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Antimicrob Agents Chemother 2020 May 11. Epub 2020 May 11.

School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.

causes toxin-mediated diarrhoea and pseudomembranous colitis, primarily among hospital inpatients. Outbreaks of infection (CDI) have been caused by strains with acquired antimicrobial resistance, particularly fluoroquinolone resistance, including ribotype (RT) 027 in North America and Europe, and RT 017, the most common strain in Asia. Despite being the most common cause of hospital-acquired infection in high-income countries, and frequent misuse of antimicrobials in Asia, little is known about CDI in the Asia-Pacific region. Read More

Cells 2020 May 7;9(5). Epub 2020 May 7.

Department of Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland.

(CD) is a Gram-positive pathogen responsible for CD-associated disease (CDAD), which is characterized by symptoms ranging from mild diarrhea to pseudomembranous colitis. This work is an attempt to respond to the need of novel methods for CD infection (CDI) prevention, since the number of CDI cases is still rising. A bioinformatics approach was applied to design twenty-one peptides consisting of in silico predicted linear B-cell and T-cell epitopes of aminopeptidase M24 from CD. Read More

Chirurgia (Bucur) 2020 Mar-Apr;115(2):227-235

The emergency surgery for colorectal cancer is associated with high rates of morbidity and mortality due to factors related to the characteristics of the patients but also the therapeutic attitude. This study aims to identify the surgical interventions associated with the postoperative complications, with the main causes of morbidity, with the reinterventions and with the postoperative deaths. We included in this retrospective study 431 patients hospitalized and operated in an emergency for complicated colorectal malignant tumors in the Surgery II Clinic of the Clinical Emergency County Hospital "Sf. Read More

Braz J Microbiol 2020 May 4. Epub 2020 May 4.

Veterinary School, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil.

Clostridioides (Clostridium) difficile is responsible for most cases of nosocomial diarrhea and, despite the high prevalence of the disease worldwide, the best laboratory diagnostic approach to diagnose C. difficile infection (CDI) is a subject of ongoing debate. Although the use of multiple tests is recommended, the cost of these algorithms commonly exceeds the affordability in some countries. Read More

ANZ J Surg 2020 May 4. Epub 2020 May 4.

Department of General Surgery, Sengkang General Hospital, Singapore.

Prz Gastroenterol 2020 19;15(1):1-21. Epub 2020 Mar 19.

Central Clinical Hospital of Ministry of Inferior and Administration, Warsaw, Poland.

infection (CDI) has become a serious medical and epidemiological problem, especially in well developed countries. There has been evident increase in incidence and severity of CDI. Prevention, proper diagnosis and effective treatment are necessary to reduce the risk for the patients, deplete the spreading of infection and diminish the probability of recurrent infection. Read More

ACS Chem Biol 2020 04 1;15(4):1050-1058. Epub 2020 Apr 1.

Vaccine and Emerging Infections Research, Human Health Therapeutics Research Centre, National Research Council, Ottawa, Ontario K1A 0R6, Canada.

is an anaerobic Gram-positive, spore-forming nosocomial, gastrointestinal pathogen causing -associated disease with symptoms ranging from mild cases of antibiotic-associated diarrhea to fatal pseudomembranous colitis. We developed murine monoclonal antibodies (mAbs) specific for a conserved cell surface antigen, lipoteichoic acid (LTA)of . The mAbs were characterized in terms of their thermal stability, solubility, and their binding to LTA by surface plasmon resonance and competitive ELISA. Read More

FASEB J 2020 May 19;34(5):6244-6261. Epub 2020 Mar 19.

Institute of Pharmacology and Toxicology, University of Ulm Medical Center, Ulm, Germany.

The human pathogenic bacterium Clostridioides difficile produces two exotoxins TcdA and TcdB, which inactivate Rho GTPases thereby causing C. difficile-associated diseases (CDAD) including life-threatening pseudomembranous colitis. Hypervirulent strains produce additionally the binary actin ADP-ribosylating toxin CDT. Read More

mBio 2020 Mar 10;11(2). Epub 2020 Mar 10.

Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA

Frequent and excessive use of antibiotics primes patients to infection (CDI), which leads to fatal pseudomembranous colitis, with limited treatment options. In earlier reports, we used a drug repurposing strategy and identified amoxapine (an antidepressant), doxapram (a breathing stimulant), and trifluoperazine (an antipsychotic), which provided significant protection to mice against lethal infections with several pathogens, including However, the mechanisms of action of these drugs were not known. Here, we provide evidence that all three drugs offered protection against experimental CDI by reducing bacterial burden and toxin levels, although the drugs were neither bacteriostatic nor bactericidal in nature and had minimal impact on the composition of the microbiota. Read More

Surg J (N Y) 2020 Jan 3;6(1):e37-e41. Epub 2020 Mar 3.

