U.S. flag

An official website of the United States government

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Butler M, Bliss D, Drekonja D, et al. Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Dec. (Comparative Effectiveness Reviews, No. 31.)

Cover
  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection

Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection [Internet].

Show details

References and Included Studies

(The references below correspond to the footnotes in the body of the report. There is a separate set of references at the end of the evidence tables in Appendix C.)

1.
Gravel D, Miller M, Simor A, et al. Health care-associated Clostridium difficile infection in adults admitted to acute care hospitals in Canada: a Canadian Nosocomial Infection Surveillance Program Study. Clin Infect Dis. 2009 Mar 1;48(5):568–76. [PubMed: 19191641]
2.
McDonald LC. Confronting Clostridium difficile in inpatient health care facilities. Clin Infect Dis. 2007 Nov 15;45(10):1274–6. [PubMed: 17968820]
3.
Loo VG, Poirier L, Miller MA, et al. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med. 2005 Dec 8;353(23):2442–9. [PubMed: 16322602]
4.
Brandt LJ, Kosche KA, Greenwald DA, et al. Clostridium difficile-associated diarrhea in the elderly. Am J Gastroenterol. 1999 Nov;94(11):3263–6. [PubMed: 10566727]
5.
Hebuterne X. Gut changes attributed to ageing: effects on intestinal microflora. Curr Opin Clin Nutr Metab Care. 2003 Jan;6(1):49–54. [PubMed: 12496680]
6.
Kim J, Smathers SA, Prasad P, et al. Epidemiological features of Clostridium difficile-associated disease among inpatients at children's hospitals in the United States, 2001-2006. Pediatrics. 2008 Dec;122(6):1266–70. [PubMed: 19047244]
7.
Simor AE, Bradley SF, Strausbaugh LJ, et al. Clostridium difficile in long-term-care facilities for the elderly. Infect Control Hosp Epidemiol. 2002 Nov;23(11):696–703. [PubMed: 12452300]
8.
Laffan AM, Bellantoni MF, Greenough WB 3rd, et al. Burden of Clostridium difficile-associated diarrhea in a long-term care facility. J Am Geriatr Soc. 2006 Jul;54(7):1068–73. [PubMed: 16866677]
9.
Jarvis WR, Schlosser J, Jarvis AA, et al. National point prevalence of Clostridium difficile in US health care facility inpatients, 2008. Am J Infect Control. 2009 May;37(4):263–70. [PubMed: 19278754]
10.
Kim KH. Isolation of Clostridium difficile from the environment and contacts of patients with antibiotic-associated colitis. J Infect Dis. 1981;143(1):42–50. [PubMed: 7217711]
11.
McFarland LV. Renewed interest in a difficult disease: Clostridium difficile infections--epidemiology and current treatment strategies. Curr Opin Gastroenterol. 2009 Jan;25(1):24–35. [PubMed: 19114771]
12.
Viscidi R, Willey S, Bartlett JG. Isolation rates and toxigenic potential of Clostridium difficile isolates from various patient populations. Gastroenterol. 1981 Jul;81(1):5–9. [PubMed: 7239125]
13.
Chang JY, Antonopoulos DA, Kalra A, et al. Decreased diversity of the fecal Microbiome in recurrent Clostridium difficile-associated diarrhea. J Infect Dis. 2008 Feb 1;197(3):435–8. [PubMed: 18199029]
14.
Young VB, Schmidt TM. Antibiotic-associated diarrhea accompanied by large-scale alterations in the composition of the fecal microbiota. J Clin Microbiol. 2004 Mar;42(3):1203–6. [PMC free article: PMC356823] [PubMed: 15004076]
15.
Aslam S, Musher DM. An update on diagnosis, treatment, and prevention of Clostridium difficile-associated disease. Gastroenterol Clin North Am. 2006 Jun;35(2):315–35. [PubMed: 16880068]
16.
Dial S, Alrasadi K, Manoukian C, et al. Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies. CMAJ. 2004 Jul 6;171(1):33–8. [PMC free article: PMC437681] [PubMed: 15238493]
17.
Dial S, Delaney JAC, Barkun AN, et al. Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease. JAMA. 2005 Dec 21;294(23):2989–95. [PubMed: 16414946]
18.
Aseeri M, Schroeder T, Kramer J, et al. Gastric acid suppression by proton pump inhibitors as a risk factor for clostridium difficile-associated diarrhea in hospitalized patients. Am J Gastroenterol. 2008 Sep;103(9):2308–13. [PubMed: 18702653]
19.
Linsky A, Gupta K, Lawler EV, et al. Proton pump inhibitors and risk for recurrent Clostridium difficile infection. Arch Intern Med. 2010 May 10;170(9):772–8. [PubMed: 20458084]
20.
Bignardi GE. Risk factors for Clostridium difficile infection. J Hosp Infect. 1998 Sep;40(1):1–15. [PubMed: 9777516]
21.
Garey KW, Sethi S, Yadav Y, et al. Meta-analysis to assess risk factors for recurrent Clostridium difficile infection. J Hosp Infect. 2008 Dec;70(4):298–304. [PubMed: 18951661]
22.
Cunningham R, Dial S. Is over-use of proton pump inhibitors fuelling the current epidemic of Clostridium difficile-associated diarrhoea? J Hosp Infect. 2008 Sep;70(1):1–6. [PubMed: 18602190]
23.
Thibault A, Miller MA, Gaese C. Risk factors for the development of Clostridium difficile-associated diarrhea during a hospital outbreak. Infect Control Hosp Epidemiol. 1991 Jun;12(6):345–8. [PubMed: 2071877]
24.
Leonard J, Marshall JK, Moayyedi P. Systematic review of the risk of enteric infection in patients taking acid suppression. Am J Gastroenterol. 2007 Sep;102(9):2047–56. quiz 57. [PubMed: 17509031]
25.
Howell MD, Novack V, Grgurich P, et al. Iatrogenic gastric acid suppression and the risk of nosocomial Clostridium difficile infection. Arch Intern Med. 2010 May 10;170(9):784–90. [PubMed: 20458086]
26.
Starr JM, Campbell A, Renshaw E, et al. Spatio-temporal stochastic modelling of Clostridium difficile. J Hosp Infect. 2009 Jan;71(1):49–56. [PubMed: 19013677]
27.
