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Clostridium Difficile Toxin

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https://www.readbyqxmd.com/read/28089100/community-onset-clostridium-difficile-infection-at-a-tertiary-medical-center-in-southern-taiwan-2007-2015
#1
Chin-Shiang Tsai, Yuan-Pin Hung, Jen-Chieh Lee, Nan-Yao Lee, Po-Lin Chen, Ling-Shan Syue, Ming-Chi Li, Chia-Wen Li, Wen-Chien Ko
BACKGROUND: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. METHODS: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI)...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28077697/point-counterpoint-what-is-the-optimal-approach-for-detection-of-clostridium-difficile-infection
#2
Ferric C Fang, Christopher R Polage, Mark H Wilcox
In 2010, we published an initial point-counterpoint on laboratory diagnosis of C. difficile infection (CDI). At that time, nucleic acid amplification tests (NAATs) were just becoming commercially available, and the idea of algorithmic approaches to CDI was being explored. Now there are numerous NAATs in the marketplace and based on recent proficiency test surveys, they have become the predominant method used for CDI diagnosis in the United States. At the same time, there is a body of literature that suggests that NAATs lack clinical specificity and thus inflate CDI rates...
January 11, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28075419/surveillance-of-clostridium-difficile-infections-results-from-a-six-year-retrospective-study-in-nine-hospitals-of-a-north-italian-local-health-authority
#3
Greta Roncarati, Laura Dallolio, Erica Leoni, Manuela Panico, Angela Zanni, Patrizia Farruggia
Clostridium difficile is an emerging cause of healthcare associated infections. In nine hospitals of an Italian Local Health Authority the episodes of C. difficile infection (CDI) were identified using the data registered by the centralized Laboratory Information System, from 2010 to 2015. CDI incidence (positive patients for A and/or B toxins per patients-days) was analysed per year, hospital, and ward. A number of cases approximately equivalent to the mean of identified cases per year were studied retrospectively to highlight the risk factors associated to CDI and their severity...
January 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28060346/cefoperazone-treated-mouse-model-of-clinically-relevant-clostridium-difficile-strain-r20291
#4
Jenessa A Winston, Rajani Thanissery, Stephanie A Montgomery, Casey M Theriot
Clostridium difficile is an anaerobic, gram-positive, spore-forming enteric pathogen that is associated with increasing morbidity and mortality and consequently poses an urgent threat to public health. Recurrence of a C. difficile infection (CDI) after successful treatment with antibiotics is high, occurring in 20-30% of patients, thus necessitating the discovery of novel therapeutics against this pathogen. Current animal models of CDI result in high mortality rates and thus do not approximate the chronic, insidious disease manifestations seen in humans with CDI...
December 10, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28054368/acid-suppression-medications-and-bacterial-gastroenteritis-a-population-based-cohort-study
#5
Li Wei, Lasantha Ratnayake, Gabby Phillips, Chris C McGuigan, Steve V Morant, Robert W Flynn, Isla S Mackenzie, Thomas M MacDonald
AIMS: To investigate whether acid suppression medicines (ASMs) increase the risk of bacterial gastroenteritis. METHODS: A population-based, propensity-score matched cohort study using a record-linkage database in Tayside, Scotland. The study consisted of 188,323 exposed to ASMs [proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RA)] and 376,646 controls (a propensity-score matched cohort from the rest of population who were not exposed to ASMs) between 1999 and 2013...
January 5, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28054289/procalcitonin-is-a-poor-predictor-of-non-infectious-fever-in-the-neurocritical-care-unit
#6
Karin Halvorson, Sameer Shah, Corey Fehnel, Bradford Thompson, N Stevenson Potter, Mitchell Levy, Linda Wendell
BACKGROUND: Fever is a common occurrence in the Neurocritical Care Unit (NCCU). It is reported that up to 50 % of these fevers are associated with a non-infectious source. As this is a diagnosis of exclusion, a complete fever evaluation must be done to rule out infection. Procalcitonin (PCT) has been identified as a possible biomarker to distinguish infectious from non-infectious etiologies of fever. We hypothesized that PCT could be used as a predictor of infectious fever in febrile patients with intracranial hemorrhage admitted to the NCCU...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28031436/comparative-genome-analysis-and-global-phylogeny-of-the-toxin-variant-clostridium-difficile-pcr-ribotype-017-reveals-the-evolution-of-two-independent-sub-lineages
#7
M D Cairns, M D Preston, C L Hall, D N Gerding, P M Hawkey, H Kato, H Kim, E J Kuijper, T D Lawley, H Pituch, S Reid, B Kullin, T V Riley, K Solomon, P J Tsai, J S Weese, R A Stabler, B W Wren
The diarrhoeal pathogen Clostridium difficile consists of at least six distinct evolutionary lineages. The RT017 lineage is anomalous as strains only express toxin B, compared to strains from other lineages that produce toxins A and B and occasionally binary toxin. Historically, RT017 were initially reported in Asia but have now been reported worldwide. We used whole genome sequencing and phylogenetic analysis to investigate the patterns of global spread and population structure of 277 RT017 isolates from animal and human origins from six continents, isolated between 1990 and 2013...
