4,967 results match your criteria difficile toxin

Major genetic discontinuity and novel toxigenic species in taxonomy.

Elife 2021 Jun 11;10. Epub 2021 Jun 11.

School of Biomedical Sciences, University of Western Australia, Nedlands, Australia.

infection (CDI) remains an urgent global One Health threat. The genetic heterogeneity seen across underscores its wide ecological versatility and has driven the significant changes in CDI epidemiology seen in the last 20 years. We analysed an international collection of over 12,000 genomes spanning the eight currently defined phylogenetic clades. Read More

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Detection of Free Toxin B in the Stool of Asymptomatic Carriers by the Cell Cytotoxicity Neutralization Assay.

Open Forum Infect Dis 2021 Jun 25;8(6):ofab209. Epub 2021 Apr 25.

McGill University Faculty of Medicine, Montreal, Québec, Canada.

Cell cytotoxicity neutralization assay (CCNA) is considered to be a gold standard to diagnose infections. We performed CCNA on 77 consecutive admission screening rectal swabs from asymptomatic toxigenic carriers. Thirty-nine percent of specimens from asymptomatic carriers were positive. Read More

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Infection and Liver Cirrhosis - A Retrospective, Cohort Study.

Clin Exp Gastroenterol 2021 3;14:229-235. Epub 2021 Jun 3.

Department of Medicine, Bronx Care Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA.

Purpose: infection (CDI) is one of the most common health care-associated infections in the United States. Studies revealed a higher mortality when CDI is associated with liver cirrhosis. We aim to present the outcomes of CDI among patients with and without liver cirrhosis and to analyze the association of Model for End-Stage Liver Disease (MELD) and Child-Pugh (CPT) scoring with the severity of CDI. Read More

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Genetic diversity and phylogenetic analysis of the surface layer protein A gene (slpA) among Clostridioides difficile clinical isolates from Tehran, Iran.

Anaerobe 2021 Jun 7:102403. Epub 2021 Jun 7.

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Clostridioides difficile is the most common causative agent of healthcare-associated diarrhea. C. difficile strains produce a crystalline surface layer protein (SlpA), encoded by the slpA gene. Read More

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Very Early-Onset Inflammatory Bowel Disease (VEO-IBD) Presenting with Recurrent Leukocytoclastic Vasculitis Preceded by Streptococcal Pharyngitis.

Case Rep Pediatr 2021 20;2021:1996430. Epub 2021 May 20.

Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Nicklaus Children's Hospital, Miami, FL, USA.

Inflammatory bowel disease (IBD) that presents in children <6 years of age is known as very early-onset IBD (VEO-IBD). Extraintestinal manifestations in IBD, such as erythema nodosum (EN), pyoderma gangrenosum (PG), and, less likely, leukocytoclastic vasculitis (LV), are more commonly present in Crohn's disease. Association between LV and ulcerative colitis (UC) is not commonly seen. Read More

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The murine neonatal Fc receptor is required for transport of immunization-induced specific IgG to the gut and protection against disease but does not affect disease susceptibility.

Infect Immun 2021 Jun 7:IAI0027421. Epub 2021 Jun 7.

Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center.

The pathology associated with disease is caused in large part by TcdB, an intracellular bacterial toxin that inactivates small GTPases. Despite causing an enteric disease, anti-toxin IgG is a clear correlate of protection against infection-associated pathology. Immunization with TcdB-based immunogens or passive transfer of monoclonal antibodies specific for the TcdB carboxy-terminal domain (CTD) confers protection following infection. Read More

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Changing Results to Change Results: Nudging Antimicrobial Prescribing for .

Open Forum Infect Dis 2021 Jun 16;8(6):ofaa605. Epub 2020 Dec 16.

University of Toronto, Faculty of Medicine, Toronto, Ontario, Cananda.

Background: Patients who test positive for by polymerase chain reaction (PCR), with a negative toxin enzyme immunoassay (EIA), are commonly colonized and do not require treatment. However, clinicians often treat based on a positive PCR result regardless of the toxin EIA result. We evaluated the clinical impact of a microbiology reporting nudge, changing from a report that included both assay results along with treatment recommendations to one that suggested clinicians consider colonization or early infection. Read More

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Large Clostridial Toxins: Mechanisms and Roles in Disease.

Microbiol Mol Biol Rev 2021 Jun 2:e0006421. Epub 2021 Jun 2.

Molecular Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.

