further characterization of the cytopathic inducers in tissues of inflammatory bowel disease pati ... | 1982 | 7067958 |
| purification and characterization of toxins a and b of clostridium difficile. | toxin preparations were obtained by growing clostridium difficile vpi strain 10463 in 2-liter brain heart infusion dialysis flasks at 37 degrees c for 3 days. the initial step of the purification scheme involved ultrafiltration through an xm-100 membrane filter. two toxic activities, designated toxins a and b, were separated by ion-exchange chromatography on deae-nacl gradients. toxin a was purified to homogeneity by an acetic acid precipitation at ph 5.5. other separation techniques, including ... | 1982 | 7068210 |
| biological activities of toxins a and b of clostridium difficile. | examination of the biological activities of the two known toxins of clostridium difficile revealed that one of the toxins (toxin a) elicited a hemorrhagic fluid response in rabbit intestinal loops and a positive fluid response in infant mice. the other toxin (toxin b) did not produce a significant fluid response in either model, although the toxin was more lethal in infant mice. both toxins elicited erythematous and hemorrhagic skin reactions and increased vascular permeability in rabbit skin. | 1982 | 7068215 |
| colonization of the large bowel by clostridium difficile in healthy infants: quantitative study. | colonization of the large bowel of healthy infants by clostridium difficile was studied. feces were collected from five breast-fed aand five formula-fed infants throughout the first year of life, and levels of c. difficile were quantitated. three breast-fed and five formula-fed infants were colonized for periods of between 8 and 42 weeks, and another infant harbored the organism only during week 1. colonization of breast-fed infants commenced before or during weaning, with levels reaching 10(3) ... | 1982 | 7068220 |
| analysis of short-chain acids from bacteria by gas-liquid chromatography with a fused-silica capillary column. | the use of a flexible, fused-silica capillary column for gas-liquid chromatographic analysis of short-chain acids from bacteria is illustrated with a standard acid mixture and with a derivatized extract of culture medium from clostridium difficile. | 1982 | 7068826 |
| problems associated with counterimmunoelectrophoresis assays for detecting clostridium difficile toxin. | the antitoxins currently used for the detection of clostridium difficile by counterimmunoelectrophoresis react with other c. difficile antigens in addition to the toxins produced by the bacterium. | 1982 | 7068832 |
| the plain abdominal radiograph in pseudomembranous colitis due to clostridium difficile. | the plain abdominal radiographs have been reviewed in nine patients with proven pseudomembranous colitis. these demonstrated small intestinal dilatation in eight patients, colonic thumb-printing and haustral thickening in seven, ascites in five and colonic dilation in two cases. the elucidation of these signs, especially in combination, may suggest the diagnosis of pseudomembranous colitis in those at risk. | 1982 | 7075131 |
| clostridium difficile toxin in acute diarrhoea complicating inflammatory bowel disease. | the incidence of clostridium difficile cytotoxin has been studied in 69 consecutive patients with inflammatory bowel disease complicated by severe diarrhoea or ileostomy flux during 74 admissions to hospital. the cytotoxin was identified in only four patients, all of whom had received antimicrobials. clostridium difficle, but not cytotoxin, was identified in 10 of 43 admissions. this followed antimicrobial prophylaxis to cover a recent operation in two patients, and five were on long-term sulpha ... | 1982 | 7076018 |
| use of sodium taurocholate to enhance spore recovery on a medium selective for clostridium difficile. | isolation of clostridium difficile from fecal specimens has been facilitated by the development of a selective and differential medium, cefoxitin-cycloserinefructose agar (ccfa). we substituted 0.1% sodium taurocholate for the 2.5% egg yolk in ccfa and compared the growth of 15 isolates of c. difficile on the resulting medium with growth on conventional ccfa. the taurocholate-containing medium (tccfa) quantitatively recovered vegetative forms of c. difficile in the same numbers as ccfa medium. r ... | 1982 | 7076817 |
| rapid identification of clostridium difficile by toxin detection. | rapid identification of clostridium difficile in a stool specimen could be accomplished within 24 h by detection of toxin elaborated in an agar or broth culture containing cycloserine and cefoxitin. broth culture seemed to give a more rapid and sensitive result than the agar plate culture. for cultivation of c. difficile in stool, we recommend the use of chopped meat broth and blood agar plate, the former for toxin detection in 1 to 2 days and the latter for colonial morphology and isolation of ... | 1982 | 7076819 |
| possible foodborne transmission in a case of pseudomembranous colitis due to clostridium difficile: influence of gastrointestinal secretions on clostridium difficile infection. | a 78-yr-old woman with a history of hypochlorhydria was found to have pseudomembranous colitis due to clostridium difficile. she had not received previous antimicrobial therapy. her onset of disease followed ingestion of possibly contaminated canned salmon, suggesting possible oral transmission of disease. we assessed the possibility of ingested clostridium difficile organisms or cytotoxin surviving passage through the upper gastrointestinal tract. normal gastric juice, hypochlorhydric gastric j ... | 1982 | 7084623 |
| effects of the two toxins of clostridium difficile in antibiotic-associated cecitis in hamsters. | hamsters were vaccinated with toxoids containing toxin a, toxin b, both toxins, or a preparation containing neither toxin of clostridium difficile, the causative agent of antibiotic-associated cecitis in hamsters and pseudomembranous colitis in humans. to determine whether these vaccines would reduce the severity of antibiotic-associated cecitis, the hamsters were injected subcutaneously with clindamycin. nearly all of the hamsters protected against neither toxin or only one toxin died. these an ... | 1982 | 7085078 |
| clostridium difficile and cytotoxin in routine faecal specimens. | over a five-month period 1239 unselected, routine faecal specimens from 856 patients were examined for clostridium difficile. one hundred specimens representing 69 patients were culture-positive. toxin was detected in the stool of ten. during the study period, there were 41 salmonella, 12 campylobacter and 9 shigella infections. c difficile was isolated together with salmonella from 12 patients. no patient required specific treatment for c difficile infection. the significance of these findings ... | 1982 | 7085901 |
| antimicrobial susceptibility of clostridium difficile from different sources. | a total of 79 clostridium difficile strains from healthy young and elderly adults, elderly patients without gastrointestinal disease, elderly patients receiving antibiotics without gastrointestinal complications, and elderly patients with antibiotic-associated diarrhea or pseudomembranous colitis were tested for their susceptibilities to 24 antimicrobial agents. all of the 79 strains were inhibited by low concentrations of rifampicin, metronidazole, fusidic acid, vancomycin, ampicillin, and peni ... | 1982 | 7087801 |