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Clostridium Difficile Toxin

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https://www.readbyqxmd.com/read/29349705/stool-cultures-at-the-icu-get-rid-of-it
#1
Carolin F Manthey, Darja Dranova, Martin Christner, Laura Berneking, Stefan Kluge, Ansgar W Lohse, Valentin Fuhrmann
BACKGROUND: Stool cultures for Campylobacter, Salmonella and Shigella and/or Yersinia spp. are frequently ordered in critically ill patients with diarrhea. The aim of this study is to analyze the diagnostic yield in a large cohort of critically ill patients. Therefore, we performed a cohort study at the Department of Intensive Care Medicine of a University Hospital (11 ICUs). RESULTS: From all patients who were admitted to the ICU between 2010 and 2015, stool cultures were taken from 2...
January 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29339424/clostridium-sordellii-pathogenicity-locus-plasmid-pcs1-1-encodes-a-novel-clostridial-conjugation-locus
#2
Callum J Vidor, Thomas D Watts, Vicki Adams, Dieter Bulach, Edward Couchman, Julian I Rood, Neil F Fairweather, Milena Awad, Dena Lyras
A major virulence factor in Clostridium sordellii-mediated infection is the toxin TcsL, which is encoded within a region of the genome called the pathogenicity locus (PaLoc). C. sordellii isolates carry the PaLoc on the pCS1 family of plasmids, of which there are four characterized members. Here, we determined the potential mobility of pCS1 plasmids and characterized a fifth unique pCS1 member. Using a derivative of the pCS1-1 plasmid from strain ATCC 9714 which had been marked with the ermB erythromycin resistance gene, conjugative transfer into a recipient C...
January 16, 2018: MBio
https://www.readbyqxmd.com/read/29336928/tackling-the-recurrence-of-clostridium-difficile-infection
#3
REVIEW
N Petrosillo
The pathogenesis of recurrent Clostridium difficile infection (CDI) is still poorly understood. The risk of recurrence is approximately 20% after an initial CDI episode and dramatically increases with subsequent CDI recurrences. Several factors may play a role in recurrent CDI (rCDI), including conditions influencing germination, metabolic pathways that influence toxin production of C. difficile, and the microbiota composition offering protection against colonization and disease caused by C. difficile. Paradoxically, the currently recommended treatment for acute symptomatic CDI, i...
January 11, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29331267/identification-and-initial-optimization-of-inhibitors-of-clostridium-difficile-c-difficile-toxin-b-tcdb
#4
Jeffrey J Letourneau, Ilana L Stroke, David W Hilbert, Laurie J Sturzenbecker, Brett A Marinelli, Jorge G Quintero, Joan Sabalski, Linh Ma, David J Diller, Philip D Stein, Maria L Webb
The discovery, synthesis and preliminary structure-activity relationship (SAR) of a novel class of inhibitors of Clostridium difficile (C. difficile) toxin B (TcdB) is described. A high throughput screening (HTS) campaign resulted in the identification of moderately active screening hits 1-5 the most potent of which was compound 1 (IC50 = 0.77 µM). In silico docking of an early analog offered suggestions for structural modification which resulted in the design and synthesis of highly potent analogs 13j(IC50 = 1 nM) and 13 l(IC50 = 7 nM) which were chosen as leads for further optimization...
January 5, 2018: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/29317259/adherence-to-contact-precautions-among-different-types-of-healthcare-workers-through-video-monitoring-in-a-tertiary-hospital
#5
Yuichi Katanami, Kayoko Hayakawa, Takeshi Shimazaki, Yuko Sugiki, Saho Takaya, Kei Yamamoto, Satoshi Kutsuna, Yasuyuki Kato, Norio Ohmagari
BACKGROUND: Contact precautions are required to prevent transmission of multidrug-resistant organisms; however, reports on adherence rates vary. Through video monitoring, we evaluated adherence to the use of personal protective equipment (PPE) among different types of healthcare workers. METHODS: This study was an observational study conducted in a 781-bed tertiary hospital from July 2016 to March 2017. We installed cameras in areas where staff don PPE. Infection control teams observed the videos and assessed adherence rates...