Large clostridial toxins (LCTs) are a family of bacterial exotoxins that infiltrate and destroy target cells. Members of the LCT family include Clostridioides difficile toxins TcdA and TcdB, Paeniclostridium sordellii toxins TcsL and TcsH, Clostridium novyi toxin TcnA, and Clostridium perfringens toxin TpeL. Since the 19th century, LCT-secreting bacteria have been isolated from the blood, organs, and wounds of diseased individuals, and LCTs have been implicated as the primary virulence factors in a variety of infections, including C. Read More

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Characterization and Pharmacological Inhibition of the Pore-Forming CDTb Toxin.

Toxins (Basel) 2021 May 28;13(6). Epub 2021 May 28.

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

The clinically highly relevant releases several AB-type toxins that cause diseases such as diarrhea and pseudomembranous colitis. In addition to the main virulence factors Rho/Ras-glycosylating toxins TcdA and TcdB, hypervirulent strains produce the binary AB-type toxin CDT. CDT consists of two separate proteins. Read More

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Alimentary and Pharmaceutical Approach to Natural Antimicrobials against Gastrointestinal Infection.

Foods 2021 May 19;10(5). Epub 2021 May 19.

Departmento Microbiologia y Ecología, Facultad Ciencias Biológicas, Universitat de València, C/Dr. Moliner, 50, 46100 Burjassot, Spain.

Incidence of infection (CDI) has been increasing in recent decades due to different factors, namely (i) extended use of broad-spectrum antibiotics, (ii) transmission within asymptomatic and susceptible patients, and (iii) unbalanced gastrointestinal microbiome and collateral diseases that favor gastrointestinal domination and toxin production. Although antibiotic therapies have resulted in successful control of CDI in the last 20 years, the development of novel strategies is urged in order to combat the capability of to generate and acquire resistance to conventional treatments and its consequent proliferation. In this regard, vegetable and marine bioactives have emerged as alternative and effective molecules to fight against this concerning pathogen. Read More

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A Case of Primary Ciliary Dyskinesia Caused by a Mutation in , Which Was Diagnosed Owing to Infection.

Pediatr Rep 2021 May 10;13(2):241-244. Epub 2021 May 10.

Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.

We report a Japanese 5-year-old boy with primary ciliary dyskinesia (PCD) which was diagnosed owing to (CD) infection caused by prolonged antibiotic exposure. He had intractable otitis media with effusion (OME) and had abdominal pain and diarrhea for 4 months after starting antibiotics administration. His stool contained CD toxin. Read More

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Molecular Detection of Toxigenic among Diarrheic Dogs and Cats: A Mounting Public Health Concern.

Vet Sci 2021 May 22;8(6). Epub 2021 May 22.

Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, Cairo 12211, Egypt.

Nowadays, pet animals are known to be asymptomatic carriers of . This study was conducted to investigate the burden of toxigenic among diarrheic dogs and cats using direct PCR on fecal samples to reveal better insights about the epidemiology of such toxigenic strains referring to its public health significance. For this purpose, fecal samples were obtained from 58 dogs and 42 cats experiencing diarrhea. Read More

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A cost of illness comparison for toxigenic Clostridioides difficile diagnosis algorithms in developing countries.

Anaerobe 2021 May 28:102390. Epub 2021 May 28.

Bcmed GmbH, Ulm, Germany; Witten/Herdecke University, Witten, Germany.

Background: Availability of several commercial tests with different Clostridioides difficile targets contributes to uncertainty and controversies around the optimal diagnostic algorithm. While numerous studies have estimated the financial impact of C. difficile infection, models to guide testing strategies decisions in developing countries, where economic value significantly impacts clinical practice, are currently not available. Read More

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Binding and neutralization of C. difficile toxins A and B by purified clinoptilolite-tuff.

PLoS One 2021 27;16(5):e0252211. Epub 2021 May 27.

GLOCK Health, Science and Research G.m.b.H., Deutsch-Wagram, Austria.

Clostridioides difficile (C. difficile) infection is a major public health problem worldwide. The current treatment of C. Read More

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Prevalence and molecular subtyping of Blastocystis in patients with Clostridium difficile infection, Singapore.

Parasit Vectors 2021 May 24;14(1):277. Epub 2021 May 24.

Laboratory of Molecular and Cellular Parasitology, Healthy Longevity Translational Research Programme and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117545, Singapore.