December 28, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28025502/role-of-p38alpha-beta-map-kinase-in-cell-susceptibility-to-clostridium-sordellii-lethal-toxin-and-clostridium-difficile-toxin-b
#8
Ilona Schelle, Janina Bruening, Mareike Buetepage, Harald Genth
Lethal Toxin from Clostridium sordellii (TcsL), which is casually involved in the toxic shock syndrome and in gas gangrene, enters its target cells by receptor-mediated endocytosis. Inside the cell, TcsL mono-O-glucosylates and thereby inactivates Rac/Cdc42 and Ras subtype GTPases, resulting in actin reorganization and an activation of p38 MAP kinase. While a role of p38 MAP kinase in TcsL-induced cell death is well established, data on a role of p38 MAP kinase in TcsL-induced actin reorganization are not available...
December 22, 2016: Toxins
https://www.readbyqxmd.com/read/28002482/clinical-characteristics-and-treatment-outcomes-of-clostridium-difficile-infections-by-pcr-ribotype-017-and-018-strains
#9
Jieun Kim, Yeonjae Kim, Hyunjoo Pai
The objective of this study was to identify the clinical characteristics of Clostridium difficile infections (CDIs) caused by toxin A-negative/toxin B-positive (A-B+) PCR ribotype 017 (R017) and A+B+ ribotype 018 (R018) strains, prevalent in Asian countries. From February 2010 through January 2013, all CDI patients in our hospital were enrolled; their medical records were retrospectively reviewed, and the isolates were characterized by toxigenic culture and PCR ribotyping. Based on the ribotypes, a total of 510 cases were categorized as R017 (139, 27...
2016: PloS One
https://www.readbyqxmd.com/read/27999606/traditional-chinese-medicine-qpyf-as-preventive-treatment-for-clostridium-difficile-associated-diarrhea-in-a-mouse-model
#10
Guo Ya-Nan, Wang Jun, Zhang Hao-Jun, Jia Hong-Bing, Li Ping, Liu Xin-Zhu
Traditional Chinese medicine QPYF has a good effect for treating antibiotic-associated diarrhea in clinical practice. The aim of this study is to test its efficacy to prevent Clostridium difficile associated diarrhea (CDAD) in a mouse model. C57BL/6 mice were infected with Clostridium difficile VPI 10463 after exposure to antimicrobial mixture. QPYF was administered from 7 days prior to Clostridium difficile infection to 20 days after infection, and its effect was compared with no treatment and receiving placebo...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/27997854/the-emerging-metabolic-view-of-clostridium-difficile-pathogenesis
#11
REVIEW
Andrew J Hryckowian, Kali M Pruss, Justin L Sonnenburg
It is widely accepted that Clostridium difficile exploits dysbiosis and leverages inflammation to thrive in the gut environment, where it can asymptomatically colonize humans or cause a toxin-mediated disease ranging in severity from frequent watery diarrhea to pseudomembranous colitis or toxic megacolon. Here, we synthesize recent findings from the gut microbiota and enteric pathogenesis fields to inform the next steps toward a better understanding of C. difficile infection (CDI). In this review, we present a model in which the lifestyle of C...
December 17, 2016: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/27990723/presence-of-clostridium-difficile-in-pig-faecal-samples-and-wild-animal-species-associated-with-pig-farms
#12
S Andrés-Lasheras, R Bolea, R C Mainar-Jaime, E Kuijper, E Sevilla, I Martín-Burriel, M Chirino-Trejo
AIMS: To determine the presence of Clostridium difficile on fattening pig farms in north-eastern Spain. METHODS AND RESULTS: Twenty-seven farms were sampled. Pools of pig faecal samples (n = 210), samples of intestinal content from common farm pest species (n = 95) and environment-related samples (n = 93) were collected. Isolates were tested for toxin genes of C. difficile, and typed by PCR-ribotyping and toxinotyping. The minimal inhibitory concentrations of six antimicrobial agents were determined using Etest...
November 5, 2016: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/27990343/homogeneous-and-digital-proximity-ligation-assays-for-the-detection-of-clostridium-difficile-toxins-a-and-b
#13
Harvinder S Dhillon, Gemma Johnson, Mark Shannon, Christina Greenwood, Doug Roberts, Stephen Bustin
BACKGROUND: The proximity ligation assay (PLA) detects proteins via their interaction with pairs of proximity probes, which are antibodies coupled to noncomplementary DNA oligonucleotides. The binding of both proximity probes to their epitopes on the target protein brings the oligonucleotides together, allowing them to be bridged by a third oligonucleotide with complementarity to the other two. This enables their ligation and the detection of the resulting amplicon by real-time quantitative PCR (qPCR), which acts as a surrogate marker for the protein of interest...
