Clostridium difficile infection: new developments in epidemiology and pathogenesis

The Pervasive Effects of an Antibiotic on the Human Gut Microbiota, as Revealed by Deep 16S rRNA Sequencing

2008 • 2,252 citations

An Epidemic, Toxin Gene–Variant Strain ofClostridium difficile

2005 • 2,004 citations

A Predominantly Clonal Multi-Institutional Outbreak ofClostridium difficile–Associated Diarrhea with High Morbidity and Mortality

2005 • 1,938 citations

Interventions to improve antibiotic prescribing practices for hospital inpatients

2013 • 1,706 citations

Nosocomial Acquisition ofClostridium difficileInfection

1989 • 1,367 citations

A Comparison of Vancomycin and Metronidazole for the Treatment of Clostridium difficile-Associated Diarrhea, Stratified by Disease Severity

2007 • 1,254 citations

Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity

2004 • 1,134 citations

Glucosylation of Rho proteins by Clostridium difficile toxin B

1995 • 1,025 citations

Emergence of Fluoroquinolones as the Predominant Risk Factor for Clostridium difficile-Associated Diarrhea: A Cohort Study during an Epidemic in Quebec

2005 • 997 citations

Decreased Diversity of the Fecal Microbiome in RecurrentClostridium difficile–Associated Diarrhea

2008 • 981 citations

Asymptomatic Carriage ofClostridium difficileand Serum Levels of IgG Antibody against Toxin A

2000 • 937 citations

The multidrug-resistant human pathogen Clostridium difficile has a highly mobile, mosaic genome

2006 • 866 citations

Meta-Analysis of Probiotics for the Prevention of Antibiotic Associated Diarrhea and the Treatment of Clostridium difficile Disease

2006 • 848 citations

Emergence of Clostridium difficile-associated disease in North America and Europe

2006 • 828 citations

PROSPECTIVE RANDOMISED TRIAL OF METRONIDAZOLE VERSUS VANCOMYCIN FOR CLOSTRIDIUM-DIFFICILE-ASSOCIATED DIARRHOEA AND COLITIS

1983 • 798 citations

Association between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea

2001 • 789 citations

Toxin B is essential for virulence of Clostridium difficile

2009 • 724 citations

The ClosTron: A universal gene knock-out system for the genus Clostridium

2007 • 632 citations

Emergence ofClostridium difficileInfection Due to a New Hypervirulent Strain, Polymerase Chain Reaction Ribotype 078

2008 • 628 citations

Fulminant Clostridium difficile: An Underappreciated and Increasing Cause of Death and Complications

2002 • 623 citations

A Large Outbreak ofClostridium difficile–Associated Disease with an Unexpected Proportion of Deaths and Colectomies at a Teaching Hospital Following Increased Fluoroquinolone Use

2005 • 621 citations

The Comprehensive Sourcebook of Bacterial Protein Toxins

2015 • 601 citations

Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies

2004 • 584 citations

Asymptomatic Carriers Are a Potential Source for Transmission of Epidemic and Nonepidemic Clostridium difficile Strains among Long-Term Care Facility Residents

2007 • 542 citations

RecurrentClostridium difficileColitis: Case Series Involving 18 Patients Treated with Donor Stool Administered via a Nasogastric Tube

2003 • 515 citations

Clinical Recognition and Diagnosis ofClostridium difficileInfection

2008 • 512 citations

Production of actin-specific ADP-ribosyltransferase (binary toxin) by strains of Clostridium difficile

2000 • 428 citations

Effects of Clostridium difficile toxins given intragastrically to animals

1985 • 398 citations

Primary symptomless colonisation by Clostridium difficile and decreased risk of subsequent diarrhoea

1998 • 390 citations

Epidemics of Diarrhea Caused by a Clindamycin-Resistant Strain ofClostridium difficilein Four Hospitals

1999 • 380 citations

A case-control study of community-associated Clostridium difficile infection

2008 • 378 citations

Impact of Emergency Colectomy on Survival of Patients With Fulminant Clostridium difficile Colitis During an Epidemic Caused by a Hypervirulent Strain

2007 • 359 citations

Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea

1996 • 346 citations

Clostridium difficile toxin B is more potent than toxin A in damaging human colonic epithelium in vitro.