Background: Blastocystis is a common anaerobic colonic protist in humans with controversial pathogenicity. Clostridium difficile (C. difficile) is the commonest cause of infectious diarrhea in healthcare settings. Read More

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ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections.

Am J Gastroenterol 2021 06;116(6):1124-1147

Division of Gastroenterology, Alta Bates Summit Medical Center, East Bay Center for Digestive Health, Oakland, California, USA.

Clostridioides difficile infection occurs when the bacterium produces toxin that causes diarrhea and inflammation of the colon. These guidelines indicate the preferred approach to the management of adults with C. difficile infection and represent the official practice recommendations of the American College of Gastroenterology. Read More

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Immune response against and translation to therapy.

Therap Adv Gastroenterol 2021 7;14:17562848211014817. Epub 2021 May 7.

Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.

The pathogenesis of infection (CDI) has largely been attributed to the action of two major toxins - A and B. An enhanced systemic humoral immune response against these toxins has been shown to be protective against recurrent CDI. Over the years, fully human monoclonal antibodies against both of these toxins have been developed in an attempt to counter the increasing incidence of recurrent CDI. Read More

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A Palmitoylethanolamide Producing Improves Toxin A-Induced Colitis.

Front Pharmacol 2021 27;12:639728. Epub 2021 Apr 27.

Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, Naples, Italy.

Genetically engineered probiotics, able to deliver therapeutically active compounds while restoring gut , could represent an attractive therapeutic alternative in infection (CDI). Palmitoylethanolamide is an endogenous lipid able to exert immunomodulatory activities and restore epithelial barrier integrity in human models of colitis, by binding the peroxisome proliferator-activated receptor-α (PPARα). The aim of this study was to explore the efficacy of a newly designed PEA-producing probiotic (pNAPE-LP) in a mice model of toxin A (TcdA)-induced colitis. Read More

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Fecal Microbiota Transplantation: The Evolving Risk Landscape.

Am J Gastroenterol 2021 Apr;116(4):647-656

1Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA; 2Harvard Medical School, Boston, Massachusetts, USA; 3Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.

Fecal microbiota transplantation (FMT) has been recommended in clinical guidelines for the treatment of recurrent Clostridioides difficile infection (CDI). However, it is considered investigational by most regulatory agencies. As the adoption of FMT has increased from a small group of CDI experts alone to more widespread use, there has been a corresponding increase in concern regarding potential risk. Read More

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The duration of antibiotic treatment is associated with carriage of toxigenic and non-toxigenic strains of Clostridioides difficile in dogs.

PLoS One 2021 12;16(5):e0245949. Epub 2021 May 12.

Veterinary Pathology, Public Health and Disease Investigation, School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom.

Clostridioides difficile is a leading cause of human antibiotic-associated diarrhoeal disease globally. Zoonotic reservoirs of infection are increasingly suspected to play a role in the emergence of this disease in the community and dogs are considered as one potential source. Here we use a canine case-control study at a referral veterinary hospital in Scotland to assess: i) the risk factors associated with carriage of C. Read More

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Antibiotic exposure and the risk of hospital-acquired diarrhoea and Clostridioides difficile infection: a cohort study.

J Antimicrob Chemother 2021 May 10. Epub 2021 May 10.

Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Israel.

Background: Hospital-acquired diarrhoea (HAD) and Clostridioides difficile infection (CDI) may be triggered by antibiotic use.

Objectives: To determine the effect of specific antibiotic agents and duration of therapy on the risk of HAD and CDI.

Patients And Methods: A single-centre retrospective cohort study was conducted between May 2012 and December 2014 in the internal medicine division. Read More

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Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level: A case report.

World J Clin Cases 2021 May;9(13):3219-3226

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Background: Acute severe ulcerative colitis (ASUC) is a complication of ulcerative colitis associated with high levels of circulating tumor necrosis factor alpha, due to the intense inflammation and faster stool clearance of anti-tumor necrosis factor drugs. Dose-intensified infliximab treatment can be beneficial and is associated with lower rates of colectomy. The aim of the study was to present a case of a patient with ASUC and megacolon, treated with hydrocortisone and accelerated scheme of infliximab that was monitored by drug trough level. Read More

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Frequency of toxin genes and antibiotic resistance pattern of isolates in diarrheal samples among hospitalized patients in Hamadan, Iran.

Gastroenterol Hepatol Bed Bench 2021 ;14(2):165-173

Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Aim: This study was designed to investigate the prevalence of , its toxin-producing genes, and antibiotic resistance patterns in diarrheal samples from hospitalized patients in Hamadan, Iran.

