Clostridium difficile isolation

Bouza E, Pelaez T, Alonso R, Catalan P, Munoz P, Creixems MR Second-look cytotoxicity An evaluation of culture plus cyto-toxin assay of Clostridium difficile isolates in the laboratory diagnosis of CDAD. J Hosp Infect 2001 48 233-237. 

Viscidi R, Willey S, Bartlett JG. Isolation rates and toxigenic potential of Clostridium difficile isolates from various patient populations. Gastroenterology 1981 81(l) 5-9. 

Samore M, Killgore G, Johnson S, Goodman R, Shim J, Venkataraman L, Sambol S, DeGirolami P, Tenover F, Arbeit R, Gerding D. Multicenter typing comparison of sporadic and outbreak Clostridium difficile isolates from geographically diverse hospitals. J Infect Dis 1997 176(5) 1233-8. 

Barbut F, Deere D, Burghoffer B, Lesage D, Delisle F, Lalande V, Delmee M, Avesani V, Sano N, Coudert C, Petit JC. Antimicrobial susceptibilities and serogroups of clinical strains of Clostridium difficile isolated in France in... 

Keel, K., Brazier, J. S., Post, K. W., Weese, S., and Songer, J. G. (2007). Prevalence of PCR ribotypes among Clostridium difficile isolates from pigs, calves, and other species. /. Clin. Microbiol. 45(6), 1963-1964. 

O Neill, G., Adams, J. E., Bowman, R. A., and Riley, T. V. (1993). A molecular characterization of Clostridium difficile isolates from humans, animals and their environments. Epidemiol. Infect. Ill, 257-264. 

O Neill, G. L. Brazier, J. S. Magee, J. T. Duerden, B. I. A comparison of PCR ribotyping and pyrolysis mass spectrometry for typing clinical isolates of Clostridium difficile. Anaerobe 1996, 2, 211-215. 

Clostridium difficile has been isolated in 11-33% of patients with antibiotic-associated diarrhea, 60-75% of patients with antibiotic-associated colitis, and 96-100% of patients with pseudomembranous colitis (117,134,135). However, about 2% of the adult population are asymptomatic carriers (127). Primary symptomless colonization with C. difficile reduces the risk of antibiotic-associated diarrhea (136). Infants up to 2 years seem to be refractory to pseudomembranous colitis, although a high percentage may be carriers of C. difficile (135,137). The reasons for this are unknown. It has been speculated that infants lack receptors for the toxin. 

Florin I (1991) Isolation of a fibroblast mutant resistant to Clostridium difficile toxins A and B. in Microb. Pathogen. 11 337-346. 

UK-69,753 (SMI) was isolated from cultures of Amycolatopsis orientalis [265]. Its structure was determined using UV, FABMS, elemental analysis, H and NMR, acid hydrolysis to give the disaccharide, and X-ray crystallography of the disaccharide unit [266], In vitro assay showed 90 posesscd antibacterial activity, being particularly effective against Clostridium difficile and Treponema hyodysenteriae (MIC = 0.39 pg/ml and 0.78 pg/ml, respectively [266], In vivo, 90 (3.6 or 7.1 mg/kg/day) provided effective treatment of mice colonized with T. hyodysenteriae [266]. 

Barbut, F., Mastrantonio, P., Delmee, M., Brazier, J., Kuijper, E., and Poxton, 1. (2007). European study group on Clostridium difficile (ESGCD). Prospective study of Clostridium difficile infections in Europe with phenotypic and genotypic characterisation of the isolates. Clin. Microbiol. Infect. 13,1048-1057. 

Debast, S. B., van Leengoed, L. A., Goorhuis, A., Harmanus, C., Kuijper, E. J., and Bergwerff, A. A. (2009). Clostridium difficile PCR ribotype 078 toxinotype V found in diarrhoeal pigs identical to isolates from affected humans. Environ. Microbiol. 11(2), 505-511. 

Zidaric, V., Zemljic, M., Janezic, S., Kocuvan, A., and Rupnik, M. (2008). High diversity of Clostridium difficile genotypes isolated from a single poultry farm producing replacement laying hens. Anaerobe 14(6), 325-327. 

An elderly woman who had been treated with low-dose methotrexate 5 mg weekly and loxoprofen for one month developed acute pyelonephritis. Intravenous eefotiam was started, and on day 7 she developed severe watery diarrhoea. Analysis showed pancytopenia and Clostridium difficile infection. Methotrexate and cefotiam were stopped, and vancomycin started, and the patient reeovered. It was suggested that the combination of the antineoplastic drug and antibacterial increased the risk of Clostridium difficile diarrhoea. In addition, the NSAID (see Methotrexate + NSAIDs , p.649) and renal impairment from the pyelonephritis could have eontrib-uted to the methotrexate toxicity. This appears to be an isolated ease, and any interaetion with cefotiam is not established. 

Observational studies Oral moxifloxacin (after initial intravenous cloxacillin, cefazo-lin or vancomycin) was studied in 48 patients with orthopedic implant infections due to sensitive Staphylococcus aureus ( = 33) or coagulase-negative staphylococci ( = 15) [40 ]. Overall cure rate was 83% and 71% if the implant was retained. Two subjects withdrew because of side-effects (4.2% 95% Cl = 0,9.5) with one case each of Clostridium difficile colitis and persistent dizziness. Eight relapses occurred, but in the six cases in which the organism was re-isolated resistance did not develop. 

Pedersen and co-workers have reported for the first time, a total synthesis of five lipoteichoic acids (LTA) of Clostridium difficile (53) with a defined chain length. These synthetic LTAs represent the main components found in the heterogeneous natural isolates. Initial biological results have been also presented. ... 

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