December 2016: Biomolecular Detection and Quantification
https://www.readbyqxmd.com/read/27986664/clinical-and-microbiological-characteristics-of-clostridium-difficile-infection-among-hospitalized-children-in-the-netherlands
#14
Sofie M van Dorp, Edela Smajlović, Cornelis W Knetsch, Daan W Notermans, Sabine C de Greeff, Ed J Kuijper
BACKGROUND: Little is known about pediatric Clostridium difficile infection (CDI) epidemiology. We describe the clinical and microbiological characteristics of CDI among hospitalized children in the Netherlands. METHODS: Between May 2009 and May 2015, 26 hospitals registered characteristics of pediatric (aged 2-18 years) and adult (aged 18 years) CDI in a national sentinel surveillance study. Routine polymerase chain reaction (PCR) ribotyping and multiple-locus variable-number tandem-repeat analysis (MLVA) of selected strains was performed...
October 19, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27984397/donor-screening-experience-for-fecal-microbiota-transplantation-in-patients-with-recurrent-c-difficile-infection
#15
Raseen Tariq, Renee Weatherly, Patricia Kammer, Darrell S Pardi, Sahil Khanna
GOALS: To evaluate our experience with stool donor recruitment, screening, retention, and donor perception for fecal microbiota transplantation (FMT). BACKGROUND: Multiply recurrent Clostridium difficile infection is being increasingly managed with FMT from donor stools. However, donor selection and recruitment is challenging due to lack of standard evidence-based guidelines, donor exclusion criteria, frequency of screening and donor commitment. METHODS: Data on donors screened using institutional guidelines with history, blood and stool testing and their perspectives on donation were analyzed...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27981237/dipicolinic-acid-release-by-germinating-clostridium-difficile-spores-occurs-through-a-mechanosensing-mechanism
#16
Michael B Francis, Joseph A Sorg
Classically, dormant endospores are defined by their resistance properties, particularly their resistance to heat. Much of the heat resistance is due to the large amount of dipicolinic acid (DPA) stored within the spore core. During spore germination, DPA is released and allows for rehydration of the otherwise-dehydrated core. In Bacillus subtilis, 7 proteins are encoded by the spoVA operon and are important for DPA release. These proteins receive a signal from the activated germinant receptor and release DPA...
November 2016: MSphere
https://www.readbyqxmd.com/read/27977555/recurrent-clostridium-difficile-infection-in-children-patient-risk-factors-and-markers-of-intestinal-inflammation
#17
Maribeth R Nicholson, Jonathan D Crews, Jeffrey R Starke, Zhi-Dong Jiang, Herbert DuPont, Kathryn Edwards
BACKGROUND: The management of Clostridium difficile infection (CDI) in children is complicated by recurrence rates of 20-30%. The identification of risk factors associated with recurrent disease might allow early recognition of those children at highest risk. METHODS: Pediatric patients with CDI were identified through clinical laboratory records at two tertiary care children's hospitals from March 2013 through May 2014. Subjects were enrolled and followed for 60 days to assess for recurrent CDI (rCDI)...
December 12, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27974547/molecular-epidemiology-of-clostridium-difficile-infection-in-hospitalized-patients-in-eastern-china
#18
Dazhi Jin, Yun Luo, Chen Huang, Jian Cai, Julian Ye, Yi Zheng, Liqian Wang, Peng Zhao, Anbing Liu, Weijia Fang, Xianjun Wang, Shichang Xia, Jianmin Jiang, Yi-Wei Tang
Few studies on risk factors and transmission of Clostridium difficile infection (CDI) have been reported from China. A cross-sectional study was conducted for three years in Eastern China. Consecutive stool specimens from hospitalized patients with diarrhea were cultured for C. difficile C. difficle isolates from these patients then were analyzed for toxin genes, genotypes and antimicrobial resistance. Severity of CDI was determined in each patient by a blinded review of the medical record and ranged from 1 to 6...
December 14, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27957599/evaluation-of-the-biofire-filmarray%C3%A2-gastrointestinalpanel-in-a-midwestern-academic-hospital
#19
C N Murphy, R C Fowler, P C Iwen, P D Fey
The BioFire FilmArray® Gastrointestinal Panel (GIP) was implemented to replace traditional stool culture and enzyme immunoassay (EIA) testing for stool pathogens. The purpose of this study was to evaluate the detection rate, incidence of coinfection, and culture recovery rate of gastrointestinal (GI) pathogens detected by the GIP over a 1-year period. A total of 2257 stools collected from January to December 2015 were tested using the GIP. Clostridium difficile colonization was also evaluated by an antigen/toxin EIA and confirmatory polymerase chain reaction (PCR)...
December 12, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27942025/clostridium-difficile-toxin-a-undergoes-clathrin-independent-pacsin2-dependent-endocytosis
#20
Ramyavardhanee Chandrasekaran, Anne K Kenworthy, D Borden Lacy
Clostridium difficile infection affects a significant number of hospitalized patients in the United States. Two homologous exotoxins, TcdA and TcdB, are the major virulence factors in C. difficile pathogenesis. The toxins are glucosyltransferases that inactivate Rho family-GTPases to disrupt host cellular function and cause fluid secretion, inflammation, and cell death. Toxicity depends on receptor binding and subsequent endocytosis. TcdB has been shown to enter cells by clathrin-dependent endocytosis, but the mechanism of TcdA uptake is still unclear...
December 2016: PLoS Pathogens
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