1995 • 344 citations

Comparison of Seven Techniques for Typing International Epidemic Strains of Clostridium difficile : Restriction Endonuclease Analysis, Pulsed-Field Gel Electrophoresis, PCR-Ribotyping, Multilocus Sequence Typing, Multilocus Variable-Number Tandem-Repeat Analysis, Amplified Fragment Length Polymorphism, and Surface Layer Protein A Gene Sequence Typing

2007 • 336 citations

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

2007 • 334 citations

Diagnosis of Clostridium difficile infection by toxin detection kits: a systematic review

2008 • 334 citations

A Novel Toxinotyping Scheme and Correlation of Toxinotypes with Serogroups of Clostridium difficile Isolates

1998 • 324 citations

Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission

1990 • 319 citations

Definition of the single integration site of the pathogenicity locus in Clostridium difficile

1996 • 315 citations

Clostridium difficile: History of Its Role as an Enteric Pathogen and the Current State of Knowledge About the Organism

1994 • 311 citations

Epidemiological Features of Clostridium difficile-Associated Disease Among Inpatients at Children's Hospitals in the United States, 2001–2006

2008 • 309 citations

Update of Clostridium difficile infection due to PCR ribotype 027 in Europe, 2008

2008 • 285 citations

Environmental Control to Reduce Transmission ofClostridium difficile

2000 • 280 citations

Production of a complete binary toxin (actin-specific ADP-ribosyltransferase) by Clostridium difficile CD196

1997 • 277 citations

Comparison of the effect of detergent versus hypochlorite cleaning on environmental contamination and incidence of Clostridium difficile infection

2003 • 273 citations

Prevalence of PCR Ribotypes among Clostridium difficile Isolates from Pigs, Calves, and Other Species

2007 • 273 citations

The distribution of Clostridium difficile in the environment of South Wales

1996 • 265 citations

Clostridium difficilein Retail Ground Meat, Canada

2007 • 264 citations

Clostridium difficilein Retail Meat Products, USA, 2007

2009 • 262 citations

Outbreak ofClostridium difficileInfection in a Long‐Term Care Facility: Association with Gatifloxacin Use

2004 • 254 citations

Large clostridial cytotoxins — a family of glycosyltransferases modifying small GTP-binding proteins

1996 • 250 citations

Regulation of toxin synthesis in Clostridium difficile by an alternative RNA polymerase sigma factor

2001 • 245 citations

Emergence of reduced susceptibility to metronidazole in Clostridium difficile

2008 • 244 citations

Epidemiology of Community-Acquired Clostridium difficile-Associated Diarrhea

1994 • 242 citations

Autocatalytic cleavage of Clostridium difficile toxin B

2007 • 239 citations

Prospective Derivation and Validation of a Clinical Prediction Rule for Recurrent Clostridium difficile Infection

2008 • 238 citations

Control of an Outbreak of Infection with the Hypervirulent Clostridium difficile BI Strain in a University Hospital Using a Comprehensive "Bundle" Approach

2007 • 237 citations

Clostridium difficile toxin expression is inhibited by the novel regulator TcdC

2007 • 224 citations

Repression of Clostridium difficile toxin gene expression by CodY

2007 • 223 citations

Toxinotype VClostridium difficilein Humans and Food Animals

2008 • 221 citations

Comparison of Real-Time PCR for Detection of the tcdC Gene with Four Toxin Immunoassays and Culture in Diagnosis of Clostridium difficile Infection

2008 • 219 citations

Clostridium difficile PCR Ribotypes in Calves, Canada

2006 • 217 citations

Effective Detection of Toxigenic Clostridium difficile by a Two-Step Algorithm Including Tests for Antigen and Cytotoxin

2006 • 212 citations

Probiotic therapy for the prevention and treatment of Clostridium difficile-associated diarrhea: a systematic review

2005 • 210 citations

Clostridium difficile: An important pathogen of food animals

2005 • 206 citations

tcdC Genotypes Associated with Severe TcdC Truncation in an Epidemic Clone and Other Strains of Clostridium difficile

2006 • 198 citations

Binary Toxin–Producing, Large Clostridial Toxin–NegativeClostridium difficileStrains Are Enterotoxic but Do Not Cause Disease in Hamsters

2006 • 196 citations

A Portrait of the Geographic Dissemination of the Clostridium difficile North American Pulsed-Field Type 1 Strain and the Epidemiology of C. difficile-Associated Disease in Quebec

2006 • 194 citations

Transcription Analysis of the Genes tcdA‐E of the Pathogenicity Locus of Clostridium Difficile

1997 • 191 citations

Auto-catalytic Cleavage of Clostridium difficile Toxins A and B Depends on Cysteine Protease Activity

2007 • 187 citations

Rho-glucosylating Clostridium difficile toxins A and B: new insights into structure and function

2007 • 178 citations

Rifampin and Rifaximin Resistance in Clinical Isolates of Clostridium difficile

2008 • 176 citations

Patterns of antibiotic use and risk of hospital admission because of Clostridium difficile infection

2008 • 167 citations

Recurrences of Clostridium difficile Diarrhea Not Caused by the Original Infecting Organism

1989 • 167 citations

Efficacy of Hospital Cleaning Agents and Germicides Against EpidemicClostridium difficileStrains