Department of Internal Medicine and Medical Gastroenterology, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.

Hepatic portal venous gas (HPVG), a rare radiological finding, is historically considered an ominous sign with 100% mortality rates. The dictum that HPVG warrants surgical intervention is challenged in the recent literature. This is because of the identification of various causes of HVPG other than bowel gangrene. Read More

Clin Colon Rectal Surg 2020 Mar 25;33(2):82-86. Epub 2020 Feb 25.

Department of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, Alabama.

(reclassified as " ") colitis is a common nosocomial infection associated with increased morbidity and mortality. Like many clinical encounters, a focused history and physical examination will help to guide initial management. Further laboratory testing will assist with diagnosis through stool studies, and blood tests, such as white blood cell counts and serum creatinine, can help to stratify patients into illness severity groups for treatment decisions. Read More

Curr Opin Microbiol 2020 Feb 20;53:19-25. Epub 2020 Feb 20.

Division of Protective Immunity, Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA. Electronic address:

Clostridioides difficile is the leading cause of hospital-acquired gastrointestinal infections and a major public health burden in the United States. C. difficile infection causes a spectrum of disease from mild diarrhea to severe complications such as pseudomembranous colitis, toxic megacolon and death. Read More

Am Fam Physician 2020 02;101(3):168-175

Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

Guidelines for the diagnosis and treatment of Clostridioides difficile infection have recently been updated. Risk factors include recent exposure to health care facilities or antibiotics, especially clindamycin. C. Read More

Sci Rep 2020 Jan 22;10(1):960. Epub 2020 Jan 22.

National Centre for Macromolecular Hydrodynamics, School of Biosciences, University of Nottingham, Sutton Bonington, LE12 5RD, UK.

Vancomycin, a branched tricyclic glycosylated peptide antibiotic, is a last-line defence against serious infections caused by staphylococci, enterococci and other Gram-positive bacteria. Orally-administered vancomycin is the drug of choice to treat pseudomembranous enterocolitis in the gastrointestinal tract. However, the risk of vancomycin-resistant enterococcal infection or colonization is significantly associated with oral vancomycin. Read More

J Exp Med 2020 Mar;217(3)

Laboratory of Immunoinflammation, Department of Genetics and Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.

Antibiotic-induced dysbiosis is a key predisposing factor for Clostridium difficile infections (CDIs), which cause intestinal disease ranging from mild diarrhea to pseudomembranous colitis. Here, we examined the impact of a microbiota-derived metabolite, short-chain fatty acid acetate, on an acute mouse model of CDI. We found that administration of acetate is remarkably beneficial in ameliorating disease. Read More

Emerg Microbes Infect 2020 24;9(1):42-52. Epub 2019 Dec 24.

Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan.

causes healthcare-related diarrhoea in high-income countries. Highly resistant spores persist in healthcare facilities, primarily infecting patients who have recently received antimicrobials. infection (CDI) has been studied in detail in North America and Europe; however, the epidemiology of CDI elsewhere, including the Asia-Pacific region, is largely unknown. Read More

Aliment Pharmacol Ther 2020 01;51(1):208-209

Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, TX, USA.

Crit Rev Microbiol 2019 Sep - Nov;45(5-6):729-742. Epub 2019 Dec 14.

China Academy of Chinese Medical Sciences, Beijing, China.

infection (CDI) is featured as the dysbiosis of gut microbiota and consequent mild diarrhoea or severe pseudomembranous colitis. However, the frequent recurrence of CDI following treatment course challenged the antibiotic therapy. Currently, to address the relapse of CDI, several novel therapeutic approaches have emerged, including Bezlotoxumab, SYN-004 (Ribaxamase), RBX2660, and faecal microbial transplant. Read More

Acta Microbiol Immunol Hung 2019 Dec 9:1-8. Epub 2019 Dec 9.

Department of Microbiology, Faculty of Medicine, Jagiellonian University Collegium Medicum, Kraków, Poland.

(formerly ) infections (CDIs) are becoming more common and more serious. is the etiologic agent of antibiotic-associated diarrhea, pseudomembranous enterocolitis, and toxic megacolon while CDIs recur in 7.9% of patients. Read More

BMJ Case Rep 2019 Dec 5;12(12). Epub 2019 Dec 5.