Background: Today, concerns over infection (CDI) have significantly increased due to reduced susceptibility to antibiotics used for CDI treatment. Toxins produced by strains are associated with disease severity and outcome. Read More

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January 2021

Rapid molecular syndromic testing for aetiological diagnosis of gastrointestinal infections and targeted antimicrobial prescription: experience from a reference paediatric hospital in Spain.

Eur J Clin Microbiol Infect Dis 2021 May 8. Epub 2021 May 8.

Institut de Recerca Sant Joan de Deu, Barcelona, Spain.

Aetiological diagnosis of gastrointestinal infections is challenging since a wide range of bacteria, parasites and viruses can be causal agents and derived clinical manifestations appear quite similar. Our aim was to evaluate contribution of the novel QIAstat-DxGastrointestinal Panel (GIP) to aetiological diagnosis of gastrointestinal infections and rational antimicrobial prescription in a reference paediatric hospital. Evaluation included comparison of diagnostic yield and agreement of results of QIAstat-Dx GIP and conventional microbiological methods. Read More

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Safety of fecal microbiota transplantation for infection focusing on pathobionts and SARS-CoV-2.

Therap Adv Gastroenterol 2021 21;14:17562848211009694. Epub 2021 Apr 21.

Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.

infection (CDI) is a consequence of flagrant use of antibiotics, an aging population with increasing comorbidities, and increased hospitalizations. The treatment of choice for CDI is antibiotics (vancomycin or fidaxomicin), with a possibility of recurrent CDI despite lack of additional risk factors for CDI. For the last 10 years, fecal microbiota transplantation (FMT) has emerged as a promising therapy for recurrent CDI, with success rates of over 85% compared with less than 50% with antibiotics for multiple recurrent CDI. Read More

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Molecular Characterization of, and Antimicrobial Resistance in, from Thailand, 2017-2018.

Microb Drug Resist 2021 May 5. Epub 2021 May 5.

School of Biomedical Sciences, The University of Western Australia, Nedlands, Australia.

Antimicrobial resistance (AMR) plays an important role in the pathogenesis and spread of infection (CDI). Many antimicrobials, such as fluoroquinolones, have been associated with outbreaks of CDI globally. This study characterized AMR among clinical strains in Thailand, where antimicrobial use remains inadequately regulated. Read More

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A rare case of emphysematous gastritis caused by Lactobacillus fermentum in a patient with diabetes.

Rev Esp Enferm Dig 2021 May 5. Epub 2021 May 5.

Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México.

A 42-year-old man with a history of type 2 diabetes mellitus (complicated by end stage renal disease on peritoneal dialysis) and chronic diarrhea was admitted to the emergency department for having an exacerbation in the number of evacuations. The patient was hypotensive and lethargic. Arterial blood gases were obtained and reported pH 7. Read More

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C. difficile exploits a host metabolite produced during toxin-mediated disease.

Nature 2021 May 28;593(7858):261-265. Epub 2021 Apr 28.

Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA.

Several enteric pathogens can gain specific metabolic advantages over other members of the microbiota by inducing host pathology and inflammation. The pathogen Clostridium difficile is responsible for a toxin-mediated colitis that causes 450,000 infections and 15,000 deaths in the United States each year; however, the molecular mechanisms by which C. difficile benefits from this pathology remain unclear. Read More

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Cwl0971, a novel peptidoglycan hydrolase, plays pleiotropic roles in Clostridioides difficile R20291.

Environ Microbiol 2021 Apr 24. Epub 2021 Apr 24.

Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.

Clostridioides difficile is a Gram-positive, spore-forming, toxin-producing anaerobe that can cause nosocomial antibiotic-associated intestinal disease. Although the production of toxin A (TcdA) and toxin B (TcdB) contribute to the main pathogenesis of C. difficile, the mechanism of TcdA and TcdB release from cell remains unclear. Read More

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Microbiota restoration for recurrent Clostridioides difficile: Getting one step closer every day!

S Khanna

J Intern Med 2021 Apr 15. Epub 2021 Apr 15.

From the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Clostridioides difficile infection (CDI) is an urgent health threat being the most common healthcare-associated infection, and its management is a clinical conundrum. Over 450 000 infections are seen in the United States with similar incidence seen in the rest of the developed world. The majority of infections seen are mild-moderate with fulminant disease and mortality being rare complications seen in the elderly and in those with comorbidities. Read More

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