In the past decade, Clostridium difficile has emerged as an important gut pathogen. Symptoms of C. difficile infection range from mild diarrhea to pseudomembranous colitis. Besides the two main virulence factors toxin A and toxin B, other virulence factors are likely to play a role in the pathogenesis of the disease. In other Gram-positive and Gram-negative pathogenic bacteria, conserved high-t...

Clostridium difficile infection was cited in one of every 250 death certificates completed in the United Kingdom in 2005, and it has become the leading cause of death from healthcare associated infections in much of the industrialised world. More than 50 000 cases of C difficile infection were reported in England in 2007 —a 50-fold increase since 1990. Pseudomembranous colitis was first describ...

The appearance of Clostridium difficile NAP1/027 (the epidemic strain) has been blamed for an increase in the incidence and severity of C. difficile infection. Some authors consider quinolone resistance to be a good marker of the epidemic strain. We performed a prospective study to assess C. difficile infection at our institution in Madrid, Spain (Hospital General Universitario Gregorio Marañón...

The binary toxin Clostridium difficile transferase (CDT) is frequently observed in C. difficile strains and is associated with an increased severity of C. difficile infection. CDT-producing C. difficile infections cause higher fatality rates than infections with CDT negative isolates. Thus, the rapid and accurate identification of a CDT positive C. difficile infection is critical for effective ...

In the last decade, Clostridium difficile infection (CDI) has reached an epidemic state with increasing incidence and severity in both health care and community settings. Vancomycin is an important first-line therapy for CDI, and the emergence of resistance would have significant clinical consequences. In this study, we describe for the first time a vanB2 vancomycin resistance operon in C. diff...

BACKGROUND Recurrent Clostridium difficile infection is difficult to treat, and failure rates for antibiotic therapy are high. We studied the effect of duodenal infusion of donor feces in patients with recurrent C. difficile infection. METHODS We randomly assigned patients to receive one of three therapies: an initial vancomycin regimen (500 mg orally four times per day for 4 days), followed ...

Context: Clostridioides difficile (C. difficile) is an agent responsible for severe infection with a high mortality rate in healthcare facilities. With the discovery of C. community, it was assumed that this bacterium might be transmitted to humans through non-hospital sources. Evidence Acquisition: This study examined different aspects epidemiology Asian countries review literature using searc...

TO THE EDITOR—Bartsch and colleagues recently evaluated the cost-effectiveness of fidaxomicin treatment for Clostridium difficile infection and should be commended for addressing this important question [1]. In light of a recent Centers for Disease Control and Prevention report estimating 250 000 C. difficile infections per year resulting in 14 000 deaths and excess medical costs of $1 billion ...

BACKGROUND Clostridium difficile infection is often considered to result from recent acquisition of a C difficile isolate in a healthcare setting. However, C difficile spores can persist for long periods of time, suggesting a potentially large community environmental reservoir. The objectives of this study were to assess community environmental contamination of toxigenic C difficile and to asse...

It is hypothesized that the depletion of microbial members responsible for converting primary bile acids into secondary bile acids reduces resistance to Clostridium difficile colonization. To date, inhibition of C. difficile growth by secondary bile acids has only been shown in vitro. Using targeted bile acid metabolomics, we sought to define the physiologically relevant concentrations of prima...