Department of Nephrology, Saint Vincent Hospital, Worcester, Massachusetts, USA.

Acute oxalate nephropathy has been associated with chronic diarrheal illness and only one case has been reported due to acute diarrhea secondary to colitis. To the best of our knowledge, this is the second case report of acute oxalate nephropathy due to colitis. A 75-year-old man with a medical history of hypertension, type 2 diabetes mellitus, chronic kidney disease stage IV, recent colitis was admitted for acute kidney injury with a creatinine (Cr) of 8. Read More

Saudi J Gastroenterol 2019 Nov-Dec;25(6):384-389

Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey.

Background / Aims: Clostridium difficile is a Gram-positive, strict anaerobe, spore-forming bacterium. It can cause self-limiting mild diarrhea, severe diarrhea, pseudomembranous colitis, and fatal fulminant colitis. We aimed to investigate the changes in epidemiology and incidence of C. Read More

BMJ Case Rep 2019 Nov 26;12(11). Epub 2019 Nov 26.

Department of Gastroenterology, University of Virginia, Charlottesville, Virginia, USA.

(formerly ) is a major cause of nocosomial infection in the USA and worldwide. It has a wide spectrum of presentation, ranging from an asymptomatic carrier state to fulminant colitis. Pseudomembranous colitis is a manifestation of severe infection (CDI), typically with progressive symptoms including watery diarrhoea, abdominal cramping and fevers and elevated white cell count and/or creatinine. Read More

J Gastrointest Surg 2020 Feb 25;24(2):484-491. Epub 2019 Nov 25.

Department of Surgery, University of California, Davis, Medical Center, 2335 Stockton Blvd., Sacramento, CA, 95817, USA.

Clostridium difficile infection remains a common nosocomial illness with a significant impact on health care delivery. As molecular phenotyping of this organism has changed our understanding of its transmission and virulence, so too have diagnostic methods and treatment strategies evolved in recent years. The burden of this infection falls predominantly on elderly patients with comorbidities who have recently received antibiotics. Read More

Microorganisms 2019 Nov 14;7(11). Epub 2019 Nov 14.

Department of Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland.

(CD) cause a severe diarrhea which can lead to pseudomembranous colitis and even patient death. CD infection (CDI) is connected mainly with changes in intestinal microbiota as a consequence of antibiotic treatment. The growing resistance to antibiotics, justifies the search for new methods of combating CD. Read More

Diagn Microbiol Infect Dis 2020 Jan 24;96(1):114915. Epub 2019 Oct 24.

Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Johns Hopkins University School of Medicine, Baltimore, MD, USA; General Internal Medicine Unit, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.

Clostridioides (Clostridium) difficile infection manifests as intestinal infections, namely pseudomembranous colitis. The occurrence of extra-intestinal disease is thought to be rare with a rate of 1.08% of 2034 isolates of C. Read More

Gastroenterology 2020 02 31;158(3):780-782.e3. Epub 2019 Oct 31.

Department of Medicine, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address:

Anaerobe 2019 Dec 20;60:102109. Epub 2019 Oct 20.

Dipartimento di Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Roma, Italy. Electronic address:

The burden of Clostridium difficile associated diarrhea is a worrying clinical issue worldwide, mainly as regarding the high incidence of recurrences after standard antibiotic therapy and the risk for more severe clinical manifestations. For this reason, new and more effective therapies are needed for the treatment of recurrent episodes. Fecal microbiota transplantation seems to be a valid tool considering the mechanism of action and the growing number of studies that demonstrate its clinical efficacy. Read More

Gut 2020 01 14;69(1):83-91. Epub 2019 Oct 14.

Center for Gut Microbiota Research, The Chinese University of Hong Kong, Hong Kong, China.

Objective: The underlying microbial basis, predictors of therapeutic outcome and active constituent(s) of faecal microbiota transplantation (FMT) mediating benefit remain unknown. An international panel of experts presented key elements that will shape forthcoming FMT research and practice.

Design: Systematic search was performed, FMT literature was critically appraised and a 1-day round-table discussion was conducted to derive expert consensus on key issues in FMT research. Read More

Surg Endosc 2019 Oct 10. Epub 2019 Oct 10.

Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1259, New York, NY, 10029, USA.

Background: Transanal total mesorectal excision (taTME) is a surgical approach for low rectal cancer with a learning curve estimated at 40-50 cases. The experience among taTME surgeons beyond their learning curve is limited.