Gerding DN, Muto CA, Ownes RC Jr. Measuresto control and prevent Clostridium difficile infection. Clin Infect Dis. 2008 Jan 15;46 Suppl 1:S43–9. [PubMed: 18177221]
28.
Severe Clostridium difficile-associated disease in populations previously at low risk--four states, 2005. MMWR Morb Mortal Wkly Rep. 2005 Dec 2;54(47):1201–5. [PubMed: 16319813]
29.
Hensgens MP, Goorhuis A, Notermans DW, et al. Decrease of hypervirulent Clostridium difficile PCR ribotype 027 in the Netherlands. Euro Surveill. 2009;14(45) [PubMed: 19941791]
30.
Belmares J, Johnson S, Parada JP, et al. Molecular epidemiology of Clostridium difficile over the course of 10 years in a tertiary care hospital. Clin Infect Dis. 2009 Oct 15;49(8):1141–7. [PubMed: 19780659]
31.
Alcala L, Sanchez-Cambronero L, Catalan MP, et al. Comparison of three commercial methods for rapid detection of Clostridium difficile toxins A and B from fecal specimens. J Clin Microbiol. 2008 Nov;46(11):3833–5. [PMC free article: PMC2576614] [PubMed: 18784313]
32.
Eastwood K, Else P, Charlett A, et al. Comparison of nine commercially available Clostridium difficile toxin detection assays, a real-time PCR assay for C. difficile tcdB, and a glutamate dehydrogenase detection assay to cytotoxin testing and cytotoxigenic culture methods. J Clin Microbiol. 2009 Oct;47(10):3211–7. [PMC free article: PMC2756932] [PubMed: 19710274]
33.
Musher DM, Manhas A, Jain P, et al. Detection of Clostridium difficile toxin: comparison of enzyme immunoassay results with results obtained by cytotoxicity assay. J Clin Microbiol. 2007 Aug;45(8):2737–9. [PMC free article: PMC1951241] [PubMed: 17567791]
34.
Samra Z, Luzon A, Bishara J. Evaluation of two rapid immunochromatography tests for the detection of Clostridium difficile toxins. Dig Dis Sci. 2008 Jul;53(7):1876–9. [PubMed: 17990108]
35.
Sloan LM, Duresko BJ, Gustafson DR, et al. Comparison of real-time PCR for detection of the tcdC gene with four toxin immunoassays and culture in diagnosis of Clostridium difficile infection. J Clin Microbiol. 2008 Jun;46(6):1996–2001. [PMC free article: PMC2446834] [PubMed: 18434563]
36.
O'Connor D, Hynes P, Cormican M, et al. Evaluation of methods for detection of toxins in specimens of feces submitted for diagnosis of Clostridium difficile-associated diarrhea. J Clin Microbiol. 2001 Aug;39(8):2846–9. [PMC free article: PMC88248] [PubMed: 11474001]
37.
Kvach EJ, Ferguson D, Riska PF, et al. Comparison of BD GeneOhm Cdiff real-time PCR assay with a two-step algorithm and a toxin A/B enzyme-linked immunosorbent assay for diagnosis of toxigenic Clostridium difficile infection. J Clin Microbiol. 2010 Jan;48(1):109–14. [PMC free article: PMC2812270] [PubMed: 19864479]
38.
Turgeon DK, Novicki TJ, Quick J, et al. Six rapid tests for direct detection of Clostridium difficile and its toxins in fecal samples compared with the fibroblast cytotoxicity assay. J Clin Microbiol. 2003 Feb;41(2):667–70. [PMC free article: PMC149656] [PubMed: 12574264]
39.
Miendje Deyi VY, Vandenberg O, Mascart G, et al. Diagnostic value of five commercial tests for the rapid diagnosis of Clostridium difficile-associated disease. Clin Lab. 2008;54(1-2):9–13. [PubMed: 18510038]
40.
Novak-Weekley SM, Marlowe EM, Miller JM, et al. Clostridium difficile testing in the clinical laboratory by use of multiple testing algorithms. J Clin Microbiol. 2010 Mar;48(3):889–93. [PMC free article: PMC2832460] [PubMed: 20071552]
41.
Davey P, Brown E, Fenelon L, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2005;(4) CD003543. [PubMed: 16235326]
42.
Fowler S, Webber A, Cooper BS, et al. Successful use of feedback to improve antibiotic prescribing and reduce Clostridium difficile infection: a controlled interrupted time series. J Antimicrob Chemother. 2007 May;59(5):990–5. [PubMed: 17387117]
43.
Wilcox MH, Freeman J, Fawley W, et al. Long-term surveillance of cefotaxime and piperacillin-tazobactam prescribing and incidence of Clostridium difficile diarrhoea. J Antimicrob Chemother. 2004 Jul;54(1):168–72. [PubMed: 15163654]
44.
O'Connor KA, Kingston M, O'Donovan M, et al. Antibiotic prescribing policy and Clostridium difficile diarrhoea. QJM. 2004 Jul;97(7):423–9. [PubMed: 15208430]
45.
Ludlam H, Brown N, Sule O, et al. An antibiotic policy associated with reduced risk of Clostridium difficile-associated diarrhoea. Age Ageing. 1999 Oct;28(6):578–80. [PubMed: 10604512]
46.
Johnson S, Gerding DN, Olson MM, et al. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med. 1990 Feb;88(2):137–40. [PubMed: 2301439]
47.
Brooks SE, Veal RO, Kramer M, et al. Reduction in the incidence of Clostridium difficile-associated diarrhea in an acute care hospital and a skilled nursing facility following replacement of electronic thermometers with single-use disposables. Infect Control Hosp Epidemiol. 1992 Feb;13(2):98–103. [PubMed: 1541811]
48.
Brooks S, Khan A, Stoica D, et al. Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers. Infect Control Hosp Epidemiol. 1998 May;19(5):333–6. [PubMed: 9613694]
49.
Jernigan JA. A randomized crossover study of disposable thermometers for prevention of Clostridium difficile and other nosocomial infections. Infect Control Hosp Epidemiol. 1998;19(7):494–9. [PubMed: 9702571]
50.
Rupp ME, Fitzgerald T, Puumala S, et al. Prospective, controlled, cross-over trial of alcohol-based hand gel in critical care units. Infect Control Hosp Epidemiol. 2008 Jan;29(1):8–15. [PubMed: 18171181]
51.
