Surface-layer protein A (SlpA) is a major contributor to host-cell adherence of Clostridium difficile.

Clostridium difficile is a leading cause of antibiotic-associated diarrhea, and a significant etiologic agent of healthcare-associated infections. The mechanisms of attachment and host colonization of C. difficile are not well defined.

Assessment of 30-day all-cause mortality in metronidazole-treated patients with Clostridium difficile infection.

The Society for Healthcare Epidemiology (SHEA) and the Infectious Diseases Society of America (IDSA) clinical practice guidelines for Clostridium difficile infection (CDI) help to define and make recommendations for the treatment of mild to moderate disease with metronidazole and severe disease with vancomycin. We retrospectively evaluated 285 patients who were initially treated with metronidazole and stratified them by severity of illness using the guideline criteria. We compared the outcomes in the 2 groups including the need to change therapy, recurrences, and 30-day all-cause mortality.

Decreasing incidence of Staphylococcus aureus bacteremia over 9 years: greatest decline in community-associated methicillin-susceptible and hospital-acquired methicillin-resistant isolates.

Background: The impact of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) emergence on the epidemiology of S aureus bacteremia (SAB) is not well documented.

Methods: This was an observational study of adult (aged ≥18 years) inpatients with SAB in a single 808-bed teaching hospital during 2002-2003, 2005-2006, 2008-2009, and 2010 with period-stratified SAB rate, onset mode, patient characteristics, and outcome.

Results: We encountered a total of 1,098 cases over the entire study period.

Current state of Clostridium difficile treatment options.

Recent reports of reduced response to standard therapies for Clostridium difficile infection (CDI) and the risk for recurrent CDI that is common with all currently available treatment agents have posed a significant challenge to clinicians. Current recommendations include metronidazole for treatment of mild to moderate CDI and vancomycin for severe CDI. Results from small clinical trials suggest that nitazoxanide and teicoplanin may be alternative options to standard therapies, whereas rifaximin has demonstrated success in uncontrolled trials for the management of multiple recurrences.

Risk and prognostic factors among patients with bacteremia due to Eggerthella lenta.

Eggerthella lenta is a Gram-positive non-spore forming anaerobic commensal bacilli that can cause bacteremia due to abdominal or soft tissue sources. Patients are frequently bedridden and infection is associated with a high mortality rate. Absence of fever at presentation and need for ICU stay are risk factors for 30-day mortality.

Fidaxomicin: a novel macrocyclic antibiotic approved for treatment of Clostridium difficile infection.

Fidaxomicin, a nonabsorbed macrocyclic compound, is the first antimicrobial agent approved by the FDA for the treatment of Clostridium difficile infection (CDI) in adults over the last 25 years. It is bactericidal, and its mechanism of action relates to inhibition of a RNA polymerase at a site distinct from where rifamycins interact. Fidaxomicin, 200 milligrams by mouth twice daily, is not inferior to vancomycin, 125 milligrams by mouth 4 times daily, for treatment of CDI as determined by clinical response after 10 days of treatment and is superior to vancomycin for sustained response without recurrence 25 days after treatment completion.

Gemcitabine-associated "pseudocellulitis" and "pseudosepsis": a case report and review of the literature.

Chemotherapeutic agents have been associated with sepsis and a variety of opportunistic and nonopportunistic infections. This was attributed to their immunosuppressive effects. Like all other chemotherapeutic agents, the use of gemcitabine has been associated with different infectious processes, yet many conditions that mimic infections have also been linked to its use.

Clostridium difficile infection rates and spectrum of disease among peripartum women at one hospital from 2003 to 2007 with molecular typing analysis of recovered Clostridium difficile isolates.

Background: Peripartum women are at risk for Clostridium difficile infection (CDI), but the risk magnitude and clinical disease spectrum are unknown. We determined the incidence and clinical features of CDI in peripartum women in the Loyola University Medical Center system and describe typing of C difficile isolates by restriction endonuclease analysis (REA).

Methods: A retrospective chart review of peripartum CDI from 2003 to 2007 was performed after identifying patients from the clinical laboratory log of positive C difficile toxin assays.

Human hypervirulent Clostridium difficile strains exhibit increased sporulation as well as robust toxin production.

Toxigenic Clostridium difficile strains produce two toxins (TcdA and TcdB) during the stationary phase of growth and are the leading cause of antibiotic-associated diarrhea. C. difficile isolates of the molecular type NAP1/027/BI have been associated with severe disease and hospital outbreaks worldwide.

Emergence of community-associated methicillin-resistant Staphylococcus aureus infection among patients with end-stage renal disease.

Objective: To evaluate the frequency of infections due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains among our patients with end-stage renal disease.

Design: Prospective observational clinical and laboratory study of patients in 2005. Molecular features of isolates recovered from these patients were compared with those of isolates recovered in 2000 from patients with end-stage renal disease.