clostridium infections


Summary: Infections with bacteria of the genus CLOSTRIDIUM.

Top Publications

  1. Louie T, Miller M, Mullane K, Weiss K, Lentnek A, Golan Y, et al. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med. 2011;364:422-31 pubmed publisher
    ..This phase 3 clinical trial compared the efficacy and safety of fidaxomicin with those of vancomycin in treating C. difficile infection...
  2. Eyre D, Cule M, Wilson D, Griffiths D, Vaughan A, O Connor L, et al. Diverse sources of C. difficile infection identified on whole-genome sequencing. N Engl J Med. 2013;369:1195-205 pubmed publisher
    ..However, endemic spread has hampered identification of precise sources of infection and the assessment of the efficacy of interventions...
  3. Fernandes da Costa S, Mot D, Bokori Brown M, Savva C, Basak A, Van Immerseel F, et al. Protection against avian necrotic enteritis after immunisation with NetB genetic or formaldehyde toxoids. Vaccine. 2013;31:4003-8 pubmed publisher
    ..The immunisation of poultry with a formaldehyde NetB toxoid or with a NetB genetic toxoid (W262A) resulted in the induction of antibody responses against NetB and provided partial protection against disease...
  4. Bokori Brown M, Kokkinidou M, Savva C, Fernandes da Costa S, Naylor C, Cole A, et al. Clostridium perfringens epsilon toxin H149A mutant as a platform for receptor binding studies. Protein Sci. 2013;22:650-9 pubmed publisher
    ..These findings have important implications for developing strategies designed to neutralise toxin activity...
  5. Stranges P, Hutton D, Collins C. Cost-effectiveness analysis evaluating fidaxomicin versus oral vancomycin for the treatment of Clostridium difficile infection in the United States. Value Health. 2013;16:297-304 pubmed publisher
    ..This new treatment, however, is associated with a higher acquisition cost compared with alternatives. The objective of this study was to evaluate the cost-effectiveness of fidaxomicin or oral vancomycin for the treatment of CDIs...
  6. Waslawski S, Lo E, Ewing S, Young V, Aronoff D, Sharp S, et al. Clostridium difficile ribotype diversity at six health care institutions in the United States. J Clin Microbiol. 2013;51:1938-41 pubmed publisher
    ..Regionally important ribotypes were identified, and institutions in close proximity did not necessarily share more ribotype diversity than institutions that were farther apart...
  7. Yakob L, Riley T, Paterson D, Clements A. Clostridium difficile exposure as an insidious source of infection in healthcare settings: an epidemiological model. BMC Infect Dis. 2013;13:376 pubmed publisher
  8. Tagashira Y, Kato H, Senoh M, Nakamura A. Two cases of fulminant colitis due to binary toxin-positive Clostridium difficile that are not PCR ribotype 027 or type 078. J Med Microbiol. 2013;62:1486-9 pubmed publisher
    ..This type may be a new hypervirulent strain, but further studies of the epidemiology and pathogenicity of the strain are needed. ..
  9. Keyburn A, Portela R, Sproat K, Ford M, Bannam T, Yan X, et al. Vaccination with recombinant NetB toxin partially protects broiler chickens from necrotic enteritis. Vet Res. 2013;44:54 pubmed publisher

More Information


  1. Burnham C, Carroll K. Diagnosis of Clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. Clin Microbiol Rev. 2013;26:604-30 pubmed publisher
    ..As detection of C. difficile in clinical specimens does not always equate with disease, the diagnosis of C. difficile infection continues to be a challenge for both laboratories and clinicians...
  2. Biazzo M, Cioncada R, Fiaschi L, Tedde V, Spigaglia P, Mastrantonio P, et al. Diversity of cwp loci in clinical isolates of Clostridium difficile. J Med Microbiol. 2013;62:1444-52 pubmed publisher
    ..This is the first report on the distribution and variability of a number of genes encoding CWPs in C. difficile...
  3. Bartsch S, Umscheid C, Fishman N, Lee B. Is fidaxomicin worth the cost? An economic analysis. Clin Infect Dis. 2013;57:555-61 pubmed publisher
    ..It has been found to be noninferior to vancomycin; however, its cost-effectiveness for the treatment of CDI remains undetermined...
