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PubMed2005

Antimicrobial susceptibility of polymerase chain reaction ribotypes of Clostridium difficile commonly isolated from symptomatic hospital patients in the UK.

Two hundred and seventy-one clinical isolates of Clostridium difficile, including the six most common polymerase chain reaction (PCR) ribotypes isolated from symptomatic patients in UK hospitals, were tested against nine antibiotics (imipenem, erythromycin, levofloxacin, piperacillin/tazobactam, ciprofloxacin, co-amoxiclav, cefotaxime, amoxicillin and clindamycin). All 271 strains were susceptible to co-amoxiclav, piperacillin/tazobactam and amoxicillin, and resistant to cefotaxime and ciprofloxacin. Variable degrees of resistance were found to imipenem, erythromycin, levofloxacin and clindamycin. Significantly greater resistance to erythromycin, levofloxacin and imipenem was found in virtually all members of the two most common PCR ribotypes, 001 and 106. Resistance to these agents may have played a part in their selection as the most common strains of C. difficile found in UK hospitals.

Anti-Bacterial Agents↗
PubMed2004

Active and passive immunization against Clostridium difficile diarrhea and colitis.

Clostridium difficile, a gram-positive bacterium, is the major cause of hospital-acquired infectious diarrhea and colitis in industrialized nations. C. difficile colonization results from antibiotic administration and subsequent loss of protection provided by intestinal flora. C. difficile induced-colitis is caused by the release of two exotoxins, toxin A and B. Host factors including advanced age, pre-existing severe illness and weakened immune defenses predispose individuals to symptomatic infection. The generation of antibody responses to toxin A through natural exposure is associated with protection from disease. In addition, an inability to acquire immunity to toxin A puts individuals at risk for recurrent and/or severe disease. Immunological approaches for the management of this disease are being developed which could reduce the reliance on antibiotics for treatment and allow for re-establishment of the natural barrier provided by an intact commensal flora. An active vaccine and various immunotherapeutic strategies under evaluation may prove to be effective against severe or relapsing C. difficile infection.

Animals↗
PubMed2001

How to detect Clostridium difficile variant strains in a routine laboratory.

Toxin A-negative, toxin B-positive strains (A-/B+) are the best studied examples of Clostridium difficile variant strains. In addition, there are some other groups of variant C. difficile strains that produce both toxins (A+/B+) or are non-cytotoxic (A-/B-) but differ from the reference strain VPI 10463 in their toxin genes. Here we describe two simple methods (amplification of the tcdA gene and amplification of the binary toxin gene cdtA) which can be used in rapid screening for variant C. difficile strains in collections or in routine laboratories.

Bacterial Proteins↗
PubMed2002

Prevalence of gastrointestinal disease caused by Clostridium difficile in a university hospital in Hungary.

A one-year survey was undertaken to investigate the frequency of diarrhoea caused by Clostridium difficile among patients in a 1200-bed university hospital in Hungary. The VIDAS (bioMérieux) toxin A detection kit was used for screening specimens for the presence of C. difficile toxin. For all other diarrhoeal specimens selected according to special criteria, cytotoxin testing was used to determine the presence of 'free toxin' in the faeces. During the study period, a total of 945 diarrhoeal faecal samples were tested for the presence of C. difficile toxin. Of 375 requested samples, 58 (18.3%) were toxin-A positive. Of the 570 remaining faecal samples selected by the laboratory, 120 (21%) proved to be toxin positive. The results showed that patients from the surgical (33.3%), internal (24%) and haematological (12.8%) wards had the greatest frequency of diarrhoea attributable to C. difficile.

Adult↗
PubMed2003

Hepatitis associated with Clostridium difficile in an ostrich chick.

A live 19-day-old male ostrich chick was euthanized and necropsied. It was one of 12 chicks in a group in which 8 had died with history of anorexia, diarrhoea and weight loss. The birds had been treated with amikacin, piperacillin and enrofloxacin. Necropsy of the ostrich revealed dehydration, mild ascites and serous atrophy of fat around the heart. The liver had numerous yellow tan foci on the capsular surface as well as on the cut surface. Caecal contents were watery. Microscopic examination of the liver revealed multifocal necrosis of hepatocytes with infiltration of heterophils mixed with fibrin, few lymphocytes, and multinucleated giant cells. A Gram stain of the liver revealed a few gram-positive bacilli scattered within the necrotic foci. Clostridium difficile was isolated from the liver, and toxin A was detected by ELISA. A retrospective examination of approximately 1000 ostriches submitted during a seven year period to the laboratory system revealed seven cases of hepatitis due to Clostridium perfringens, two additional cases due to C. difficile and two cases due to C. sordelli.

Animals↗
PubMed1995

Gamma globulin administration in relapsing Clostridium difficile-induced pseudomembranous colitis with a defective antibody response to toxin A.

A 53-year-old woman suffered six episodes of Clostridium difficile-pseudomembranous colitis. The serological follow-up demonstrated the absence of a rise in IgG and IgA to toxin A. Human pooled gamma globulin was administered during the fifth relapse and raised IgG levels to toxin A. Normal stools reappeared a week later. The role of the antibodies to toxin A and gamma globulin in C. difficile colitis are discussed.

Bacterial Toxins↗