Gordin FM, Schultz ME, Huber RA, et al. Reduction in nosocomial transmission of drug-resistant bacteria after introduction of an alcohol-based handrub. Infect Control Hosp Epidemiol. 2005 Jul;26(7):650–3. [PubMed: 16092747]
52.
Kaier K. Two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection. Infect Control Hosp Epidemiol. 2009;30(4):346–53. [PubMed: 19236282]
53.
Mayfield JL, Leet T, Miller J, et al. Environmental control to reduce transmission of Clostridium difficile. Clin Infect Dis. 2000 Oct;31(4):995–1000. [PubMed: 11049782]
54.
Kaatz GW, Gitlin SD, Schaberg DR, et al. Acquisition of Clostridium difficile from the hospital environment. Am J Epidemiol. 1988 Jun;127(6):1289–94. [PubMed: 2835900]
55.
Struelens MJ, Maas A, Nonhoff C, et al. Control of nosocomial transmission of Clostridium difficile based on sporadic case surveillance. Am J Med. 1991 Sep 16;91(3B):138S–44S. [PubMed: 1928155]
56.
Abbett SK, Yokoe DS, Lipsitz SR, et al. Proposed checklist of hospital interventions to decrease the incidence of healthcare-associated Clostridium difficile infection. Infect Control Hosp Epidemiol. 2009 Nov;30(11):1062–9. [PubMed: 19751156]
57.
Boyce JM, Havill NL, Otter JA, et al. Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting. Infect Control Hosp Epidemiol. 2008 Aug;29(8):723–9. [PubMed: 18636950]
58.
Brown E, Talbot GH, Axelrod P, et al. Risk factors for Clostridium difficile toxin-associated diarrhea. Infect Control Hosp Epidemiol. 1990 Jun;11(6):283–90. [PubMed: 2373850]
59.
Cartmill TD, Panigrahi H, Worsley MA, et al. Management and control of a large outbreak of diarrhoea due to Clostridium difficile. J Hosp Infect. 1994 May;27(1):1–15. [PubMed: 7916358]
60.
Drudy D, Harnedy N, Fanning S, et al. Emergence and control of fluoroquinolone-resistant, toxin A-negative, toxin B-positive Clostridium difficile. Infect Control Hosp Epidemiol. 2007 Aug;28(8):932–40. [PubMed: 17620240]
61.
McNulty C, Logan M, Donald IP, et al. Successful control of Clostridium difficile infection in an elderly care unit through use of a restrictive antibiotic policy. J Antimicrob Chemother. 1997 Nov;40(5):707–11. [PubMed: 9421320]
62.
Pear SM, Williamson TH, Bettin KM, et al. Decrease in nosocomial Clostridium difficile-associated diarrhea by restricting clindamycin use. Ann Intern Med. 1994 Feb 15;120(4):272–7. [PubMed: 8080497]
63.
Valiquette L, Cossette B, Garant MP, et al. Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain. Clin Infect Dis. 2007 Sep 1;45 Suppl 2:S112–21. [PubMed: 17683015]
64.
Zafar AB, Gaydos LA, Furlong WB, et al. Effectiveness of infection control program in controlling nosocomial Clostridium difficile. Am J Infect Control. 1998 Dec;26(6):588–93. [PubMed: 9836844]
65.
Whitaker J, Brown BS, Vidal S, et al. Designing a protocol that eliminates Clostridium difficile: a collaborative venture. Am J Infect Control. 2007 Jun;35(5):310–4. [PubMed: 17577477]
66.
Vernaz N, Sax H, Pittet D, et al. Temporal effects of antibiotic use and hand rub consumption on the incidence of MRSA and Clostridium difficile. J Antimicrob Chemother. 2008 Sep;62(3):601–7. [PubMed: 18468995]
67.
Hacek DM, Ogle AM, Fisher A, et al. Significant impact of terminal room cleaning with bleach on reducing nosocomial Clostridium difficile. Am J Infect Control. 2010 Jun;38(5):350–3. [PubMed: 20123150]
68.
McMullen KM, Zack J, Coopersmith CM, et al. Use of hypochlorite solution to decrease rates of Clostridium difficile-associated diarrhea. Infect Control Hosp Epidemiol. 2007 Feb;28(2):205–7. [PubMed: 17265404]
69.
Musher DM, Logan N, Bressler AM, et al. Nitazoxanide versus vancomycin in Clostridium difficile infection: a randomized, double-blind study. Clin Infect Dis. 2009 Feb 15;48(4):e41–6. [PubMed: 19133801]
70.
Zar FA, Bakkanagari SR, Moorthi KM, et al. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis. 2007 Aug 1;45(3):302–7. [PubMed: 17599306]
71.
Lagrotteria D, Holmes S, Smieja M, et al. Prospective, randomized inpatient study of oral metronidazole versus oral metronidazole and rifampin for treatment of primary episode of Clostridium difficile-associated diarrhea. Clin Infect Dis. 2006 Sep 1;43(5):547–52. [PubMed: 16886144]
72.
Musher DM, Logan N, Hamill RJ, et al. Nitazoxanide for the treatment of Clostridium difficile colitis. Clin Infect Dis. 2006 Aug 15;43(4):421–7. [PubMed: 16838229]
73.
Wenisch C, Parschalk B, Hasenhundl M, et al. Comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of Clostridium difficile-associated diarrhea. Clin Infect Dis. 1996 May;22(5):813–8. [PubMed: 8722937]
74.
Dudley MN, McLaughlin JC, Carrington G, et al. Oral bacitracin vs vancomycin therapy for Clostridium difficile-induced diarrhea. A randomized double-blind trial. Arch Intern Med. 1986 Jun;146(6):1101–4. [PubMed: 3521518]
75.
Fekety R, Silva J, Kauffman C, et al. Treatment of antibiotic-associated Clostridium difficile colitis with oral vancomycin: comparison of two dosage regimens. Am J Med. 1989 Jan;86(1):15–9. [PubMed: 2910090]
76.
Teasley DG, Gerding DN, Olson MM, et al. Prospective randomised trial of metronidazole versus vancomycin for Clostridium-difficile-associated diarrhoea and colitis. Lancet. 1983 Nov 5;2(8358):1043–6. [PubMed: 6138597]
77.
Young GP, Ward PB, Bayley N, et al. Antibiotic-associated colitis due to Clostridium difficile: double-blind comparison of vancomycin with bacitracin. Gastroenterol. 1985 Nov;89(5):1038–45. [PubMed: 4043661]
78.