  4. Goh S, Hussain H, Chang B, Emmett W, Riley T, Mullany P. Phage ?C2 mediates transduction of Tn6215, encoding erythromycin resistance, between Clostridium difficile strains. MBio. 2013;4:e00840-13 pubmed publisher
    ..This element is 13,008 bp in length and contains 17 putative open reading frames (ORFs). It could also be transferred at a lower frequency by filter mating...
  5. Mot D, Timbermont L, Delezie E, Haesebrouck F, Ducatelle R, Van Immerseel F. Day-of-hatch vaccination is not protective against necrotic enteritis in broiler chickens. Avian Pathol. 2013;42:179-84 pubmed publisher
    ..Single vaccination with crude supernatant at day 3 resulted in significant protection, while vaccination of 1-day-old chickens with crude supernatant or toxoid, as envisaged for practical field application, did not induce protection...
  6. Deshpande A, Pasupuleti V, Thota P, Pant C, Rolston D, Sferra T, et al. Community-associated Clostridium difficile infection and antibiotics: a meta-analysis. J Antimicrob Chemother. 2013;68:1951-61 pubmed publisher
    ..e. symptom onset in the community with no healthcare facility admission within 12 weeks) and to determine the classes of antibiotics posing the greatest risk...
  7. Garcia J, Adams V, Beingesser J, Hughes M, Poon R, Lyras D, et al. Epsilon toxin is essential for the virulence of Clostridium perfringens type D infection in sheep, goats, and mice. Infect Immun. 2013;81:2405-14 pubmed publisher
    ..These results indicate that ETX is necessary for type D isolates to induce disease, supporting a key role for this toxin in type D disease pathogenesis...
  8. Meader E, Mayer M, Steverding D, Carding S, Narbad A. Evaluation of bacteriophage therapy to control Clostridium difficile and toxin production in an in vitro human colon model system. Anaerobe. 2013;22:25-30 pubmed publisher
    ..The results demonstrate the potential of phage therapy, and highlight the limitations of using phages that have lysogenic capacity. ..
  9. Eyre D, Walker A, Freeman J, Baines S, Fawley W, Chilton C, et al. Short-term genome stability of serial Clostridium difficile ribotype 027 isolates in an experimental gut model and recurrent human disease. PLoS ONE. 2013;8:e63540 pubmed publisher
    ..Clostridium difficile whole genome sequencing has the potential to identify related isolates, even among otherwise indistinguishable strains, but interpretation depends on understanding genomic variation within isolates and individuals...
  10. Kuehne S, Collery M, Kelly M, Cartman S, Cockayne A, Minton N. Importance of toxin A, toxin B, and CDT in virulence of an epidemic Clostridium difficile strain. J Infect Dis. 2014;209:83-6 pubmed publisher
    ..We demonstrated that either toxin A or toxin B alone can cause fulminant disease in the hamster infection model and present tantalizing data that C. difficile toxin may also contribute to virulence. ..
  11. Eyre D, Fawley W, Best E, Griffiths D, Stoesser N, Crook D, et al. Comparison of multilocus variable-number tandem-repeat analysis and whole-genome sequencing for investigation of Clostridium difficile transmission. J Clin Microbiol. 2013;51:4141-9 pubmed publisher
    ..With improvements in WGS technology, it is likely that MLVA locus data will be available from WGS in the near future. ..
  12. Eyre D, BABAKHANI F, Griffiths D, Seddon J, Del Ojo Elias C, Gorbach S, et al. Whole-genome sequencing demonstrates that fidaxomicin is superior to vancomycin for preventing reinfection and relapse of infection with Clostridium difficile. J Infect Dis. 2014;209:1446-51 pubmed publisher
    ..Fidaxomicin reduced the risk of both relapse (competing risks hazard ratio [HR], 0.40 [95% confidence interval {CI}, .25-.66]; P = .0003) and reinfection (competing risks HR, 0.33 [95% CI, 0.11-1.01]; P = .05). ..
