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Clostridium Difficile Toxin

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https://www.readbyqxmd.com/read/28721981/detection-of-clostridium-difficile-antigen-and-toxin-in-stool-specimens-comparison-of-the-c-difficile-quik-chek-complete-enzyme-immunoassay-and-genexpert-c-difficile-polymerase-chain-reaction-assay
#1
Abiola C Senok, Kamel M Aldosari, Rayan A Alowaisheq, Othman A Abid, Khalid A Alsuhaibani, Mohammad A Khan, Ali M Somily
BACKGROUND/AIMS: Accurate and rapid laboratory diagnosis of Clostridium difficile infections (CDI) remains a significant challenge. A two-step algorithm for detection of toxigenic C. difficile in stool based on initial screening for glutamate dehydrogenase assay followed by confirmation by toxin A+B detection using an enzyme immunoassay (EIA) or molecular assay has been proposed. We aimed to evaluate the C. difficile Quik Chek Complete® (QCC-EIA) versus the GeneXpert® C. difficile polymerase chain reaction (PCR) assay in this two-step algorithm...
July 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28707191/clostridium-difficile-colitis-and-colonoscopy-pediatric-perspective
#2
REVIEW
Randolph McConnie, Arthur Kastl
PURPOSE OF THE REVIEW: Review tests available for detection of Clostridium difficile (C. Diff) induced disease, including when such tests should be done in children and how they should be interpreted. RECENT FINDINGS: Multiple tests are available for detecting disease due to C. diff. These include colonoscopy and stool analysis. Colonoscopy with biopsy is the most sensitive test for detecting the presence of colitis. The toxins produced by the C. diff. (toxin A, toxin B, and binary toxin) are the agents that cause injury and disease...
August 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28705932/use-of-a-neutralizing-antibody-helps-identify-structural-features-critical-for-binding-of-clostridium-difficile-toxin-tcda-to-the-host-cell-surface
#3
Heather K Kroh, Ramyavardhanee Chandrasekaran, Kim Rosenthal, Rob Woods, Xiaofang Jin, Melanie D Ohi, Andrew C Nyborg, G Jonah Rainey, Paul Warrener, Benjamin W Spiller, D Borden Lacy
Clostridium difficile is a clinically significant pathogen that causes mild-to-severe (and often recurrent) colon infections. Disease symptoms stem from the activities of two large, multi-domain toxins known as TcdA and TcdB. The toxins can bind, enter, and perturb host cell function through a multi-step mechanism of receptor binding, endocytosis, pore formation, autoproteolysis, and glucosyltransferase-mediated modification of host substrates. Monoclonal antibodies that neutralize toxin activity provide a survival benefit in preclinical animal models and prevent recurrent infections in human clinical trials...
July 13, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28705583/prevalence-and-risk-factors-for-colonization-by-clostridium-difficile-and-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-rehabilitation-clinics-in-germany
#4
Mardjan Arvand, Claudia Ruscher, Gudrun Bettge-Weller, Markus Goltz, Yvonne Pfeifer
BACKGROUND: Rehabilitation clinics may vary widely in terms of type of care provided, duration of hospital stay, and case severity. Only few data are available on prevalence of Clostridium difficile or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) colonization in rehabilitation clinics in Germany. AIM: This study investigated the frequency of intestinal colonization by these pathogens among patients in rehabilitation clinics of different specialization...
July 10, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28704538/intestinal-calcium-and-bile-salts-facilitate-germination-of-clostridium-difficile-spores
#5
Travis J Kochan, Madeline J Somers, Alyssa M Kaiser, Michelle S Shoshiev, Ada K Hagan, Jessica L Hastie, Nicole P Giordano, Ashley D Smith, Alyxandria M Schubert, Paul E Carlson, Philip C Hanna
Clostridium difficile (C. difficile) is an anaerobic gram-positive pathogen that is the leading cause of nosocomial bacterial infection globally. C. difficile infection (CDI) typically occurs after ingestion of infectious spores by a patient that has been treated with broad-spectrum antibiotics. While CDI is a toxin-mediated disease, transmission and pathogenesis are dependent on the ability to produce viable spores. These spores must become metabolically active (germinate) in order to cause disease. C. difficile spore germination occurs when spores encounter bile salts and other co-germinants within the small intestine, however, the germination signaling cascade is unclear...