2007 • 163 citations

Heterogeneity of large clostridial toxins: importance ofClostridium difficiletoxinotypes

2008 • 159 citations

The Comparative Pathology of Clostridium difficile-associated Disease

2006 • 158 citations

Metronidazole Resistance in Clostridium difficile Is Heterogeneous

2008 • 155 citations

Clostridium difficile Infections in a Canadian Tertiary Care Hospital before and during a Regional Epidemic Associated with the BI/NAP1/027 Strain

2008 • 149 citations

The Comprehensive Sourcebook of Bacterial Protein Toxins

2006 • 147 citations

A novel toxin homologous to large clostridial cytotoxins found in culture supernatant of Clostridium perfringens type C

2007 • 143 citations

Clostridium difficile toxin synthesis is negatively regulated by TcdC

2008 • 143 citations

Evidence for holin function of tcdE gene in the pathogenicity of Clostridium difficile

2001 • 143 citations

Comparison of the efficacy of ramoplanin and vancomycin in both in vitro and in vivo models of clindamycin-induced Clostridium difficile infection

2005 • 140 citations

Binary Toxin Production in Clostridium difficile Is Regulated by CdtR, a LytTR Family Response Regulator

2007 • 139 citations

Systematic Review of Antimicrobial Drug Prescribing in Hospitals

2006 • 133 citations

Clostridium difficile–associated diarrhea: an emerging threat to pregnant women

2008 • 120 citations

Relapse versus reinfection withClostridium difficile

1991 • 119 citations

Effects of Clostridium difficile Toxins on Epithelial Cell Barrier

2000 • 104 citations

Human antibody response to surface layer proteins inClostridium difficileinfection

2004 • 103 citations

Revised nomenclature of Clostridium difficile toxins and associated genes

2005 • 98 citations

Long-term surveillance of cefotaxime and piperacillin-tazobactam prescribing and incidence of Clostridium difficile diarrhoea

2004 • 98 citations

gp96 Is a Human Colonocyte Plasma Membrane Binding Protein for Clostridium difficile Toxin A

2008 • 96 citations

Surface layer proteins from Clostridium difficile induce inflammatory and regulatory cytokines in human monocytes and dendritic cells

2006 • 89 citations

Proteomic analysis of cell surface proteins from Clostridium difficile

2005 • 89 citations

Treatment of Clostridium difficile colitis and diarrhea with vancomycin

1981 • 81 citations

Variability of Clostridium difficile Surface Proteins and Specific Serum Antibody Response in Patients with Clostridium difficile -Associated Disease

2005 • 79 citations

Identification of Clostridium difficile toxin B cardiotoxicity using a zebrafish embryo model of intoxication

2006 • 78 citations

Activity of vancomycin against epidemic Clostridium difficile strains in a human gut model

2008 • 76 citations

Reduction in Vancomycin-Resistant Enterococcus and Clostridium Difficile Infections Following Change to Tympanic Thermometers

1998 • 76 citations

A Randomized Crossover Study of Disposable Thermometers for Prevention of Clostridium difficile and Other Nosocomial Infections

1998 • 75 citations

Patterns of Sequence Conservation in the S-Layer Proteins and Related Sequences in Clostridium difficile

2002 • 61 citations

Use of Highly Discriminatory Fingerprinting to Analyze Clusters of Clostridium difficile Infection Cases Due to Epidemic Ribotype 027 Strains

2008 • 60 citations

Cytotoxic Effects of the Clostridium difficile Toxins

2000 • 59 citations

Increased number of Clostridium difficile infections and prevalence of Clostridium difficile PCR ribotype 001 in southern Germany

2008 • 58 citations

Comparison of oritavancin versus vancomycin as treatments for clindamycin-induced Clostridium difficile PCR ribotype 027 infection in a human gut model

2008 • 56 citations

Effects of Exposure of Clostridium difficile PCR Ribotypes 027 and 001 to Fluoroquinolones in a Human Gut Model

2008 • 53 citations

Prevention of FatalClostridium difficile–Associated Disease during Continuous Administration of Clindamycin in Hamsters

2003 • 53 citations

Reduction in Vancomycin-Resistant Enterococcus and Clostridium difficile Infections following Change to Tympanic Thermometers

1998 • 47 citations

A Randomized Crossover Study of Disposable Thermometers for Prevention of Clostridium difficile and Other Nosocomial Infections

1998 • 46 citations

Rates of Clostridium difficile Infection in Patients Discharged From Spanish Hospitals, 1997-2005

2008 • 39 citations

Susceptibility of hamsters to human pathogenic Clostridium difficile strain B1 following clindamycin, ampicillin or ceftriaxone administration

2003 • 25 citations

Cross-Contamination of Clostridium difficile Spores on Bed Linen During Laundering

2007 • 17 citations