  13. Cheung J, Keyburn A, Carter G, Lanckriet A, Van Immerseel F, Moore R, et al. The VirSR two-component signal transduction system regulates NetB toxin production in Clostridium perfringens. Infect Immun. 2010;78:3064-72 pubmed publisher
    ..We postulate that in the gastrointestinal tract of infected birds, NetB production is upregulated when the population of C. perfringens cells reaches a threshold level that leads to activation of the VirSR system. ..
  14. Li J, Sayeed S, Robertson S, Chen J, McClane B. Sialidases affect the host cell adherence and epsilon toxin-induced cytotoxicity of Clostridium perfringens type D strain CN3718. PLoS Pathog. 2011;7:e1002429 pubmed publisher
    ..perfringens type D isolates and also increase ETX action. ..
  15. Buckley A, Spencer J, Candlish D, Irvine J, Douce G. Infection of hamsters with the UK Clostridium difficile ribotype 027 outbreak strain R20291. J Med Microbiol. 2011;60:1174-80 pubmed publisher
    ..These data describe the fatal infection kinetics of the clinical UK epidemic C. difficile strain R20291 in the hamster infection model. ..
  16. Goldstein M, Kruth S, Bersenas A, Holowaychuk M, Weese J. Detection and characterization of Clostridium perfringens in the feces of healthy and diarrheic dogs. Can J Vet Res. 2012;76:161-5 pubmed
    ..perfringens and PCR for toxin genes is of limited diagnostic usefulness due to its high prevalence in normal dogs and the lack of apparent difference in the distribution of toxin genes between normal and diarrheic dogs...
  17. Rea M, O Sullivan O, Shanahan F, O Toole P, Stanton C, Ross R, et al. Clostridium difficile carriage in elderly subjects and associated changes in the intestinal microbiota. J Clin Microbiol. 2012;50:867-75 pubmed publisher
    ..However, in contrast, a marked reduction in microbial diversity at genus level was observed in patients who had been diagnosed with CDAD at the time of sampling and from whom C. difficile R027 was isolated. ..
  18. Shan J, Patel K, Hickenbotham P, Nale J, Hargreaves K, Clokie M. Prophage carriage and diversity within clinically relevant strains of Clostridium difficile. Appl Environ Microbiol. 2012;78:6027-34 pubmed publisher
    ..This study reveals the high incidence of prophage carriage in clinically relevant strains of C. difficile and correlates the molecular data to the morphological observation...
  19. Costa M, Stampfli H, Arroyo L, Pearl D, Weese J. Epidemiology of Clostridium difficile on a veal farm: prevalence, molecular characterization and tetracycline resistance. Vet Microbiol. 2011;152:379-84 pubmed publisher
    ..The low prevalence before slaughter may be of importance for the evaluation of foodborne risks. Oxytetracycline administration to calves may have an impact on prevalence of C. difficile colonization. ..
  20. Hiscox T, Chakravorty A, Choo J, Ohtani K, Shimizu T, Cheung J, et al. Regulation of virulence by the RevR response regulator in Clostridium perfringens. Infect Immun. 2011;79:2145-53 pubmed publisher
    ..These results provide evidence that RevR regulates virulence in C. perfringens; it is the first response regulator other than VirR to be shown to regulate virulence in this important pathogen. ..
  21. Kachrimanidou M, Malisiovas N. Clostridium difficile infection: a comprehensive review. Crit Rev Microbiol. 2011;37:178-87 pubmed publisher
    ..This review summarizes the pathogenesis and changing epidemiology of C. difficile associated disease, the clinical spectrum and laboratory methods to diagnose C. difficile infection, and current treatment strategies. ..
  22. Hardy K, Manzoor S, Marriott C, Parsons H, Waddington C, Gossain S, et al. Utilizing rapid multiple-locus variable-number tandem-repeat analysis typing to aid control of hospital-acquired Clostridium difficile Infection: a multicenter study. J Clin Microbiol. 2012;50:3244-8 pubmed publisher
    ..9% in the control. The study demonstrated the utility of rapidly typing C. difficile strains, demonstrating that it aided the management of clusters, enabling effective targeting of infection control resources. ..