January 6, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29289484/what-do-we-know-about-the-diagnostics-treatment-and-epidemiology-of-clostridioides-clostridium-difficile-infection-in-europe
#6
REVIEW
Elisabeth Nagy
Clostridium difficile, recently reclassified as Clostridioides difficile is responsible for a significant part of diarrheal diseases in the hospitals and in the community. Besides the main pathogenic factors, toxin A, toxin B and the binary toxin, several other putative virulence factors have been investigated. This manuscript summarize recent findings in Europe concerning source of infection, epidemiology of CDI, the changing pattern of PCR ribotypes of C. difficile strains in different European countries, recommendations for diagnosis and treatment of CDI...
December 27, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29285574/clostridium-difficile-related-postinfectious-ibs-a-case-of-enteroglial-microbiological-stalking-and-or-the-solution-of-a-conundrum
#7
EDITORIAL
Gabrio Bassotti, Lara Macchioni, Lanfranco Corazzi, Pierfrancesco Marconi, Katia Fettucciari
Post-infectious irritable bowel syndrome is a well-defined pathological entity that develops in about one-third of subjects after an acute infection (bacterial, viral) or parasitic infestation. Only recently it has been documented that an high incidence of post-infectious irritable bowel syndrome occurs after Clostridium difficile infection. However, until now it is not known why in some patients recovered from this infection the gastrointestinal disturbances persist for months or years. Based on our in vitro studies on enteric glial cells exposed to the effects of C...
December 28, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/29247010/cell-penetrating-peptides-derived-from-clostridium-difficile-tcdb2-and-a-related-large-clostridial-toxin
#8
Jason L Larabee, Garrett D Hauck, Jimmy D Ballard
Clostridium difficile TcdB (2366 amino acid residues) is an intracellular bacterial toxin that binds to cells and enters the cytosol where it glucosylates small GTPases. In the current study, we examined a putative cell entry region of TcdB (amino acid residues 1753-1851) for short sequences that function as cell penetrating peptides (CPPs). To screen for TcdB-derived CPPs, a panel of synthetic peptides were tested for the ability to enhance transferrin (Tf) association with cells. Four candidate CPPs were discovered and further study on one peptide (PepB2) pinpointed an asparagine residue necessary for CPP activity...
December 15, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29238589/cannabidiol-restores-intestinal-barrier-dysfunction-and-inhibits-the-apoptotic-process-induced-by-clostridium-difficile-toxin-a-in-caco-2-cells
#9
Stefano Gigli, Luisa Seguella, Marcella Pesce, Eugenia Bruzzese, Alessandra D'Alessandro, Rosario Cuomo, Luca Steardo, Giovanni Sarnelli, Giuseppe Esposito
Background: Clostridium difficile toxin A is responsible for colonic damage observed in infected patients. Drugs able to restore Clostridium difficile toxin A-induced toxicity have the potential to improve the recovery of infected patients. Cannabidiol is a non-psychotropic component of Cannabis sativa, which has been demonstrated to protect enterocytes against chemical and/or inflammatory damage and to restore intestinal mucosa integrity. Objective: The purpose of this study was to evaluate (a) the anti-apoptotic effect and (b) the mechanisms by which cannabidiol protects mucosal integrity in Caco-2 cells exposed to Clostridium difficile toxin A...
December 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29237788/naat-quantitation-as-predictor-of-toxin-presence-in-clostridium-difficile-infection
#10
M J T Crobach, N Duszenko, E M Terveer, C M Verduin, E J Kuijper
Multi-step algorithmic testing in which a sensitive nucleic acid amplification test (NAAT) is followed by a specific toxin A and B Enzyme Immunoassay (Tox A/B EIA) is among the most accurate methods for Clostridium difficile infection (CDI) diagnosis. The obvious shortcoming of this approach is that multiple tests must be performed to establish a CDI diagnosis, which may delay treatment. As such, we sought to determine whether a preliminary diagnosis could be made on the basis of the quantitative result of the first test in algorithmic testing, which provides a measure of organism burden...