Keighley MR, Burdon DW, Arabi Y, et al. Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea. BMJ. 1978 Dec 16;2(6153):1667–9. [PMC free article: PMC1609009] [PubMed: 367509]
79.
Louie TJ, Miller MA, Mullane KM, et al. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med. 2011 Feb 3;364(5):422–31. [PubMed: 21288078]
80.
Surawicz CM, McFarland LV, Greenberg RN, et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis. 2000 Oct;31(4):1012–7. [PubMed: 11049785]
81.
Wullt M, Hagslatt ML, Odenholt I. Lactobacillus plantarum 299v for the treatment of recurrent Clostridium difficile-associated diarrhoea: a double-blind, placebo-controlled trial. Scand J Infect Dis. 2003;35(6-7):365–7. [PubMed: 12953945]
82.
Mattila E, Anttila VJ, Broas M, et al. A randomized, double-blind study comparing Clostridium difficile immune whey and metronidazole for recurrent Clostridium difficile-associated diarrhoea: efficacy and safety data of a prematurely interrupted trial. Scand J Infect Dis. 2008;40(9):702–8. [PubMed: 19086244]
83.
McFarland LV, Surawicz CM, Greenberg RN, et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA. 1994 Jun 22-29;271(24):1913–8. [PubMed: 8201735]
84.
Mogg GA, George RH, Youngs D, et al. Randomized controlled trial of colestipol in antibiotic-associated colitis. Br J Surg. 1982 Mar;69(3):137–9. [PubMed: 7039758]
85.
Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterol. 1989 Apr;96(4):981–8. [PubMed: 2494098]
86.
Lewis SJ, Potts LF, Barry RE. The lack of therapeutic effect of Saccharomyces boulardii in the prevention of antibiotic-related diarrhoea in elderly patients. J Infect. 1998 Mar;36(2):171–4. [PubMed: 9570649]
87.
Thomas MR, Litin SC, Osmon DR, et al. Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial. Mayo Clin Proc. 2001 Sep;76(9):883–9. [PubMed: 11560298]
88.
Plummer S, Weaver MA, Harris JC, et al. Clostridium difficile pilot study: effects of probiotic supplementation on the incidence of C. difficile diarrhoea. Int Microbiol. 2004 Mar;7(1):59–62. [PubMed: 15179608]
89.
Can M, Besirbellioglu BA, Avci IY, et al. Prophylactic Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea: a prospective study. Med Sci Monit. 2006 Apr;12(4):P19–22. [PubMed: 16572062]
90.
Hickson M, D'Souza AL, Muthu N, et al. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ. 2007 Jul 14;335(7610):80. [PMC free article: PMC1914504] [PubMed: 17604300]
91.
Lewis S, Burmeister S, Cohen S, et al. Failure of dietary oligofructose to prevent antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2005 Feb 15;21(4):469–77. [PubMed: 15709999]
92.
Lewis S, Burmeister S, Brazier J. Effect of the prebiotic oligofructose on relapse of Clostridium difficile-associated diarrhea: a randomized, controlled study. Clin Gastroenterol Hepatol. 2005 May;3(5):442–8. [PubMed: 15880313]
93.
Munoz P, Bouza E, Cuenca-Estrella M, et al. Saccharomyces cerevisiae fungemia: an emerging infectious disease. Clin Infect Dis. 2005 Jun 1;40(11):1625–34. [see comment] [PubMed: 15889360]
94.
Eriksson S, Aronsson B. Medical implications of nosocomial infection with Clostridium difficile. Scand J Infect Dis. 1989;21(6):733–4. [PubMed: 2617213]
95.
Lowy I, Molrine DC, Leav BA, et al. Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med. 2010 Jan 21;362(3):197–205. [PubMed: 20089970]
96.
Tvede M, Rask-Madsen J. Bacteriotherapy for chronic relapsing Clostridium difficile diarrhoea in six patients. Lancet. 1989 May 27;1(8648):1156–60. [PubMed: 2566734]
97.
Persky SE, Brandt LJ. Treatment of recurrent Clostridium difficile-associated diarrhea by administration of donated stool directly through a colonoscope. Am J Gastroenterol. 2000 Nov;95(11):3283–5. [PubMed: 11095355]
98.
Planche T, Aghaizu A, Holliman R, et al. Diagnosis of Clostridium difficile infection by toxin detection kits: a systematic review. Lancet Infect Dis. 2008 Dec;8(12):777–84. [PubMed: 18977696]
99.
Crobach MJ, Dekkers OM, Wilcox MH, et al. European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI). Clin Microbiol Infect. 2009 Dec;15(12):1053–66. [PubMed: 19929972]
100.
Samore MH, DeGirolami PC, Tlucko A, et al. Clostridium difficile colonization and diarrhea at a tertiary care hospital. Clin Infect Dis. 1994 Feb;18(2):181–7. [PubMed: 8161624]
101.
Samore MH, Venkataraman L, DeGirolami PC, et al. Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. Am J Med. 1996 Jan;100(1):32–40. [PubMed: 8579084]
102.
Shim JK, Johnson S, Samore MH, et al. Primary symptomless colonisation by Clostridium difficile and decreased risk of subsequent diarrhoea. Lancet. 1998 Feb 28;351(9103):633–6. [PubMed: 9500319]
103.
McFarland LV, Mulligan ME, Kwok RY, et al. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med. 1989 Jan 26;320(4):204–10. [PubMed: 2911306]
104.
Gerding DN, Johnson S, Peterson LR, et al. Clostridium difficile-associated diarrhea and colitis. Infect Control Hosp Epidemiol. 1995 Aug;16(8):459–77. [PubMed: 7594392]
105.
Juang P, Skledar SJ, Zgheib NK, et al. Clinical outcomes of intravenous immune globulin in severe clostridium difficile-associated diarrhea. Am J Infect Control. 2007 Mar;35(2):131–7. [PubMed: 17327194]
106.
Abougergi MS, Broor A, Cui W, et al. Intravenous immunoglobulin for the treatment of severe Clostridium difficile colitis: an observational study and review of the literature. J Hosp Med (Online). 2010 Jan;5(1):E1–9. [PubMed: 20063275]
107.