  23. Boone J, Goodykoontz M, Rhodes S, Price K, Smith J, Gearhart K, et al. Clostridium difficile prevalence rates in a large healthcare system stratified according to patient population, age, gender, and specimen consistency. Eur J Clin Microbiol Infect Dis. 2012;31:1551-9 pubmed publisher
    ..We observed different rates for toxigenic C. difficile in stratified patient populations, with the highest rate for NH, a low overall nontoxigenic rate, and fluoroquinolone resistance...
  24. Manges A, Labbe A, Loo V, Atherton J, Behr M, Masson L, et al. Comparative metagenomic study of alterations to the intestinal microbiota and risk of nosocomial Clostridum difficile-associated disease. J Infect Dis. 2010;202:1877-84 pubmed publisher
    ..Hospital exposures were associated with changes in the intestinal microbiota and risk of CDAD, and these changes were not driven exclusively by antimicrobial use. ..
  25. Lanckriet A, Timbermont L, Eeckhaut V, Haesebrouck F, Ducatelle R, Van Immerseel F. Variable protection after vaccination of broiler chickens against necrotic enteritis using supernatants of different Clostridium perfringens strains. Vaccine. 2010;28:5920-3 pubmed publisher
    ..Our results indicate that the protective characteristics of the supernatants are not solely based on the presence of NetB or alpha toxin. ..
  26. Holmer C, Zurbuchen U, Siegmund B, Reichelt U, Buhr H, Ritz J. Clostridium difficile infection of the small bowel--two case reports with a literature survey. Int J Colorectal Dis. 2011;26:245-51 pubmed publisher
    ..Early diagnosis of the disease by toxin detection and endoscopy is of paramount importance and can play a substantial role in improving outcomes. ..
  27. Petrella L, Sambol S, Cheknis A, Nagaro K, Kean Y, Sears P, et al. Decreased cure and increased recurrence rates for Clostridium difficile infection caused by the epidemic C. difficile BI strain. Clin Infect Dis. 2012;55:351-7 pubmed publisher
    ..Similarly, the CDI recurrence rate is increased in patients with the BI strain compared with patients with other C. difficile strains. ..
  28. Burnell C, Turgeon T, Hedden D, Bohm E. Paraneoplastic Clostridium septicum infection of a total knee arthroplasty. J Arthroplasty. 2011;26:666.e9-11 pubmed publisher
    ..The importance of full anaerobic bacterial identification by the microbiology laboratory is underscored by this case. ..
  29. Coursodon C, Glock R, Moore K, Cooper K, Songer J. TpeL-producing strains of Clostridium perfringens type A are highly virulent for broiler chicks. Anaerobe. 2012;18:117-21 pubmed publisher
    ..perfringens. However, TpeL(pos) and Tpel(neg) strains compared here were not isogenic, and definitive results await the production and testing of specific TpeL mutants...
  30. Sirard S, Valiquette L, Fortier L. Lack of association between clinical outcome of Clostridium difficile infections, strain type, and virulence-associated phenotypes. J Clin Microbiol. 2011;49:4040-6 pubmed publisher
    ..Our study also suggests that current assertions regarding the NAP1/027 may not apply to all isolates and that other factors may come into play. ..
  31. Lessa F, Gould C, McDonald L. Current status of Clostridium difficile infection epidemiology. Clin Infect Dis. 2012;55 Suppl 2:S65-70 pubmed publisher
    ..In the face of these changes in the epidemiology and microbiology of CDI, surveillance systems are necessary to monitor trends and inform public health actions. ..
  32. Zilberberg M, Tabak Y, Sievert D, Derby K, Johannes R, Sun X, et al. Using electronic health information to risk-stratify rates of Clostridium difficile infection in US hospitals. Infect Control Hosp Epidemiol. 2011;32:649-55 pubmed publisher
    ..Electronic health information can be leveraged to risk-stratify HO CDI rates by patient age and CO-NHA prevalence on admission. Hospitals should optimize diagnostic testing to improve patient care and measured CDI rates. ..