July 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28693926/high-in%C3%A2-vitro-activity-of-fidaxomicin-against-clostridium-difficile-isolates-from-a-university-teaching-hospital-in-china
#6
Jing-Wei Cheng, Qi-Wen Yang, Meng Xiao, Shu-Ying Yu, Meng-Lan Zhou, Timothy Kudinha, Fanrong Kong, Jian-Wei Liao, Ying-Chun Xu
BACKGROUND: Clostridium difficile infection (CDI) is a significant cause of morbidity and mortality in both the acute care setting and the wider healthcare system. The purpose of this study was to evaluate the in vitro activity of fidaxomicin against C.difficile isolates from a university teaching hospital in China. METHODS: One hundred and one C.difficile isolates were collected and analyzed for toxin genes by multiplex PCR. The toxin gene positive strains were also typed by multilocus sequence typing (MLST) and PCR-ribotyping...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28689671/detection-of-toxigenic-clostridium-difficile-in-paediatric-patients
#7
Iker Falces-Romero, Paloma Troyano-Hernáez, Silvia García-Bujalance, Fernando Baquero-Artigao, María José Mellado-Peña, Julio García-Rodríguez
INTRODUCTION: Our main objective was a revision of clinical, microbiological and epidemiological results of Clostridium difficile-associated infection in paediatric patients (2010-2015). We compared the diagnoses performed by detection of toxins in feces and those performed by real-time PCR. METHODS: This retrospective study included 82 paediatric patients. Detection of toxigenic C. difficile was performed sequentially, in diarrheal feces and under clinical request...
July 6, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28689506/description-and-validation-of-a-new-automated-surveillance-system-for-clostridium-difficile-in-denmark
#8
M Chaine, S Gubbels, M Voldstedlund, B Kristensen, J Nielsen, L P Andersen, S Ellermann-Eriksen, J Engberg, A Holm, B Olesen, H C Schønheyder, C Østergaard, S Ethelberg, K Mølbak
The surveillance of Clostridium difficile (CD) in Denmark consists of laboratory based data from Departments of Clinical Microbiology (DCMs) sent to the National Registry of Enteric Pathogens (NREP). We validated a new surveillance system for CD based on the Danish Microbiology Database (MiBa). MiBa automatically collects microbiological test results from all Danish DCMs. We built an algorithm to identify positive test results for CD recorded in MiBa. A CD case was defined as a person with a positive culture for CD or PCR detection of toxin A and/or B and/or binary toxin...
July 10, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28681203/increasing-incidence-of-clostridium-difficile-ribotype-001-associated-with-severe-course-of-the-infection-and-previous-fluoroquinolone-use-in-the-czech-republic-2015
#9
M Krutova, J Matejkova, P Drevinek, E J Kuijper, O Nyc
The aim of the study was to provide an update on the epidemiology of C. difficile infection (CDI) in a representative number of hospitals within the Czech Republic in 2015. In 2015, twenty-eight Czech hospitals were invited to participate in a CDI study. Laboratories sent the first 20 consecutive C. difficile isolates for characterization by capillary-electrophoresis (CE) ribotyping and the presence of toxin genes and collected patient data on previous hospitalization, antibiotic treatment, the number of CDI episodes and the course of CDI...
July 5, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28677344/cwp2-from-clostridium-difficile-exhibits-an-extended-three-domain-fold-and-cell-adhesion-in-vitro
#10
William J Bradshaw, Jonathan M Kirby, April K Roberts, Clifford C Shone, K Ravi Acharya
Colonisation of the gut by Clostridium difficile requires the adhesion of the bacterium to host cells. A range of cell surface located factors have been linked to adhesion including the S-layer protein LMW SLP and the related protein Cwp66. As well as these proteins, the S-layer of C. difficile may contain around thirty others. One such protein is Cwp2. Here, we demonstrate the production of a C. difficile strain 630 cwp2 knockout mutant and assess the effect on the bacterium. The mutant results in increased TcdA (toxin A) release and impaired cellular adherence in vitro...