Bricker E, Garg R, Nelson R, et al. Antibiotic treatment for Clostridium difficile-associated diarrhea in adults. Cochrane Database Syst Rev. 2005;(1):004610. [update in Cochrane Database Syst Rev. 2007;(3):CD004610; PMID: 17636768] [PubMed: 15674956]
108.
Bartlett JG, Gerding DN. Clinical recognition and diagnosis of Clostridium difficile infection. Clin Infect Dis. 2008 Jan 15;46 Suppl 1:S12–8. [PubMed: 18177217]
109.
Peterson LR, Robicsek A. Does my patient have Clostridium difficile infection? Ann Intern Med. 2009 Aug 4;151(3):176–9. [PubMed: 19652187]
110.
Cohen SH, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol. 2010 May;31(5):431–55. [PubMed: 20307191]
111.
Katz DA, Bates DW, Rittenberg E, et al. Predicting Clostridium difficile stool cytotoxin results in hospitalized patients with diarrhea. J Gen Intern Med. 1997 Jan;12(1):57–62. [PMC free article: PMC1497057] [PubMed: 9034947]
112.
Peled N, Pitlik S, Samra Z, et al. Predicting Clostridium difficile toxin in hospitalized patients with antibiotic-associated diarrhea. Infect Control Hosp Epidemiol. 2007 Apr;28(4):377–81. [PubMed: 17385141]
113.
Cooper GS, Lederman MM, Salata RA. A predictive model to identify Clostridium difficile toxin in hospitalized patients with diarrhea. Am J Gastroenterol. 1996 Jan;91(1):80–4. [PubMed: 8561149]
114.
Fekety R. Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis. American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 1997 May;92(5):739–50. [PubMed: 9149180]
115.
Gerding DN, Muto CA, Owens RC Jr. Treatment of Clostridium difficile infection. Clin Infect Dis. 2008 Jan 15;46 Suppl 1:S32–42. [PubMed: 18177219]
116.
Pepin J. Vancomycin for the treatment of Clostridium difficile Infection: for whom is this expensive bullet really magic? Clin Infect Dis. 2008 May 15;46(10):1493–8. [PubMed: 18419481]
117.
HICPAC. Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol. 1995 Feb;16(2):105–13. [PubMed: 7759811]
118.
Donskey CJ, Chowdhry TK, Hecker MT, et al. Effect of antibiotic therapy on the density of vancomycin-resistant enterococci in the stool of colonized patients. N Engl J Med. 2000 Dec 28;343(26):1925–32. [PMC free article: PMC4370337] [PubMed: 11136263]
119.
Olivas AD, Umanskiy K, Zuckerbraun B, et al. Avoiding colectomy during surgical management of fulminant clostridium difficile colitis. Surg Infect (Larchmt). 2010 Jun;11(3):299–305. [PubMed: 20583866]
120.
van Nood E, Speelman P, Kuijper EJ, et al. Struggling with recurrent Clostridium difficile infections: is donor faeces the solution? Euro Surveill. 2009;14(34) [PubMed: 19712646]
121.
Jodlowski TZ, Oehler R, Kam LW, et al. Emerging therapies in the treatment of Clostridium difficile-associated disease. Ann Pharmacother. 2006 Dec;40(12):2164–9. [PubMed: 17119105]
122.
Stepan C, Surawicz CM. Treatment strategies for C. difficile associated diarrhea. Acta Gastroenterologica Latinoamericana. 2007 Sep;37(3):183–91. [PubMed: 17955730]
123.
Halsey J. Current and future treatment modalities for Clostridium difficile-associated disease. Am J Health Syst Pharm. 2008 Apr 15;65(8):705–15. [PubMed: 18387898]
124.
Bakken JS. Fecal bacteriotherapy for recurrent Clostridium difficile infection. Anaerobe. 2009 Dec;15(6):285–9. [PubMed: 19778623]
125.
Food and Agriculture Organization of the United Nations; World Health Organization. Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria. Cordoba, Argentina: 2001. Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria.
126.
Khoruts A, Dicksved J, Jansson JK, et al. Changes in the composition of the human fecal microbiome after bacteriotherapy for recurrent Clostridium difficile-associated diarrhea. J Clin Gastroenterol. 2010 May-Jun;44(5):354–60. [PubMed: 20048681]
127.
Floch M. Fecal bacteriotherapy, fecal transplant, and the microbiome. J Clin Gastroenterol. 2010;44(8):529–30. [PubMed: 20601895]
128.
Silverman MS, Davis I, Pillai DR. Success of self-administered home fecal transplantation for chronic Clostridium difficile infection. Clin Gastroenterol Hepatol. 2010 May;8(5):471–3. [PubMed: 20117243]
129.
MacConnachie AA, Fox R, Kennedy DR, et al. Faecal transplant for recurrent Clostridium difficile-associated diarrhoea: a UK case series. QJM. 2009 Nov;102(11):781–4. [PubMed: 19726581]
130.
Yoon S, Brandt L. Treatment of refractory/recurrent C. difficile-associated disease by donated stool transplanted via colonoscopy: a case series of 12 patients. J Clin Gastroenterol. 2010;44(8):562–6. [PubMed: 20463588]
131.
Dubberke ER, Gerding DN, Classen D, et al. Strategies to prevent clostridium difficile infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008 Oct;29 Suppl 1:S81–92. [PubMed: 18840091]
132.
Jabbar U, Leischner J, Kasper D, et al. Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile spores from hands. Infect Control Hosp Epidemiol. 2010 Jun;31(6):565–70. [PubMed: 20429659]
133.
Roberts K, Smith CF, Snelling AM, et al. Aerial dissemination of Clostridium difficile spores. BMC Infectious Diseases. 2008;8:7. [PMC free article: PMC2245947] [PubMed: 18218089]
134.
Chang TW, Lauermann M, Bartlett JG. Cytotoxicity assay in antibiotic-associated colitis. J Infect Dis. 1979 Nov;140(5):765–70. [PubMed: 231071]
135.
Riegler M, Sedivy R, Pothoulakis C, et al. Clostridium difficile toxin B is more potent than toxin A in damaging human colonic epithelium in vitro. J Clin Invest. 1995 May;95(5):2004–11. [PMC free article: PMC295778] [PubMed: 7738167]
136.
Lyras D, O'Connor JR, Howarth PM, et al. Toxin B is essential for virulence of Clostridium difficile. Nature. 2009 Apr 30;458(7242):1176–9. [PMC free article: PMC2679968] [PubMed: 19252482]
137.