December 13, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29237206/-piperacillin-tazobactam-shortage-central-restriction-and-alternative-recommendations-as-effective-antibiotic-stewardship-intervention-at-a-maximal-care-hospital
#11
Johanna Kessel, Barbara Dolff, Thomas Wichelhaus, Nils Keiner, Michael Hogardt, Claudia Reinheimer, Imke Wieters, Sebastian Harder, Volkhard A J Kempf, Christoph Stephan
Background Drug supply bottleneck is a worldwide challenge, e. g. the antibiotics Piperacillin/Tazobactam shortage in 2016/2017. The efficacy of an appropriate replacement management was evaluated at the University Hospital Frankfurt (UHF). Methods The Antibiotic-Stewardship (ABS)-Team at UHF decreed a restriction of PIP/TAZ and provided alternative antibiotic therapy recommendations during the shortage period. Consequences of this intervention on antibiotic consumption and overall costs were investigated...
December 13, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29236304/enterovirus-detection-in-patients-with-acute-gastroenteritis-in-switzerland
#12
Rainer Gosert, Ulrich Heininger, Hans H Hirsch
Acute gastroenteritis (GE) has a major impact on morbidity and mortality worldwide, yet comprehensive data regarding infectious agents including enteroviruses are scarce. We hypothesized that enteroviruses constitute a significant cause of acute GE. We analyzed 677 stool samples from 504 patients, which had been submitted for suspected infectious GE. 0.2 ml of stool suspension was extracted using the Abbott m2000 sp robot and analysed by multiplex nucleic acid testing (NAT) using the Luminex xTAG gastrointestinal pathogen panel (GPP) as well as by specific NATs detecting enteroviruses and polioviruses...
December 13, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/29229281/potential-of-real-time-pcr-threshold-cycle-ct-to-predict-presence-of-free-toxin-and-clinically-relevant-c-difficile-infection-cdi-in-patients-with-cancer
#13
Mini Kamboj, Jennifer Brite, Tracy McMillen, Elizabeth Robilotti, Alejandro Herrera, Kent Sepkowitz, N Esther Babady
OBJECTIVES: Clostridium difficile infection (CDI) is a toxin-mediated disease. Oncology patients are at increased risk for developing CDI. Diagnosis of CDI by PCR has led to misclassification of some C. difficile carriers as CDI cases. We determined if an optimized C. difficile PCR cycle threshold value (CT) could reliably predict presence of free toxin, and in turn improve the utility of PCR in detecting clinically relevant CDI in oncology patients. METHODS: 183 consecutive patients positive for C...
December 8, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29229019/clostridium-difficile-epidemiology-pathogenicity-and-an-update-on-the-limitations-of-and-challenges-in-its-diagnosis
#14
Abdullah A Alyousef
The bacterium originally named Bacillus difficilis was later renamed Clostridium difficile because of the difficulty associated with its isolation in the laboratory. C. difficile causes human-associated diarrhea, which is now known as C. difficile infection (CDI), a major cause of nosocomial infection mainly occurring in developed countries. Changes in antibiotic patterns in its strains produce toxins that are responsible for the high mortality rates associated with CDI; therefore, the epidemiology and severity of CDI have recently changed...
December 12, 2017: Journal of AOAC International
https://www.readbyqxmd.com/read/29218569/toxin-positivity-and-tcdb-gene-load-in-broad-spectrum-clostridium-difficile-infection
#15
Hyeong Nyeon Kim, Hanah Kim, Hee-Won Moon, Mina Hur, Yeo-Min Yun
PURPOSE: This study aimed to evaluate the clinical significance of toxin positivity and toxin gene load, and the relation between them in the broad spectrum of Clostridium difficile infection (CDI) including colonization, significant diarrhea, and severe disease. METHODS: We included 2671 fecal samples submitted for CDI diagnosis and 180 samples from healthy individuals. The clinical spectrum was categorized as category I (toxigenic C. difficile positive without clinical CDI criteria), category II (mild CDI), and category III (severe CDI)...