July 4, 2017: FEBS Journal
https://www.readbyqxmd.com/read/28669616/clostridium-difficile-chimeric-toxin-receptor-binding-domain-vaccine-induced-protection-against-different-strains-in-active-and-passive-challenge-models
#11
Jing-Hui Tian, Gregory Glenn, David Flyer, Bin Zhou, Ye Liu, Eddie Sullivan, Hua Wu, James F Cummings, Larry Elllingsworth, Gale Smith
Clostridium difficile is the number one cause of nosocomial antibiotic-associated diarrhea in developed countries. Historically, pathogenesis was attributed two homologous glucosylating toxins, toxin-A (TcdA) and toxin-B (TcdB). Over the past decade, however, highly virulent epidemic strains of C. difficile (B1/NAP1/027) have emerged and are linked to an increase in morbidity and mortality. Increased virulence is attributed to multiple factors including: increased production of A- and B-toxins; production of binary toxin (CDT); and the emergence of more toxic TcdB variants (TcdB(027))...
July 24, 2017: Vaccine
https://www.readbyqxmd.com/read/28662012/fatal-course-of-takotsubo-cardiomyopathy-in-a-female-with-recurrent-clostridium-difficile-infection
#12
Waldemar Elikowski, Małgorzata Małek-Elikowska, Monika Lisiecka, Iwona Mozer-Lisewska
Among diverse triggering factors of stress-induced takotsubo cardiomyopathy (TC), a viral or bacterial infection is rarely observed. Sepsis is an exception, regardless of the etiologic pathogen, in which case an excess of catecholamines may result in acute left ventricular dysfunction. TC precipitated by Clostridium difficile infection (CDI) has been reported only in two patients so far. A CASE REPORT: The authors describe another case of TC triggered this time by recurrent C. difficile colitis which occurred in a 72-yearold female...
June 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28657883/clostridium-difficile-toxin-biology
#13
Klaus Aktories, Carsten Schwan, Thomas Jank
Clostridium difficile is the cause of antibiotics-associated diarrhea and pseudomembranous colitis. The pathogen produces three protein toxins: C. difficile toxins A (TcdA) and B (TcdB), and C. difficile transferase toxin (CDT). The single-chain toxins TcdA and TcdB are the main virulence factors. They bind to cell membrane receptors and are internalized. The Nterminal glucosyltransferase and autoprotease domains of the toxins translocate from low-pH endosomes into the cytosol. After activation by inositol hexakisphosphate (InsP6), the autoprotease cleaves and releases the glucosyltransferase domain into the cytosol, where GTP-binding proteins of the Rho/Ras family are mono-O-glucosylated and, thereby, inactivated...
June 28, 2017: Annual Review of Microbiology
https://www.readbyqxmd.com/read/28655582/prevalence-of-clostridium-perfringens-toxin-in-patients-suspected-of-having-antibiotic-associated-diarrhea
#14
Young Jin Kim, Si Hyun Kim, Junggu Ahn, Soongmoon Cho, Dongchun Kim, Kwanghyun Kim, Heegun Lee, Hyunwoo Son, Hee Joo Lee, Dongeun Yong, Jun Yong Choi, Hye Ran Kim, Jeong Hwan Shin
BACKGROUND: Although Clostridium perfringens has been reported as a cause of antibiotic-associated diarrhea (AAD), it is uncommon to detect this pathogen in clinical microbiology laboratories in Korea. The aim of this study was to investigate the prevalence of C. perfringens toxin in patients suspected of having AAD. METHODS: A total of 135 stool specimens submitted to a clinical microbiology laboratory for C. difficile toxin assay were tested. We tried to detect both C...