Wilkins TD, Lyerly DM. Clostridium difficile testing: after 20 years, still challenging. J Clin Microbiol. 2003 Feb;41(2):531–4. [PMC free article: PMC149726] [PubMed: 12574241]
138.
Brazier JS. The diagnosis of Clostridium difficile-associated disease. J Antimicrob Chemother. 1998 May;41 Suppl C:29–40. [PubMed: 9630372]
139.
Bouza E, Pelaez T, Alonso R, et al. “Second-look” cytotoxicity: an evaluation of culture plus cytotoxin assay of Clostridium difficile isolates in the laboratory diagnosis of CDAD. J Hosp Infect. 2001 Jul;48(3):233–7. [PubMed: 11439012]
140.
Delmee M. Laboratory diagnosis of Clostridium difficile disease. Clin Microbiol Infect. 2001 Aug;7(8):411–6. [PubMed: 11591203]
141.
Fenner L, Widmer AF, Goy G, et al. Rapid and reliable diagnostic algorithm for detection of Clostridium difficile. J Clin Microbiol. 2008 Jan;46(1):328–30. [PMC free article: PMC2224300] [PubMed: 18032627]
142.
Ticehurst JR, Aird DZ, Dam LM, et al. Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin. J Clin Microbiol. 2006 Mar;44(3):1145–9. [PMC free article: PMC1393084] [PubMed: 16517916]
143.
Wren MW, Sivapalan M, Kinson R, et al. Laboratory diagnosis of clostridium difficile infection. An evaluation of tests for faecal toxin, glutamate dehydrogenase, lactoferrin and toxigenic culture in the diagnostic laboratory. Br J Biomed Sci. 2009;66(1):1–5. [PubMed: 19348118]
144.
Bartlett JG, Perl TM. The new Clostridium difficile--what does it mean? N Engl J Med. 2005 Dec 8;353(23):2503–5. [PubMed: 16322604]
145.
McFarland LV. Update on the changing epidemiology of Clostridium difficile-associated disease. Nat Clin Pract Gastroenterol Hepatol. 2008 Jan;5(1):40–8. [PubMed: 18174906]
146.
al-Barrak A, Embil J, Dyck B, et al. An outbreak of toxin A negative, toxin B positive Clostridium difficile-associated diarrhea in a Canadian tertiary-care hospital. Can Commun Dis Rep. 1999 Apr 1;25(7):65–9. [PubMed: 10344088]
147.
Samra Z, Talmor S, Bahar J. High prevalence of toxin A-negative toxin B-positive Clostridium difficile in hospitalized patients with gastrointestinal disease. Diagn Microbiol Infect Dis. 2002 Jul;43(3):189–92. [PubMed: 12106951]
148.
Hookman P, Barkin JS. Clostridium difficile associated infection, diarrhea and colitis. World J Gastroenterol. 2009 Apr 7;15(13):1554–80. [PMC free article: PMC2669939] [PubMed: 19340897]
149.
Yucesoy M, McCoubrey J, Brown R, et al. Detection of toxin production in Clostridium difficile strains by three different methods. Clin Microbiol Infect. 2002 Jul;8(7):413–8. [PubMed: 12199851]
150.
Kelly CP, Pothoulakis C, LaMont JT. Clostridium difficile colitis. N Engl J Med. 1994 Jan 27;330(4):257–62. [PubMed: 8043060]
151.
Lamontagne F, Labbe AC, Haeck O, et al. Impact of emergency colectomy on survival of patients with fulminant Clostridium difficile colitis during an epidemic caused by a hypervirulent strain. Ann Surg. 2007 Feb;245(2):267–72. [PMC free article: PMC1876996] [PubMed: 17245181]
152.
Zhanel G, Hammond G. Key research issues in Clostridium difficile. Can J Infect Dis Med Microbiol. 2005 Sep;16(5):282–5. [PMC free article: PMC2095041] [PubMed: 18159559]
153.
McDonald LC, Killgore GE, Thompson A, et al. An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med. 2005 Dec 8;353(23):2433–41. [PubMed: 16322603]
154.
Courvalin P. Vancomycin resistance in gram-positive cocci. Clin Infect Dis. 2006 Jan 1;42 Suppl 1:S25–34. [PubMed: 16323116]
155.
Whiting PF, Weswood ME, Rutjes AW, et al. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol. 2006;6:9. [PMC free article: PMC1421422] [PubMed: 16519814]
156.
Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003 Nov 10;3:25. [PMC free article: PMC305345] [PubMed: 14606960]
157.
Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration; 2008. Version 5.0.2 [updated September 2009]
158.
Schulz KF, Grimes DA. Allocation concealment in randomised trials: defending against deciphering. Lancet. 2002 Feb 16;359(9306):614–8. [PubMed: 11867132]
159.
Owens DK, Lohr KN, Atkins D, et al. AHRQ series paper 5: grading the strength of a body of evidence when comparing medical interventions--agency for healthcare research and quality and the effective healthcare program. J Clin Epidemiol. 2010 May;63(5):513–23. [PubMed: 19595577]
160.
Review Manager [computer program]. Version 5.0. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2008.
161.
Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003 Sep 6;327(7414):557–60. [PMC free article: PMC192859] [PubMed: 12958120]
162.
Tang NS, Li HQ, Tang ML. A comparison of methods for the construction of confidence interval for relative risk in stratified matched-pair designs. Stat Med. 2010 Jan 15;29(1):46–62. [PubMed: 19856277]
163.
van den Berg RJ, Vaessen N, Endtz HP, et al. Evaluation of real-time PCR and conventional diagnostic methods for the detection of Clostridium difficile-associated diarrhoea in a prospective multicentre study. J Med Microbiol. 2007 Jan;56(Pt 1):36–42. [PubMed: 17172514]
164.
Alcala L, Marin M, Madrid M, et al. Comparison of ImmunoCard Toxins A&B and the new semiautomated Vidas Clostridium difficile Toxin A&B tests for diagnosis of C. difficile infection. J Clin Microbiol. 2010 Mar;48(3):1014–5. [PMC free article: PMC2832450] [PubMed: 20071550]
165.
Swindells J, Brenwald N, Reading N, et al. Evaluation of diagnostic tests for Clostridium difficile infection. J Clin Microbiol. 2010 Feb;48(2):606–8. [PMC free article: PMC2815642] [PubMed: 20032256]
166.