  33. Hope V, Palmateer N, Wiessing L, Marongiu A, White J, Ncube F, et al. A decade of spore-forming bacterial infections among European injecting drug users: pronounced regional variation. Am J Public Health. 2012;102:122-5 pubmed publisher
    ..Six countries reported 367 cases; rates varied from 0.03 to 7.54 per million people. Most cases (92%) were reported from 3 neighboring countries: Ireland, Norway, and the United Kingdom. This geographic variation needs investigation...
  34. Babady N, Stiles J, Ruggiero P, Khosa P, Huang D, Shuptar S, et al. Evaluation of the Cepheid Xpert Clostridium difficile Epi assay for diagnosis of Clostridium difficile infection and typing of the NAP1 strain at a cancer hospital. J Clin Microbiol. 2010;48:4519-24 pubmed publisher
    ..The excellent sensitivity and specificity and the rapid turnaround time of the Xpert PCR assay as well as its strain-typing capability make it an attractive option for diagnosis of C. difficile infection. ..
  35. Huang H, Weintraub A, Fang H, Wu S, Zhang Y, Nord C. Antimicrobial susceptibility and heteroresistance in Chinese Clostridium difficile strains. Anaerobe. 2010;16:633-5 pubmed publisher
    ..1%; gyrA mutation, 63.2%; gyrB mutation, 4.4%; gyrA and gyrB mutation, 32.4%; rpoB mutation, 100%, respectively. The resistance related fusA mutation was only found in one isolate with minimum inhibitory concentration of 4 mg/L. ..
  36. Spigaglia P, Barbanti F, Mastrantonio P. Multidrug resistance in European Clostridium difficile clinical isolates. J Antimicrob Chemother. 2011;66:2227-34 pubmed publisher
    ..difficile strains in Europe in 2005 and represents an important source of data for future comparative European studies. ..
  37. Cornely O, Miller M, Louie T, Crook D, Gorbach S. Treatment of first recurrence of Clostridium difficile infection: fidaxomicin versus vancomycin. Clin Infect Dis. 2012;55 Suppl 2:S154-61 pubmed publisher
    ..003). In patients with a first recurrence of CDI, fidaxomicin was similar to vancomycin in achieving a clinical response at end of therapy but superior in preventing a second recurrence within 28 days. ..
  38. Kamboj M, Khosa P, Kaltsas A, Babady N, Son C, Sepkowitz K. Relapse versus reinfection: surveillance of Clostridium difficile infection. Clin Infect Dis. 2011;53:1003-6 pubmed publisher
    ..Of 49 second episodes occurring after > 8 weeks, 65% were relapses. Categorization of a recurrent episode occurring after >8 weeks as a new infection may misrepresent the majority of episodes for surveillance. ..
  39. Best E, Freeman J, Wilcox M. Models for the study of Clostridium difficile infection. Gut Microbes. 2012;3:145-67 pubmed publisher
    ..difficile research. It is important for future study programs to carefully consider the approach to use and therefore be better placed to inform the design and interpretation of clinical studies. ..
  40. Shaughnessy M, Micielli R, DePestel D, Arndt J, Strachan C, Welch K, et al. Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol. 2011;32:201-6 pubmed publisher
    ..A prior room occupant with CDI is a significant risk factor for CDI acquisition, independent of established CDI risk factors. These findings have implications for room placement and hospital design. ..
  41. Miller M. Fidaxomicin (OPT-80) for the treatment of Clostridium difficile infection. Expert Opin Pharmacother. 2010;11:1569-78 pubmed publisher
    ..Fidaxomicin is a potential new therapy for CDI which has the capacity to substantially decrease post-treatment recurrences and is as safe and well-tolerated as standard vancomycin treatment. ..
  42. Keessen E, Gaastra W, Lipman L. Clostridium difficile infection in humans and animals, differences and similarities. Vet Microbiol. 2011;153:205-17 pubmed publisher
    ..In this review C. difficile infections in humans and animals are compared. The pathogenesis, clinical signs, diagnosis and prevalence of CDI are described and similarities and differences of CDI between humans and animals are discussed. ..