Methods: A retrospective analysis of all taTME cases performed for rectal cancer at two tertiary care hospitals from 2014 to 2019 was conducted. Read More

BMC Med Educ 2019 Oct 11;19(1):368. Epub 2019 Oct 11.

2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Background: Fecal microbiota transplantation (FMT) has become an emergent method in the therapy of several intestinal diseases, mainly in Clostridium difficile recurrence. The training of FMT in medical schools is at its beginning and in countries where FMT is only occasionally carried out, it is important to know the perception of medical students on FMT.

Methods: We undertook a survey of 3rd year medical students not exposed to official academic information on FMT in order to find out their knowledge, beliefs and attitude toward FMT. Read More

Br Med Bull 2019 09;131(1):109-118

Nottingham Digestive Diseases Centre, Queen's Medical Centre, Nottingham, UK.

Background: Clostridium difficile infection is transmitted via spores, and the disease is mediated via secreted toxins. It represents a significant healthcare problem, and clinical presentation can range from asymptomatic carriage to life-threatening pseudomembranous colitis.

Sources Of Data: publications in the field, with a focus on recent developments and concepts. Read More

Arab J Gastroenterol 2019 Sep 27;20(3):148-162. Epub 2019 Sep 27.

Department Gastroenterology-Hepatology, Meibergdreef, 1105 AZ Amsterdam, Netherlands.

J Pediatr 2019 12 27;215:281-281.e1. Epub 2019 Sep 27.

Department of Pediatric Surgery, Takatsuki Hospital, Takatsuki, Japan.

ANZ J Surg 2020 01 30;90(1-2):67-71. Epub 2019 Sep 30.

Department of Surgery, St George Hospital, Sydney, New South Wales, Australia.

Background: Laparoscopic ventral repair is safe, with lower wound infection rates compared with open repair. 'Venetian blinds' technique of plication in combination with mesh reinforcement, is totally intra-corporeal, with hernia defect and sac plication to reduce seroma formation. While laparoscopic suturing of the abdominal wall can represent a technical challenge, pre-operative botulinum toxin A (BTA) injections as an adjunct can assist. Read More

World J Clin Cases 2019 Sep;7(17):2597-2604

Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.

Background: Moderately severe acute pancreatitis (MSAP) is a critical form of acute pancreatitis that is related with high morbidity and mortality. Severe infection (sCDI) is a serious and rare nosocomial diarrheal complication, especially in MSAP patients. Fecal microbiota transplantation (FMT) is a highly effective treatment for refractory and recurrent CDI (rCDI). Read More

J Clin Microbiol 2019 10 24;57(10). Epub 2019 Sep 24.

Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.

J Clin Microbiol 2019 10 24;57(10). Epub 2019 Sep 24.

University of Washington School of Medicine, Seattle, Washington, USA.

Biomedica 2019 05 1;39(s1):63-70. Epub 2019 May 1.

Servicio de Medicina Interna, Centro Médico Imbanaco, Cali, Colombia; Resistencia bacteriana, CIDEIM, Cali, Colombia; Departamento de Medicina Interna, Escuela de Medicina, Universidad del Valle, Cali, Colombia.

Introduction: Clostridium difficile causes nosocomial infections leading to high morbidity and mortality. The NAP1/027 strain is associated with a higher toxin production and disease severity, which increases the load of the disease. Objective: To describe the epidemiology of the infections associated with C. Read More

Toxins (Basel) 2019 09 11;11(9). Epub 2019 Sep 11.

Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia.

is a broad genus of anaerobic, spore-forming, rod-shaped, Gram-positive bacteria that can be found in different environments all around the world. The genus includes human and animal pathogens that produce potent exotoxins that cause rapid and potentially fatal diseases responsible for countless human casualties and billion-dollar annual loss to the agricultural sector. Diseases include botulism, tetanus, enterotoxemia, gas gangrene, necrotic enteritis, pseudomembranous colitis, blackleg, and black disease, which are caused by pathogenic . Read More

Bioconjug Chem 2019 09 9;30(9):2373-2383. Epub 2019 Sep 9.

Laboratory for Biomaterials, Institute for Biotechnology and Helmholtz-Institute for Biomedical Engineering , RWTH Aachen University , Pauwelsstrasse 20 , 52074 Aachen , Germany.

infections cause gastrointestinal disorders and can lead to life-threatening conditions. The symptoms can vary from severe diarrhea to the formation of pseudomembranous colitis and therefore trigger a need for new therapies. The initial step of disease is the binding of the bacterial enterotoxins toxin A and B to the cell surface of epithelial intestinal cells. Read More

Rev Esp Quimioter 2019 Sep;32 Suppl 2:47-54

Miguel Salavert Lletí. Unidad de Enfermedades Infecciosas. Hospital Universitario y Politécnico La Fe; Valencia. Av. Fernando Abril Martorell, nº 106; 46026-Valencia. Spain.