Vesta KS, Wells PG, Gentry CA, et al. Specific risk factors for Clostridium difficile-associated diarrhea: a prospective, multicenter, case control evaluation. Am J Infect Control. 2005 Oct;33(8):469–72. [PubMed: 16216661]
167.
Kyne L, Sougioultzis S, McFarland LV, et al. Underlying disease severity as a major risk factor for nosocomial Clostridium difficile diarrhea. Infect Control Hosp Epidemiol. 2002 Nov;23(11):653–9. [PubMed: 12452292]
168.
Mody LR, Smith SM, Dever LL. Clostridium difficile-associated diarrhea in a VA medical center: clustering of cases, association with antibiotic usage, and impact on HIV-infected patients. Infect Control Hosp Epidemiol. 2001 Jan;22(1):42–5. [PubMed: 11198022]
169.
Samore MH, Venkataraman L, DeGirolami PC, et al. Genotypic and phenotypic analysis of Clostridium difficile correlated with previous antibiotic exposure. Microb Drug Resist. 2006;12(1):23–8. [PubMed: 16584304]
170.
Schwaber MJ, Simhon A, Block C, et al. Factors associated with nosocomial diarrhea and Clostridium difficile-associated disease on the adult wards of an urban tertiary care hospital. Eur J Clin Microbiol Infect Dis. 2000 Jan;19(1):9–15. [PubMed: 11699546]
171.
Yearsley KA, Gilby LJ, Ramadas AV, et al. Proton pump inhibitor therapy is a risk factor for Clostridium difficile-associated diarrhoea. Aliment Pharmacol Ther. 2006 Aug 15;24(4):613–9. [PubMed: 16907893]
172.
Carling P, Fung T, Killion A, et al. Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol. 2003 Sep;24(9):699–706. [PubMed: 14510254]
173.
Climo MW, Israel DS, Wong ES, et al. Hospital-wide restriction of clindamycin: effect on the incidence of Clostridium difficile-associated diarrhea and cost. Ann Intern Med. 1998 Jun 15;128(12 Pt 1):989–95. [PubMed: 9625685]
174.
Khan R, Cheesbrough J. Impact of changes in antibiotic policy on Clostridium difficile-associated diarrhoea (CDAD) over a five-year period in a district general hospital. J Hosp Infect. 2003 Jun;54(2):104–8. [PubMed: 12818582]
175.
Otter JA, Puchowicz M, Ryan D, et al. Feasibility of routinely using hydrogen peroxide vapor to decontaminate rooms in a busy United States hospital. Infect Control Hosp Epidemiol. 2009 Jun;30(6):574–7. [PubMed: 19415969]
176.
Starr JM, Martin H, McCoubrey J, et al. Risk factors for Clostridium difficile colonisation and toxin production. Age Ageing. 2003 Nov;32(6):657–60. [PubMed: 14600008]
177.
Winston DJ, Lazarus HM, Beveridge RA, et al. Randomized, double-blind, multicenter trial comparing clinafloxacin with imipenem as empirical monotherapy for febrile granulocytopenic patients. Clin Infect Dis. 2001 Feb 1;32(3):381–90. [PubMed: 11170945]
178.
Johnson S, Clabots CR, Linn FV, et al. Nosocomial Clostridium difficile colonisation and disease. Lancet. 1990 Jul 14;336(8707):97–100. [PubMed: 1975332]
179.
Mogg GA, Arabi Y, Youngs D, et al. Therapeutic trials of antibiotic associated colitis. Scand J Infect Dis Supplement. 1980;(Suppl 22):41–5. [PubMed: 7010533]
180.
Proceedings of the 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy; 2007 Sept 17–20; Chicago.
181.
Zar F, Davis M. Reply to Bishara et al., Huggan et al., and Lawrence et al. Clin Infect Dis. 2007;45(12):1649–51.
182.
Lawrence SJ, Dubberke ER, Johnson S, et al. Clostridium difficile-associated disease treatment response depends on definition of cure. Clin Infect Dis. 2007 Dec 15;45(12):1648. author reply 9-51. [PubMed: 18190331]
183.
Huggan PJ, Murdoch DR. Vancomycin therapy for severe Clostridium difficile-associated diarrhea. Clin Infect Dis. 2007 Dec 15;45(12):1647–8. author reply 9-51. [PubMed: 18190330]
184.
Bishara J, Wattad M, Paul M. Vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea. Clin Infect Dis. 2007 Dec 15;45(12):1646–7. author reply 9-51. [PubMed: 18190329]
185.
Al-Nassir WN, Sethi AK, Li Y, et al. Both oral metronidazole and oral vancomycin promote persistent overgrowth of vancomycin-resistant enterococci during treatment of Clostridium difficile-associated disease. Antimicrob Agents Chemother. 2008 Jul;52(7):2403–6. [PMC free article: PMC2443881] [PubMed: 18443120]
186.
Lam S, Singer C, Tucci V, et al. The challenge of vancomycin-resistant enterococci: a clinical and epidemiologic study. Am J Infect Control. 1995 Jun;23(3):170–80. [PubMed: 7677262]
187.
de Lalla F, Nicolin R, Rinaldi E, et al. Prospective study of oral teicoplanin versus oral vancomycin for therapy of pseudomembranous colitis and Clostridium difficile-associated diarrhea. Antimicrob Agents Chemother. 1992 Oct;36(10):2192–6. [PMC free article: PMC245474] [PubMed: 1444298]
188.
McFarland LV, Surawicz CM, Greenberg RN, et al. Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995 Mar;90(3):439–48. [PubMed: 7872284]
189.
MacGregor G, Smith AJ, Thakker B, et al. Yoghurt biotherapy: contraindicated in immunosuppressed patients? Postgrad Med J. 2002 Jun;78(920):366–7. [PMC free article: PMC1742399] [PubMed: 12151695]
190.
Pakyz A. A case of recurrent Clostridium difficile diarrhea. Consult Pharm. 2007 Mar;22(3):249–53. [PubMed: 17658971]
191.
McDonald GB, Vracko R. Systemic absorption of oral cholestyramine. Gastroenterol. 1984 Jul;87(1):213–5. [PubMed: 6724264]
192.
Kunimoto D, Thomson AB. Recurrent Clostridium difficile-associated colitis responding to cholestyramine. Digestion. 1986;33(4):225–8. [PubMed: 3956890]
193.