  43. Crook D, Walker A, Kean Y, Weiss K, Cornely O, Miller M, et al. Fidaxomicin versus vancomycin for Clostridium difficile infection: meta-analysis of pivotal randomized controlled trials. Clin Infect Dis. 2012;55 Suppl 2:S93-103 pubmed publisher
    ..01). Fidaxomicin has the potential to substantially improve outcomes from CDI...
  44. Lanzas C, Dubberke E, Lu Z, Reske K, Grohn Y. Epidemiological model for Clostridium difficile transmission in healthcare settings. Infect Control Hosp Epidemiol. 2011;32:553-61 pubmed publisher
    ..Our objectives were to evaluate the contributions of asymptomatic and symptomatic C. difficile carriers to new colonizations and to determine the most important epidemiological factors influencing C. difficile transmission...
  45. Dubberke E, Butler A, Yokoe D, Mayer J, Hota B, Mangino J, et al. Multicenter study of Clostridium difficile infection rates from 2000 to 2006. Infect Control Hosp Epidemiol. 2010;31:1030-7 pubmed publisher
  46. Kelsen J, Kim J, Latta D, Smathers S, McGowan K, Zaoutis T, et al. Recurrence rate of clostridium difficile infection in hospitalized pediatric patients with inflammatory bowel disease. Inflamm Bowel Dis. 2011;17:50-5 pubmed publisher
    ..In addition, IBD patients were more likely develop community-acquired CD, while the control patients developed nosocomial infections, indicating a higher susceptibility to CD infection in patients with IBD. ..
  47. Tannock G, Munro K, Taylor C, Lawley B, Young W, Byrne B, et al. A new macrocyclic antibiotic, fidaxomicin (OPT-80), causes less alteration to the bowel microbiota of Clostridium difficile-infected patients than does vancomycin. Microbiology. 2010;156:3354-9 pubmed publisher
    ..These findings help to explain the substantially reduced rates of relapse following treatment of CDI with fidaxomicin in recent clinical trials...
  48. Loo V, Bourgault A, Poirier L, Lamothe F, Michaud S, Turgeon N, et al. Host and pathogen factors for Clostridium difficile infection and colonization. N Engl J Med. 2011;365:1693-703 pubmed publisher
    ..The objective of this study was to identify host and bacterial factors associated with health care-associated acquisition of C. difficile infection and colonization...
  49. Valour F, Boisset S, Lebras L, Martha B, Boibieux A, Perpoint T, et al. Clostridium sordellii brain abscess diagnosed by 16S rRNA gene sequencing. J Clin Microbiol. 2010;48:3443-4 pubmed publisher
  50. Li J, Chen J, Vidal J, McClane B. The Agr-like quorum-sensing system regulates sporulation and production of enterotoxin and beta2 toxin by Clostridium perfringens type A non-food-borne human gastrointestinal disease strain F5603. Infect Immun. 2011;79:2451-9 pubmed publisher
    ..perfringens sporulation...
  51. Shojadoost B, Vince A, Prescott J. The successful experimental induction of necrotic enteritis in chickens by Clostridium perfringens: a critical review. Vet Res. 2012;43:74 pubmed publisher
    ..Also a scoring system is provided to assist decisions on humane euthanasia of sick birds...
  52. Lebrun M, Mainil J, Linden A. Cattle enterotoxaemia and Clostridium perfringens: description, diagnosis and prophylaxis. Vet Rec. 2010;167:13-22 pubmed publisher
  53. Khanna S, Pardi D, Aronson S, Kammer P, Baddour L. Outcomes in community-acquired Clostridium difficile infection. Aliment Pharmacol Ther. 2012;35:613-8 pubmed publisher
    ..It is being described in populations lacking traditional predisposing factors that have been previously considered at low-risk for this infection. As most studies of CDI are hospital-based, outcomes in these patients are not well known...
  54. Gilca R, Hubert B, Fortin E, Gaulin C, Dionne M. Epidemiological patterns and hospital characteristics associated with increased incidence of Clostridium difficile infection in Quebec, Canada, 1998-2006. Infect Control Hosp Epidemiol. 2010;31:939-47 pubmed publisher
    ..To explore epidemiological patterns of the incidence of Clostridium difficile infection (CDI) and hospital characteristics associated with increased incidence during nonepidemic and epidemic years...