December 7, 2017: Infection
https://www.readbyqxmd.com/read/29213333/comparative-genomic-analysis-of-clostridium-difficile-ribotype-027-strains-including-the-newly-sequenced-strain-nckuh-21-isolated-from-a-patient-in-taiwan
#16
Haruo Suzuki, Masaru Tomita, Pei-Jane Tsai, Wen-Chien Ko, Yuan-Pin Hung, I-Hsiu Huang, Jenn-Wei Chen
Background: Clostridium difficile is a Gram-positive anaerobe and the leading cause of antibiotic-associated diarrhea worldwide. The emergence of ribotype 027 (RT027) strains is associated with increased incidence of infection and mortality. To further understand the relationship between C. difficile NCKUH-21, a RT027 strain isolated from a patient in Taiwan, and other RT027 strains, we performed whole-genome shotgun sequencing on NCKUH-21 and comparative genomic analyses. Results: The genome size, G+C content, and gene number for the NCKUH-21 strain were determined to be similar to those for other C...
2017: Gut Pathogens
https://www.readbyqxmd.com/read/29207702/nagging-presence-of-clostridium-difficile-associated-diarrhoea-in-north-india
#17
Rama Chaudhry, Nidhi Sharma, Nitin Gupta, Kamla Kant, Tej Bahadur, Trupti M Shende, Lalit Kumar, Sushil K Kabra
Introduction: Clostridium Difficile Associated Diarrhoea (CDAD) is a significant cause of morbidity in hospitalised patients worldwide. The data on clinical epidemiology of this disease in Indian subcontinent is scarce. Aim: To evaluate the risk factors and clinical course of patients with CDAD. Materials and Methods: A cross-sectional study was planned at our tertiary care centre, All India Institute of Medical Sciences, whereby, all patients who had nosocomial diarrhea between 2010 and 2014 were included in the study...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29201180/rapid-visual-detection-of-binary-toxin-producing-clostridium-difficile-by-loop-mediated-isothermal-amplification
#18
Lan Yu, Huan Li, Xiangna Zhao, Xuesong Wang, Xiao Wei, Weishi Lin, Puyuan Li, Lihong Cui, Jing Yuan
The binary toxin Clostridium difficile transferase (CDT) is frequently observed in C. difficile strains and is associated with an increased severity of C. difficile infection. CDT-producing C. difficile infections cause higher fatality rates than infections with CDT negative isolates. Thus, the rapid and accurate identification of a CDT positive C. difficile infection is critical for effective treatment. The present study demonstrates how loop-mediated isothermal amplification (LAMP) can be used to detect CDT-producing C...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29195778/epidemiology-and-risk-factors-for-clostridium-difficile-associated-diarrhea-in-adult-inpatients-in-a-university-hospital-in-china
#19
Chenjie Tang, Yang Li, Chengcheng Liu, Pengfei Sun, Xu Huang, Wenying Xia, Huimin Qian, Lunbiao Cui, Genyan Liu
BACKGROUND: Clostridium difficile-associated diarrhea (CDAD) is an important disease with rising incidence and mortality in western countries. However, studies about CDAD in China are limited. The aims of this study are to investigate the epidemiology and risk factors of CDAD in a university hospital located in Eastern China. METHODS: Diarrhea samples of all adult inpatients were collected for C difficile culture prospectively from August 2013-April 2014. Suspected colonies were identified by biochemical identification cards...
November 28, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29193458/high-prevalence-of-clostridium-difficile-on-retail-root-vegetables-western-australia
#20
S C Lim, N F Foster, B Elliott, T V Riley
AIMS: The incidence of community-associated Clostridium difficile infection (CA-CDI) in Australia has increased since mid-2011. With reports of clinically important C. difficile strains being isolated from retail foods in Europe and North America, a foodborne source of C. difficile in cases of CA-CDI is a possibility. This study represents the first to investigate the prevalence and genotypes of C. difficile in Australian retail vegetables. METHODS AND RESULTS: A total of 300 root vegetables grown in Western Australia (WA) were collected from retail stores and farmers' markets...
November 28, 2017: Journal of Applied Microbiology
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