Rohlke F, Surawicz C, Stollman N. Fecal flora reconstitution for recurrent clostridium difficile infection: results and methodology. J Clin Gastroenterol. 2010;44(8):567–70. [PubMed: 20485184]
194.
Taylor CP, Tummala S, Molrine D, et al. Open-label, dose escalation phase I study in healthy volunteers to evaluate the safety and pharmacokinetics of a human monoclonal antibody to Clostridium difficile toxin A. Vaccine. 2008 Jun 25;26(27-28):3404–9. [PMC free article: PMC2628753] [PubMed: 18502001]
195.
McPherson S, Rees CJ, Ellis R, et al. Intravenous immunoglobulin for the treatment of severe, refractory, and recurrent Clostridium difficile diarrhea. Dis Colon Rectum. 2006 May;49(5):640–5. [PubMed: 16525744]
196.
Hassoun A, Ibrahim F. Use of intravenous immunoglobulin for the treatment of severe Clostridium difficile colitis. Am J Geriatr Pharmacother. 2007 Mar;5(1):48–51. [PubMed: 17608247]
197.
Murphy C, Vernon M, Cullen M. Intravenous immunoglobulin for resistant Clostridium difficile infection. Age Ageing. 2006 Jan;35(1):85–6. [PubMed: 16303776]
198.
Herpers BL, Vlaminckx B, Burkhardt O, et al. Intravenous tigecycline as adjunctive or alternative therapy for severe refractory Clostridium difficile infection. Clin Infect Dis. 2009 Jun 15;48(12):1732–5. [PubMed: 19435431]
199.
Sougioultzis S, Kyne L, Drudy D, et al. Clostridium difficile toxoid vaccine in recurrent C. difficile-associated diarrhea. Gastroenterol. 2005 Mar;128(3):764–70. [PubMed: 15765411]
200.
Seal D, Borriello SP, Barclay F, et al. Treatment of relapsing Clostridium difficile diarrhoea by administration of a non-toxigenic strain. Eur J Clin Microbiol. 1987 Feb;6(1):51–3. [PubMed: 3569251]
201.
Kimura Y, Sato K, Tokuda H, et al. Effects of combination therapy with direct hemoperfusion using polymyxin B-immobilized fiber and oral vancomycin on fulminant pseudomembranous colitis with septic shock. Dig Dis Sci. 2007 Mar;52(3):675–8. [PubMed: 17273924]
202.
Kotloff KL, Wasserman SS, Losonsky GA, et al. Safety and immunogenicity of increasing doses of a Clostridium difficile toxoid vaccine administered to healthy adults. Infect Immun. 2001 Feb;69(2):988–95. [PMC free article: PMC97978] [PubMed: 11159994]
203.
Tenover F, Novak-Weekley S, Woods C, et al. Impact of strain type on detection of toxigenic Clostridium difficile: comparison of molecular diagnostic and enzyme immunoassay approaches. J Clin Microbiol. 2010;48(10):3719–24. [PMC free article: PMC2953097] [PubMed: 20702676]
204.
Bettin K, Clabots C, Mathie P, et al. Effectiveness of liquid soap vs. chlorhexidine gluconate for the removal of Clostridium difficile from bare hands and gloved hands. Infect Control Hosp Epidemiol. 1994 Nov;15(11):697–702. [PubMed: 7852725]
205.
Kramer A, Schwebke I, Kampf G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis. 2006;6:130. [PMC free article: PMC1564025] [PubMed: 16914034]
206.
Kelly CP, LaMont JT. Clostridium difficile--more difficult than ever. N Engl J Med. 2008 Oct 30;359(18):1932–40. [PubMed: 18971494]
207.
Pillai A, Nelson R. Probiotics for treatment of Clostridium difficile-associated colitis in adults. Cochrane Database Syst Rev. 2008;(1):CD004611. [PubMed: 18254055]
208.
Eddins C, Gray M. Are probiotic or synbiotic preparations effective for the management of clostridium difficile-associated or radiation-induced diarrhea? J Wound Ostomy Continence Nurs. 2008 Jan-Feb;35(1):50–8. [PubMed: 18199939]
209.
Segarra-Newnham M. Probiotics for Clostridium difficile-associated diarrhea: focus on Lactobacillus rhamnosus GG and Saccharomyces boulardii. Ann Pharmacother. 2007 Jul;41(7):1212–21. [PubMed: 17595306]
210.
Dendukuri N, Costa V, McGregor M, et al. Probiotic therapy for the prevention and treatment of Clostridium difficile-associated diarrhea: a systematic review. CMAJ. 2005 Jul 19;173(2):167–70. [PMC free article: PMC1174857] [PubMed: 16027434]
211.
McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006 Apr;101(4):812–22. [PubMed: 16635227]
212.
O'Horo J, Safdar N. The role of immunoglobulin for the treatment of Clostridium difficile infection: a systematic review. Int J Infect Dis. 2009 Nov;13(6):663–7. [PubMed: 19186089]
213.
Schunemann HJ, Oxman AD, Brozek J, et al. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ. 2008 May 17;336(7653):1106–10. [PMC free article: PMC2386626] [PubMed: 18483053]
214.
Bakken JS. Resolution of recurrent Clostridium difficile-associated diarrhea using staggered antibiotic withdrawal and kefir. Minn Med. 2009 Jul;92(7):38–40. [PubMed: 19708314]
215.
Turnbaugh PJ, Ley RE, Hamady M, et al. The human microbiome project. Nature. 2007 Oct 18;449(7164):804–10. [PMC free article: PMC3709439] [PubMed: 17943116]
216.
Hattori M, Taylor TD. The human intestinal microbiome: a new frontier of human biology. DNA Res. 2009 Feb;16(1):1–12. [PMC free article: PMC2646358] [PubMed: 19147530]
217.
Merrigan MM, Sambol SP, Johnson S, et al. New approach to the management of Clostridium difficile infection: colonisation with non-toxigenic C. difficile during daily ampicillin or ceftriaxone administration. Int J Antimicrob Agents. 2009 Mar;33 Suppl 1:S46–50. [PubMed: 19303570]

Views

  • PubReader
  • Print View
  • Cite this Page
  • PDF version of this title (1.5M)

Other titles in these collections

Recent Activity

ClearTurn OffTurn On

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...