Recurrence rate ranges from 12% to 40% of all cases of Clostridium difficile infection (CDI) and proposes an exceptional clinical challenge. Conventionally, treatment options of CDI have been limited to regimes of established antibiotics (eg, pulsed/tapered vancomycin) or "improvised" alternative antibiotics (eg. teicoplanin, tigecycline, nitazoxanide or rifaximin) occasionally even in combination, but faecal microbiota transplantation is emerging as a useful and quite safe alternative. Read More

Stem Cells Int 2019 5;2019:4149762. Epub 2019 Aug 5.

Institute of Pharmacology and Toxicology, University of Ulm Medical Center, 89081 Ulm, Germany.

Bacitracin is an established antibiotic for local application and inhibits the cell wall synthesis of Gram-positive bacteria. Recently, we discovered a completely different mode of action of bacitracin and reported that this drug protects human cells from intoxication by a variety of medically relevant bacterial protein toxins including CDT, the binary actin ADP-ribosylating toxin of () . Bacitracin prevents the transport of CDT into the cytosol of target cells, most likely by inhibiting the transport function of the binding subunit of this toxin. Read More

Nat Rev Gastroenterol Hepatol 2019 10;16(10):581

Nature Reviews Gastroenterology & Hepatology, .

S D Med 2019 Jul;72(7):294-297

Avera Medical Group - Hematology and Bone Marrow Transplant, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota.

The term hemolytic uremic syndrome (HUS) refers to a heterogenous group of disorders arising from an initial endothelial cell injury with fibrin and platelet thrombi formation in the vasculature, leading to severe organ damage resulting in the well-known triad of microangiopathic hemolytic anemia, thrombocytopenia and kidney disease. The majority of pediatric cases (90 percent) of HUS are caused by Shiga toxin-producing Escherichia coli (STEC-HUS) or Shigella dysenteriae and rarely with Streptococcus pneumoniae (Pneumococcal-HUS). Atypical hemolytic uremic syndrome (aHUS) constitute only 5 percent of all HUS cases and are mediated by dysregulation of complement proteins. Read More

BMJ 2019 Aug 20;366:l4609. Epub 2019 Aug 20.

National Reference Laboratory for Clostridium difficile, Paris, France.

(formerly ) is a major cause of healthcare associated diarrhea, and is increasingly present in the community. Historically, infection was considered easy to diagnose and treat. Over the past two decades, however, diagnostic techniques have changed in line with a greater understanding of the physiopathology of infection and the use of new therapeutic molecules. Read More

Gastroenterol Hepatol 2019 Oct 6;42(8):524. Epub 2019 Aug 6.

Medicina Familiar y Comunitaria, Centro de Salud Covaresa, Valladolid Oeste, Valladolid, España.

Hosp Pediatr 2019 09 7;9(9):736-738. Epub 2019 Aug 7.

Wolfson Children's Hospital, Jacksonville, Florida; and.

Infect Dis Health 2019 11 3;24(4):208-211. Epub 2019 Aug 3.

School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Australia; School of Medical & Health Sciences, Edith Cowan University, Joondalup, Australia; Department of Microbiology, PathWest Laboratory Medicine, Nedlands, Australia; School of Veterinary & Life Sciences, Murdoch University, Murdoch, Australia.

Background: Clostridium difficile is a major nosocomial pathogen causing mild diarrhoea to life-threatening pseudomembranous colitis, and its spores frequently contaminate hospital environments and equipment. Washer/Disinfectors (WDs) are commonly used to clean and decontaminate soiled equipment in health care facilities. This study aimed to evaluate the effectiveness of the DEKO-190 WD in removing C. Read More

Vet Pathol 2019 11 5;56(6):959-963. Epub 2019 Aug 5.

University of Pittsburgh, Pittsburgh, PA, USA.

is a well-documented cause of enterocolitis in several species, including humans, with limited documentation in New World nonhuman primates. We report several cases of -associated pseudomembranous enterocolitis, including a case in a Geoffroy's spider monkey () and several cases in common marmosets (). The histologic lesions included a spectrum of severity, with most cases characterized by the classic "volcano" lesions described in humans and several other animal species. Read More