June 26, 2017: Anaerobe
https://www.readbyqxmd.com/read/28652311/a-nutrient-regulated-cyclic-diguanylate-phosphodiesterase-controls-clostridium-difficile-biofilm-and-toxin-production-during-stationary-phase
#15
Erin B Purcell, Robert W McKee, David S Courson, Elizabeth M Garrett, Shonna M McBride, Richard E Cheney, Rita Tamayo
The signaling molecule cyclic diguanylate (c-di-GMP) mediates physiological adaptation to extracellular stimuli in a wide range of bacteria. The complex metabolic pathways governing c-di-GMP synthesis and degradation are highly regulated, but the specific cues that impact c-di-GMP signaling are largely unknown. In the intestinal pathogen Clostridium difficile, c-di-GMP inhibits flagellar motility and toxin production, and promotes pilus-dependent biofilm formation, but no specific biological functions have been ascribed to any of the individual c-di-GMP synthases or phosphodiesterases...
June 26, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28642147/the-role-of-tigecycline-in-the-management-of-clostridium-difficile-infection-a-retrospective-cohort-study
#16
Eliza Manea, Jesús Sojo-Dorado, Raluca E Jipa, Serban N Benea, Jesús Rodríguez-Baño, Adriana Hristea
OBJECTIVE: We aimed to compare the outcomes of patients with C.difficile infection (CDI) treated either with tigecycline associated with vancomycin, or with vancomycin alone. METHODS: This single-centre retrospective cohort study included all adults hospitalized from September 2014 through August 2015 for symptomatic, incident CDI confirmed by polymerase chain reaction for C.difficile toxin in stools. The primary outcome was the rate of favourable outcome, defined as a composite of clinical response (resolution of symptoms without need for additional CDI therapy) and achieving discharge without CDI-related surgery or intensive care; a secondary outcome was CDI recurrence...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28641091/increasing-rates-of-clostridium-difficile-infection-in-mexican-hospitals
#17
Laura Palau Dávila, Elvira Garza-González, Patricia Rodríguez-Zulueta, Rayo Morfín-Otero, Eduardo Rodríguez-Noriega, Diana Villar-Compte, Juan C Rodríguez-Aldama, Adrián Camacho-Ortiz
INTRODUCTION: The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world. METHODS: This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis...
June 19, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28636484/bezlotoxumab-anti-toxin-b-monoclonal-antibody-to-prevent-recurrence-of-clostridium-difficile-infection
#18
Javier A Villafuerte Gálvez, Ciarán P Kelly
Clostridium difficile infection (CDI) is the most common nosocomial infection in the U.S. 25% of CDI patients go on to develop recurrent CDI (rCDI) following current standard of care (SOC) therapy, leading to morbidity, mortality and economic loss. The first passive immunotherapy drug targeting C.difficile toxin B (bezlotoxumab) has been approved recently by the FDA and EMA for prevention of rCDI. Areas covered: A body of key studies was selected and reviewed by the authors. The unmet needs in CDI care were ascertained with emphasis in rCDI, including the epidemiology, pathophysiology and current management...
July 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28636257/covalent-attachment-and-pro-pro-endopeptidase-ppep-1-mediated-release-of-clostridium-difficile-cell-surface-proteins-involved-in-adhesion
#19
REVIEW
Jeroen Corver, Valentina Cordo', Hans C van Leeuwen, Oleg I Klychnikov, Paul J Hensbergen
In the past decade, Clostridium difficile has emerged as an important gut pathogen. This anaerobic, Gram-positive bacterium is the main cause of infectious nosocomial diarrhea. Whereas much is known about the mechanism through which the C. difficile toxins cause diarrhea, relatively little is known about the dynamics of adhesion and motility, which is mediated by cell surface proteins. This review will discuss the recent advances in our understanding of the sortase-mediated covalent attachment of cell surface (adhesion) proteins to the peptidoglycan layer of C...
June 21, 2017: Molecular Microbiology
https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#20
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
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