  55. Britton R, Young V. Interaction between the intestinal microbiota and host in Clostridium difficile colonization resistance. Trends Microbiol. 2012;20:313-9 pubmed publisher
    ..difficile and how antibiotic administration disturbs host-microbiota homeostasis, leading to CDI...
  56. Bacci S, Mølbak K, Kjeldsen M, Olsen K. Binary toxin and death after Clostridium difficile infection. Emerg Infect Dis. 2011;17:976-82 pubmed publisher
    ..Binary toxin either is a marker for more virulent C. difficile strains or contributes directly to strain virulence. Efforts to control C. difficile infection should target all virulent strains irrespective of PCR ribotype...
  57. Gilca R, Fortin E, Frenette C, Longtin Y, Gourdeau M. Seasonal variations in Clostridium difficile infections are associated with influenza and respiratory syncytial virus activity independently of antibiotic prescriptions: a time series analysis in Quebec, Canada. Antimicrob Agents Chemother. 2012;56:639-46 pubmed publisher
    ..This association was observed at an aggregated level and may be indicative of other phenomena occurring during wintertime...
  58. Kim H, Jeong S, Roh K, Hong S, Kim J, Shin M, et al. Investigation of toxin gene diversity, molecular epidemiology, and antimicrobial resistance of Clostridium difficile isolated from 12 hospitals in South Korea. Korean J Lab Med. 2010;30:491-7 pubmed publisher
    ..The objective of this study was to characterize clinical isolates of C. difficile obtained from various regions in Korea with regard to their toxin status, molecular type, and antimicrobial susceptibility...
  59. Polage C, Chin D, Leslie J, Tang J, Cohen S, Solnick J. Outcomes in patients tested for Clostridium difficile toxins. Diagn Microbiol Infect Dis. 2012;74:369-73 pubmed publisher
    ..These data suggest that C. difficile-attributable complications are rare among patients testing negative for C. difficile toxins. More studies are needed to evaluate the clinical significance of C. difficile detection in toxin- patients...
  60. Miller B, Chen L, Sexton D, Anderson D. Comparison of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile Infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infect Control Hosp Epidemiol. 2011;32:387-90 pubmed publisher
    ..Our data suggest that C. difficile has replaced MRSA as the most common etiology of HAI in community hospitals in the southeastern United States...
  61. Crouch C, Withanage G, de Haas V, Etore F, Francis M. Safety and efficacy of a maternal vaccine for the passive protection of broiler chicks against necrotic enteritis. Avian Pathol. 2010;39:489-97 pubmed publisher
    ..These results indicate that, under commercial conditions, maternal vaccination with Netvax™ can help to control losses related to necrotic enteritis...
  62. Gurjar A, Li J, McClane B. Characterization of toxin plasmids in Clostridium perfringens type C isolates. Infect Immun. 2010;78:4860-9 pubmed publisher
    ..These findings provide new insight into plasmids of proven or potential importance for type C virulence...
  63. Tenover F, Novak Weekley S, Woods C, Peterson L, Davis T, Schreckenberger P, et al. Impact of strain type on detection of toxigenic Clostridium difficile: comparison of molecular diagnostic and enzyme immunoassay approaches. J Clin Microbiol. 2010;48:3719-24 pubmed publisher
    ..001). The Xpert C. difficile assay is a simple, rapid, and accurate method for detection of toxigenic C. difficile in unformed stool specimens and is minimally affected by strain type compared to EIA and GDH-based methods...
  64. Tenover F, Akerlund T, Gerding D, Goering R, Boström T, Jonsson A, et al. Comparison of strain typing results for Clostridium difficile isolates from North America. J Clin Microbiol. 2011;49:1831-7 pubmed publisher
    ..Unlike the other methods, the Xpert C. difficile 027/NAP1/BI assay gave results directly from stool specimens, required only 45 min to complete, but was limited to detection of a single strain type...
  65. Lasala P, Ekhmimi T, Hill A, Farooqi I, Perrotta P. Quantitative fecal lactoferrin in toxin-positive and toxin-negative Clostridium difficile specimens. J Clin Microbiol. 2013;51:311-3 pubmed publisher
    ..Differences in fecal lactoferrin levels suggest variable presence or severity of C. difficile infection among toxin-positive and toxin-negative patients...
  66. Govind R, Dupuy B. Secretion of Clostridium difficile toxins A and B requires the holin-like protein TcdE. PLoS Pathog. 2012;8:e1002727 pubmed publisher
    ..TcdE appears to be the first example of a bacterial protein that releases toxins into the environment by a phage-like system...
  67. Saleh N, Fathalla S, Nabil R, Mosaad A. Clinicopathological and immunological studies on toxoids vaccine as a successful alternative in controlling clostridial infection in broilers. Anaerobe. 2011;17:426-30 pubmed publisher
  68. Lo Vecchio A, Zacur G. Clostridium difficile infection: an update on epidemiology, risk factors, and therapeutic options. Curr Opin Gastroenterol. 2012;28:1-9 pubmed publisher
    ..Treatments currently available for CDI are inadequate to impede the increasing spread and virulence of the infection, avoid recurrence in chronic patients or prevent infection in at-risk populations...
  69. Bakken J, Borody T, Brandt L, Brill J, DeMarco D, Franzos M, et al. Treating Clostridium difficile infection with fecal microbiota transplantation. Clin Gastroenterol Hepatol. 2011;9:1044-9 pubmed publisher
    ..Fecal microbiota transplantation is safe, inexpensive, and effective; according to case and small series reports, about 90% of patients are cured. We discuss the rationale, methods, and use of fecal microbiota transplantation...
  70. Zeng J, Deng G, Wang J, Zhou J, Liu X, Xie Q, et al. Potential protective immunogenicity of recombinant Clostridium perfringens ?-?2-?1 fusion toxin in mice, sows and cows. Vaccine. 2011;29:5459-66 pubmed publisher
  71. Kamboj M, Son C, Cantu S, Chemaly R, Dickman J, Dubberke E, et al. Hospital-onset Clostridium difficile infection rates in persons with cancer or hematopoietic stem cell transplant: a C3IC network report. Infect Control Hosp Epidemiol. 2012;33:1162-5 pubmed publisher
    ..Pooled rates of HO-CDI in patients with cancer were twice the rates reported for all US patients (15.8 vs 7.4 per 10,000 patient-days). Rates were elevated regardless of diagnostic test used...
  72. Cairns M, Stabler R, Shetty N, Wren B. The continually evolving Clostridium difficile species. Future Microbiol. 2012;7:945-57 pubmed publisher
    ..difficile clones, and facilitate more rational approaches to disease control. This review will highlight the emergence of virulent C. difficile clones and our current understanding of molecular epidemiology of the species...
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    ..Caution in generalizing these observations is required, because the patients studied were younger and more likely to be from Canadian sites than were patients with recurrence who did not provide isolates...
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    ..This article summarizes genetics, non-toxin virulence factors, and host-cell biology associated with C. difficile pathogenesis as of 2011, and highlights those findings/factors that may be of interest as future intervention targets...
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    ..It is clear that further experiments are required to accurately determine the relative roles of each toxin in disease, especially in more clinically relevant current epidemic isolates...
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    ..The eMLVA scheme developed here provides insight into the genetic diversity of the C. difficile population at both global and cross-infection clusters in patient levels, with the possibility of replacing PCR ribotyping...
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    ..Similar results were observed for most strains from PCR ribotypes 014, 020 and 077. This highly discriminatory method is time-consuming and expensive, but is a valuable tool for subtyping of C. difficile, especially of 027 strains...
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    ..Our results show that C. difficile infection is indeed costly, not only to third-party payers and the hospital, but to society as well. These results are consistent with current literature citing C. difficile as a costly disease...
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    ..We demonstrate that altering the balance of these two opposing processes alters clinical outcome and thus may lead to novel preventative and therapeutic approaches for CDI...
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    ..Ribotype 005 was significantly more numerous in males and ribotype 027 was associated with significantly higher mean age. Our findings differ from national data derived from more selective testing...
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