Colitis Due to Clostridium Difficile Toxins: Underdiagnosed, Highly Virulent, and Nosocomial

• Hoberman LJ, Eigenbrodt EH, Kilman WJ, Hughes LR, Norgaard RP, Fordtran JS. Colitis associated with oral clindamycin therapy. A clinical study of 16 patients. Am J Dig Dis 1976;21 (1): 1–17.
   Google Scholar
• Larson HE, Parry JV, Price AB, Davies DR, Dolby J, Tyrrell DA. Undescribed toxin in pseudomembranous colitis. Br Med J 1977;1 (6071): 1246–1248.
   PubMedGoogle Scholar
• Rifkin GD, Fekety FR, Silva J Jr. Antibiotic-induced colitis: implication of a toxin neutralised by Clostridium sordellii antitoxin. Lancet 1977;2 (8048): 1103–1106.
   PubMed Web of Science ®Google Scholar
• Bartlett JG, Onderdonk AB, Cisneros RL, Kasper DL. Clindamycin-associated colitis due to a toxin-producing species of Clostridium in hamsters. J Infect Dis 1977;136 (5): 701–705.
   PubMed Web of Science ®Google Scholar
• George RH, Symonds JM, Dimock F, Brown JD, Arabi Y, Shinagawa N, Keighley MR, Alexander-Williams J, Burdon DW. Identification of Clostridium difficile as a cause of pseudomembranous colitis. Br Med J 1978;1 (6114): 695.
   PubMed Web of Science ®Google Scholar
• Khan MY, Hall WH. Staphylococcal enterocolitis—treatment with oral vancomycin. Ann Intern Med 1966;65 (1): 1–8.
   Web of Science ®Google Scholar
• Hall IC, O'Toole E. Intestinal flora in newborn infants with description of a new pathogenic anaerobe, Bacillus difficilis. Am J Dis Child 1935;49: 390.
   Google Scholar
• Allen SD. Pig-bel and other necrotizing disorders of the gut involving Clostridium perfringens. In Connor DH, Chandler FW, Schwartz DA, Manz HJ, Lack EE, Manz H, eds. Pathology of Infectious Diseases. New York: McGraw-Hill Professional, 1997.
   Google Scholar
• Just I, Gerhard R. Large clostridial cytotoxins. Rev Physiol Biochem Pharmacol 2004;152 (1): 23–47.
   Google Scholar
• Hurley BW, Nguyen CC. The spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea. Arch Intern Med 2002;162 (19): 2177–2184.
   PubMedGoogle Scholar
• Bouza E, Munoz P, Alonso R. Clinical manifestations, treatment and control of infections caused by Clostridium difficile. Clin Microbiol Infect 2005;11 (Suppl 4): 57–64.
   Google Scholar
• Aboudola S, Kotloff KL, Kyne L, Warny M, Kelly EC, Sougioultzis S, Giannasca PJ, Monath TP, Kelly CP. