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PubMedDate not supplied

Clostridium difficile toxin assay in psoriatic patients.

Chemotherapy-induced pseudomembranous colitis is most commonly associated with methotrexate and 5-fluorouracil. Methotrexate and mesalazine have also been used for the treatment of psoriasis but the effect of these therapies on the Clostridium difficile carriage in the stool of psoriatic patients has not been studied. Our aim was to detect the presence of C. difficile toxin in patients with psoriasis hospitalized for systemic therapy and in those receiving methotrexate and mesalazine. A total of 58 patients with psoriasis were divided into three groups: group A comprised 30 patients admitted with psoriasis involving >30% body surface area, group B1 comprised 15, psoriatic patients receiving methotrexate (0.3-0.4 mg/kg/week), group B2 included 6 patients receiving mesalazine (50-60 mg/kg/day) while group C comprised of 7 patients (5 on methotrexate, 2 on mesalazine) in whom stool samples were taken twice. Among patients in groups B1 and B2, stool samples were taken after at least 4 weeks of therapy. Detection of C. difficile toxin in stool samples was done using the latex agglutination method. Out of the 58 patients 47 were males and 11 were females. The mean age of the patients was 45+/-2.5 years and the duration of the disease was 3+/-0.9 years. Positive C. difficile toxin was found in a total of 19 patients in all three groups (5 patients in group A, 9 in group B1, 2 in group B2 and 3 in group C). Three patients complained of slight abdominal discomfort and increased frequency of stool, of whom 2 had toxin positive in low titres. The rest of the 17 patients who were positive for C. difficile toxin were asymptomatic. There is a obvious rise in the rate of GIT carriage of C. difficile to a variable degree in patients on methotrexate and mesalazine. However, no clear correlation of the gastrointestinal symptoms with either the presence of toxin or its titre could be established.

Adult↗
PubMed1991

Enzyme profiles of Clostridium difficile strains isolated from children.

Clostridium difficile isolates from children with haematological malignancies, diarrhoea and healthy neonates as well as standard strains were examined by API ZYM (standard test) system and API ZYM research kit for glucosidases and peptidases. The results of expanded enzymatic characterization are presented.

Adolescent↗
PubMed1998

Clostridium difficile disease: diagnosis and treatment.

Clostridium difficile is the most common nosocomial pathogen of the gastrointestinal tract. Disease is usually a consequence of antibiotic therapy, but sporadic cases do occur. Cytotoxin assay for toxin B remains the gold standard for confirming diagnosis. Several rapid enzyme immunoassay tests are available, but specificity and sensitivity vary; a negative test may not exclude disease. Oral metronidazole 250 to 500 mg four times a day is the recommended first-line therapy; vancomycin (125 mg four times a day) should be reserved for patients who cannot tolerate metronidazole, who do not respond to this drug, or who should not take it for various reasons (i.e., pregnancy). Recurrent C. difficile disease is a difficult problem. The nonpathogenic yeast Saccharomyces boulardii has been shown in controlled trials to be effective in reducing recurrences when given as an adjunct to standard therapy. Prevention of epidemics relies on careful hand washing and environmental decontamination.

Anti-Bacterial Agents↗
PubMed1997

Yield from stool testing of pediatric inpatients.

OBJECTIVES: To quantify the yield from stool testing in pediatric inpatients and to identify criteria to test stool more deliberately without sacrificing diagnostic sensitivity. DESIGN: A retrospective review was performed of all stool cultures, ova and parasite examinations, and Clostridium [correction of Clostridia] difficile toxin assays performed on pediatric inpatients, aged 3 days to 18 years, at Thomas Jefferson University Hospital, Philadelphia, Pa, for 1 year. Medical records were reviewed for positive cases, each with 2 controls matched for age and test type. For this study, the term admission refers to the interval between the times each patient was admitted to and discharged from the hospital. Some patients had multiple stool tests sent to the laboratory during a single admission; some patients had more than 1 admission during the study period. Statistical analysis was performed using X2 analysis and the Student 2-tailed t test with a commercially available statistical software package (Statworks, Cricket Software, Philadelphia). RESULTS: Of 250 patient admissions to the hospital for which stool was cultured, 7 cultures (2.8%) were positive. Of 63 patient admissions having ova and parasite testing, 1 (2%) had a positive result. Clostridium [correction of Clostridia] difficile toxin assays were performed on 40 patient admissions to the hospital, and 7 (18%) had a positive result. Only 18 (3.0%) of 598 of all test results reviewed were positive. Costs of negative test results totaled $26,084. More patients (71%) with positive stool cultures than control patients (21%) had a temperature higher than or equal to 38 degrees C (X2, P < .05); however, relying on this sign missed 29% of the children with bacterial infection. A white blood cell band count of at least 0.10 was 100% sensitive and 79% specific in identifying patients with positive stool culture. There was no statistically significant relationship between stool culture results and age, total white blood cell count or white blood cell segmented neutrophil count, and no relationship between C. difficile toxin assay results and any of the above characteristics. Clostridium [correction of Clostridia] difficile was the most common pathogen identified (6 of 9) in patients developing gastrointestinal symptoms after admission; however, Salmonella enteritidis and Shigella sonnei were also significant causes (3 of 9). CONCLUSIONS: There is low yield from stool testing of pediatric inpatients: C. difficile toxin assay has the highest yield. Clostridium [correction of Clostridia] difficile testing is most valuable for children with nosocomial gastrointestinal symptoms although other bacterial pathogens do cause nosocomial symptoms in children. More selective stool testing could help us be more efficient with our patient care resources.

Adolescent↗
PubMed1998

Primary symptomless colonisation by Clostridium difficile and decreased risk of subsequent diarrhoea.

BACKGROUND: Little is known about whether patients who develop Clostridium-difficile-associated diarrhoea (CDAD) are culture-positive or culture-negative before illness. The most important risk factor is antibiotic exposure. We aimed to find out whether patients identified as primary symptom-free C difficile carriers are at higher risk of developing CDAD than patients who are culture-negative. METHOD: We reviewed four longitudinal studies in which 810 patients admitted to hospital were followed up by prospective rectal-swab culture. At least two consecutive weekly cultures were obtained. We calculated the difference in risk of CDAD between colonised and non-colonised patients in each study and combined the results of the four studies in a random-effects model. FINDINGS: Of 618 non-colonised patients (mean follow-up 1.7 weeks [SD 1.3]), 22 (3.6%) developed CDAD, whereas only two (1.0%) of 192 primary symptom-free carriers (1.5 [1.5]) developed CDAD (pooled risk difference -2.3% [95% CI 0.3-4.3], p=0.021). Of patients who received antibiotics, the risk difference was increased: 22 (4.5%) of 491 non-colonised patients compared with two (1.1%) of 176 colonised patients developed CDAD (-3.2% [0.4-6.0], p=0.024). Of the primary symptom-free C difficile carriers, 95 were colonised with toxigenic strains, 76 with non-toxigenic strains, 12 with both toxigenic and non-toxigenic strains (non-concurrently), and nine with strains of undetermined toxigenicity. Nine of the 12 toxogenic strains of C difficile isolates that cause CDAD were also recovered from stools of symptom-free patients. INTERPRETATION: Primary symptomless C difficile colonisation is associated with a decreased risk of CDAD. Although the mechanism is unknown, risk reduction is found in colonisation with non-toxigenic and toxigenic strains.

Adult↗
PubMed2001

Clostridium difficile cytotoxin B in adults with diarrhea: a comparison of patients treated or not treated with antibiotics prior to infection.

OBJECTIVE: To study the detection rate of Clostridium difficile cytotoxin B in stool specimens from adults with diarrhea as related to previous antimicrobial treatment. METHODS: Stool specimens from 802 adult patients with diarrhea and 203 healthy controls were tested for C. difficile cytotoxin B using a cell cytotoxicity assay. Antibiotic susceptibility testing of C. difficile was performed with the E test. RESULTS: Of 173 patients treated with antimicrobial medication within 5 weeks of onset of diarrhea, 60 (35%) were positive for C. difficile cytotoxin B (group A) compared to only 41 (7%) of 629 untreated patients (group B) and two of the 203 (1%) healthy controls. Compared to patients in group A, patients in group B possessed characteristics not usually connected with C. difficile disease. They were generally younger (median age 40 years vs. 73 years), had been hospitalized less frequently (10% vs. 67%), had more often travelled abroad within the previous 2 weeks (46% vs. 1%), and more often had multiple enteropathogens (41% vs. 3%). Minimal inhibitory concentrations for vancomycin, metronidazole and fucidic acid to C. difficile isolates ranged from 0.5 to 4 mg/L, from 0.125 to 256 mg/L and 0.25 to 4 mg/L, respectively. CONCLUSIONS: The detection rate of C. difficile cytotoxin B in patients with diarrhea, not associated with antibiotic treatment, is comparable to that in healthy control subjects. It probably merely reflects a carrier state without clinical significance.

Adult↗
PubMed2004

Differential effects of varying concentrations of clostridium difficile toxin A on epithelial barrier function and expression of cytokines.

BACKGROUND: Presentation after Clostridium difficile infection may depend on the level of epithelial exposure to toxins. We investigated epithelial barrier function and expression of interleukin (IL)-8 and transforming growth factor (TGF)-beta in response to varying concentrations of C. difficile toxin A. METHODS: T84 cells were either preexposed or continuously exposed to C. difficile toxin A (0.01-1000 ng/mL). Barrier function was assessed by measurements of transepithelial electrical resistance. RESULTS: Preexposure to < or =10 ng/mL toxin A led to an increase in the release of TGF-beta 1, but there was no change in the expression of IL-8. In contrast, after preexposure to >10 ng/mL toxin A, there was enhanced expression of IL-8, but release of TGF-beta 1 was similar to that in control monolayers. After preexposure to >10 ng/mL toxin A, there was complete and irreversible loss of electrical resistance. At lower concentrations, loss of resistance across monolayers was followed by recovery, which was enhanced by all 3 recombinant isoforms of TGF-beta. Pretreatment with recombinant isoforms of TGF-beta or coculture with TGF-beta 3-expressing colonic subepithelial myofibroblasts was also protective. CONCLUSIONS: In C. difficile infection, the development and severity of colonic inflammation may depend on the exposure of intestinal epithelial cells to toxins and the expression of proinflammatory (IL-8) and protective (TGF-beta) factors.

Bacterial Toxins↗
PubMed1998

A randomized crossover study of disposable thermometers for prevention of Clostridium difficile and other nosocomial infections.

OBJECTIVE: To test the hypothesis that use of disposable thermometers would result in lower rates of nosocomial Clostridium difficile diarrhea and of total nosocomial infections, compared with electronic thermometers. DESIGN: Prospective randomized crossover trial. SETTING: A 700-bed university hospital providing primary and tertiary care. PATIENTS: All patients admitted to a group of 20 inpatient nursing units. INTERVENTIONS: 20 nursing units were randomized into two groups. One group randomly was assigned exclusive use of single-use disposable thermometers for patient temperature measurement, and the other group was assigned exclusive use of electronic thermometers. After 6 months, the assignments were reversed. MAIN OUTCOME MEASURES: Rates of C difficile infections, total nosocomial diarrheal episodes, and total nosocomial infections were prospectively followed in each study unit over 11 months. RESULTS: 26,350 patients were admitted to the study units and hospitalized for 120,529 patient days. There were 947 nosocomial infections (7.86 per 1,000 patient days). Nosocomial C difficile-associated diarrhea defined by positivity to both toxin B (titer > or = 1:10) and toxin A was detected in 32 patients (3.4% of all nosocomial infections). A significantly lower rate of nosocomial C difficile-associated diarrhea was observed with disposable thermometer use (0.16 per 1,000 patient days) compared with electronic thermometer use (0.37 per 1,000 patient days, relative risk [RR] = 0.44; 95% confidence interval [CI95], 0.21-0.93, P = .026). There was no difference in overall rates of nosocomial infection between the disposable and electronic groups (8.03 and 7.68 infections per 1,000 patient days, respectively; RR, 1.04; CI95, 0.92-1.19; P = .52) or in the overall rate of nosocomial diarrhea (3.34 and 3.40 per 1,000 patient days, respectively; RR, .98; CI95, 0.81-1.19; P = .87). CONCLUSIONS: The incidence of nosocomial C difficile diarrhea was reduced significantly by using single-use, disposable thermometers as compared with electronic thermometers, but there was no effect on either the overall rate of nosocomial diarrhea or the rate of total nosocomial infections.

Clostridioides difficile↗
PubMed1993

Infection due to Clostridium difficile among elderly residents of a long-term-care facility.

In a study of the epidemiology of infection due to Clostridium difficile at long-term-care facilities, we conducted point-prevalence surveys and obtained stool samples from residents receiving antibiotics and from those developing diarrhea during 1 year at a 350-bed nursing home and an adjoining 280-bed chronic-care hospital. C. difficile and/or its cytotoxin was detected in 236 specimens from 94 residents. Only 16 (17%) of these 94 individuals had diarrhea at the time C. difficile was detected. The prevalence of C. difficile infection ranged from 2.1% to 8.1% in the nursing home and from 7.1% to 14.7% in the hospital. The organism was recovered from six (8.8%) of 68 residents receiving antibiotics, and four of the six developed antibiotic-associated diarrhea. The receipt of antibiotic treatment within the previous 8 weeks (odds ratio [OR], 7.9), the presence of a nasogastric or gastrostomy feeding tube (OR, 6.5), urinary and fecal incontinence (OR, 2.5), and the presence of more than three underlying diseases (OR, 2.0) were statistically significant independent variables associated with C. difficile infection. Typing of isolates by restriction-endonuclease analysis indicated that most C. difficile infections at this long-term-care facility were associated with endogenous enteric carriage of the organism, with little evidence of cross-infection.

Aged↗
PubMed2001

Frequency of antibiotic-associated diarrhoea in 2462 antibiotic-treated hospitalized patients: a prospective study.

The frequency of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CdAD) was prospectively determined in a population of 2462 patients recruited from five Swedish hospitals, including divisions for infectious diseases, orthopaedics, surgery, geriatrics, nephrology and internal medicine. AAD developed in 4.9% of the treated patients. Faecal samples were obtained from 69% of patients with AAD and 55.4% were positive for C. difficile cytotoxin B. The frequency of AAD varied from 1.8 to 6.9% at the participating centres (P < 0.001). The frequency of AAD also varied considerably between medical disciplines and wards within different hospitals and was highest in the nephrology and geriatric units (6.7 and 7.1%, respectively). There was no difference in frequency of AAD when analysed with respect to gender or age. Medical interventions (laxative treatment, endoscopy and abdominal surgery) or presence of one concomitant disease (diabetes, malignancy, chronic renal disease and inflammatory bowel disease) did not significantly affect the frequency of AAD, whereas patients suffering from two or more of these illnesses had significantly (P = 0.001) higher frequencies of AAD. Patients treated with antibiotics for 3 days had a significantly (P = 0.009) lower frequency of AAD than those treated for longer periods. Treatment with cephalosporins, clindamycin or broad-spectrum penicillins was associated with an increased risk of AAD. With specimens from one centre, 62.5% of tested patients with AAD and 33.8% of asymptomatic patients were positive for cytotoxin B. Although C. difficile cytotoxin B in stool samples was significantly associated with AAD (P = 0.003), the causal relationship with diarrhoea is not always evident.

Adolescent↗
PubMed1995

Exchange of domains of glutamate dehydrogenase from the hyperthermophilic archaeon Pyrococcus furiosus and the mesophilic bacterium Clostridium difficile: effects on catalysis, thermoactivity and stability.

The glutamate dehydrogenase gene from the hyperthermophilic archaeon Pyrococcus furiosus has been functionally expressed in Escherichia coli under the control of the lambda PL promoter. The P. furiosus glutamate dehydrogenase amounted to 20% of the total E. coli cell protein, and the vast majority consisted of hexamers. Following activation by heat treatment, an enzyme could be purified from E. coli that was indistinguishable from the glutamate dehydrogenase purified from P. furiosus. Hybrid genes, that consisted of the coding regions for the homologous glutamate dehydrogenases from P. furiosus and the mesophilic bacterium Clostridium difficile, were constructed and successfully expressed in E. coli. One of the resulting hybrid proteins, containing the glutamate binding domain of the C. difficile enzyme and the cofactor binding domain of the P. furiosus enzyme, did not show a detectable activity. In contrast, the complementary hybrid containing the P. furiosus glutamate and the C. difficile cofactor binding domain was a catalytically active hexamer that showed a reduced substrate affinity but maintained efficient cofactor binding with the specificity found in the Clostridium symbiosum enzyme. Compared with the C. difficile glutamate dehydrogenase, the archaeal-bacterial hybrid is slightly more thermoactive, less thermostable but much more stable towards guanidinium chloride-induced inactivation and denaturation.

Archaea↗
PubMed2000

Clostridium difficile toxins A and B can alter epithelial permeability and promote bacterial paracellular migration through HT-29 enterocytes.

Clostridium difficile toxins A and B are the widely recognized etiologic agents of antibiotic-associated diseases ranging from diarrhea to pseudomembranous colitis. We hypothesized that C. difficile toxins may alter intestinal epithelial permeability and facilitate bacterial penetration of the intestinal epithelial barrier. Experiments were designed to clarify the effects of C. difficile toxins A and B on the flux of inert particles across HT-29 enterocyte monolayers, and to correlate these results with bacteria-enterocyte interactions. In all experiments, mature, confluent HT-29 cultures were preincubated 16 h with toxin A or B (1-100 ng/mL). To study alterations in epithelial permeability, toxin-treated enterocytes were incubated with 5 pM solutions of 10- and 40-kD inert dextran particles. Toxin A, but not toxin B, was associated with increased dextran flux through enterocyte monolayers. To study bacteria-enterocyte interactions, toxin-treated enterocytes were incubated with 10(8) Salmonella typhimurium, Proteus mirabilis, or Escherichia coli. Although numbers of internalized bacteria were generally unaffected, both toxins were associated with increased bacterial adherence, as well as increased bacterial transmigration through enterocyte monolayers. Bacterial transmigration was significantly greater using toxin A- compared to toxin B-treated enterocytes, consistent with the observation that dextran flux was significantly greater using toxin A- compared to toxin B-treated enterocytes. Thus intestinal colonization with toxigenic C. difficile may facilitate bacterial penetration of the intestinal epithelium by a mechanism involving increased permeability of the intestinal epithelial barrier.

Actins↗
PubMed2005

Prevalence and characteristics of bacteria and host factors in an outbreak situation of antibiotic-associated diarrhoea.

Antibiotic-associated diarrhoea (AAD) represents a clinical entity leading to prolonged hospital stays and diagnostic and therapeutic procedures, and results in additional costs. The aim of the present study was to assess the prevalence and characteristics of different bacteria in stools of patients with AAD. The reliability of diagnostic procedures under routine conditions was evaluated. Host factors were also analysed. From June 2002 to April 2003 89 cases of diarrhoea were reported at a hospital unit for internal medicine. Clostridium difficile and Clostridium perfringens toxin enzyme-immunoassays (EIAs), and culture for C. difficile, C. perfringens and Staphylococcus aureus were performed on stool samples from all patients. Toxin production was determined in isolated S. aureus strains. In vitro susceptibility of S. aureus for oxacillin and of C. difficile for vancomycin, metronidazole, linezolid, fusidic acid and tetracycline was tested. Host factors, such as age, comorbidities, antibiotic exposure and contact with other patients, were evaluated. Twenty-six stools were positive for C. difficile toxins by an EIA technique, while C. difficile was cultured from 39. C. difficile was isolated from 21 stools that were EIA negative. Additionally, from 28 stools S. aureus and/or C. perfringens could be isolated. Nine samples contained only S. aureus and/or C. perfringens. Thirty-one stools were negative in all tests. All C. difficile isolates were susceptible to vancomycin and metronidazole. Age >60 years, and diseases of the vascular system, the heart, the kidneys and the lungs were identified as risk factors for acquiring C. difficile in this setting (P values < 0.05). Stool culture for C. difficile was shown to be more sensitive than toxin EIA in this study. Risk factors for the acquisition of C. difficile in outbreak situations seem to differ from risk factors in the normal hospital setting. The role of toxin-producing S. aureus in cases of AAD needs further investigation.

Anti-Bacterial Agents↗
PubMed1992

Presence of Clostridium difficile and antibiotic and beta-lactamase activities in feces of volunteers treated with oral cefixime, oral cefpodoxime proxetil, or placebo.

Three groups of six healthy adult volunteers were randomly assigned to a treatment with 400 mg of oral cefpodoxime proxetil, oral cefixime, or placebo per day for 10 days. Informed consent was obtained from all volunteers. Clostridium difficile was not detected in the feces of any subject before treatment or at any time in the subjects in the placebo group. C. difficile was, however, detected in all subjects treated with cefpodoxime proxetil and in five of six treated with cefixime. Genomic DNA restriction patterns showed that the strains of C. difficile differed from one volunteer to another. Two subjects both shed different strains at different times during the 25-day surveillance period. All isolates were resistant to cefixime and cefpodoxime (MIC for 90% of strains, 256 and 512 mg/liter, respectively). Antibiotic activity was found in the feces of one volunteer treated with cefpodoxime proxetil and of four volunteers treated with cefixime. It was inversely correlated with the presence of fecal beta-lactamase activity. Intestinal side effects were limited to modifications of stool consistency, which occurred in only 3 of the 12 treated volunteers and did not lead to cessation of treatment. These modifications were significantly associated with the presence of fecal antibiotic activity (P less than 0.05) but not with the shedding of toxigenic or nontoxigenic strains of C. difficile or with the presence of toxin A in feces, which was detected only in one perfectly healthy treated volunteer.

Administration, Oral↗
PubMed1998

Multicenter evaluation of the Clostridium difficile TOX A/B TEST.

Clostridium difficile, the primary cause of nosocomial diarrhea in the United States and many other industrialized countries, is recognized as a major health concern because of its ability to cause severe intestinal disease leading to complications such as relapses and infections due to vancomycin-resistant enterococci. The disease results from two toxins, toxins A and B, produced by this pathogen. In this study, we evaluated the TOX A/B TEST, a new 1-h enzyme immunoassay (EIA) that detects toxins A and B. We compared the test with the tissue culture assay, which is recognized as the "gold standard" for C. difficile testing. Evaluations were performed in-house at TechLab, Inc. (Blacksburg, Va.) and off-site at four clinical laboratories. Of 1,152 specimens tested, 165 were positive by the TOX A/B TEST and tissue culture and 973 were negative by both tests. The sensitivity and specificity were 92.2 and 100%, respectively. The positive and negative predictive values were 100 and 98.6%, respectively, and the correlation of the TOX A/B TEST with tissue culture was 98.8%. When discrepant samples were resolved by culture, the sensitivity and specificity were 93.2 and 98.9%, respectively. The positive and negative predictive values were 100 and 98.8%, respectively, with a correlation of 99.0%. There were no specimens that were positive by the TOX A/B TEST and negative by tissue culture. Fourteen specimens were negative by the TOX A/B TEST but positive by tissue culture. Of these, two were negative by toxigenic culture, five were positive by toxigenic culture, and seven were not available for further testing. There were no indeterminate results, since the test does not have an indeterminant zone. In a separate study, 102 specimens that were positive by tissue culture and the TOX A/B TEST were examined in toxin A-specific EIAs. Two specimens that presumptively contained toxin A-negative, toxin B-positive (toxA-/toxB+) isolates were identified. One specimen was from a patient with a clinical history consistent with C. difficile infection. Isolates obtained from these specimens by selective culture on solid media and in broth tested toxA-/toxB+ when grown in brain heart infusion dialysis flasks, which stimulate in vitro production of both toxins. Our findings show that the TOX A/B TEST is suitable as a diagnostic aid for C. difficile disease because it correlates well with tissue culture and detects isolates that may be missed with toxin A-specific EIAs.

Bacterial Proteins↗
PubMed2006

Ramoplanin: a topical lipoglycodepsipeptide antibacterial agent.

Ramoplanin, a novel antibiotic with activity against aerobic and anaerobic gram-positive bacteria, acts to prevent cell wall peptidoglycan formation by binding to a key intermediate moiety, lipid II. It has been fast-tracked by the US FDA for the prevention of enterococcal infections and the treatment of Clostridium difficile. The minimum inhibitory concentration(90s) have been < or = 1.0 microg/ml against gram-positive organisms examined. In carriers of vancomycin-resistant enterococci, a double-blind, placebo-controlled Phase II trial of two doses of ramoplanin versus placebo showed proof of concept. A second Phase II trial also demonstrated the equivalence of ramoplanin compared with vancomycin for the treatment of C. difficile colitis. The clinical value and place in therapy of ramoplanin is dependent upon the results of Phase III trials addressing its utility in suppressing carriage of target organisms in the gastrointestinal tract or in the nares.

Administration, Topical↗
PubMed2006

Clostridium difficile-associated disease: new challenges from an established pathogen.

Clostridium difficile-associated disease (CDAD) can range from uncomplicated diarrhea to sepsis and even death. CDAD rates and severity are increasing, possibly due to a new strain. Transmission of C difficile occurs primarily in health care facilities via the fecal-oral route following transient contamination of the hands of health care workers and patients; contamination of the patient care environment also plays an important role.

Anti-Bacterial Agents↗
PubMed1992

Gas chromatographic detection of anaerobic bacteria from environment.

A rapid method of detection of anaerobic bacteria in environment using gas chromatograph is described. Metabolically produced volatile and non-volatile fatty acid by the anaerobic bacteria are detected gas-chromatographically. Using this technique anaerobic bacteria are detected from soil, air, laboratory and operation theatre environments and drinking water samples. In the polluted drinking water apart from drug resistant E. coli, Clostridium difficile is isolated indicating faecal pollution of drinking water from cases of antibiotic associated pseudomembraneous colitis. The method has great significance in detection of anaerobic bacteria in environment especially in the management of war wounds.

Bacteria, Anaerobic↗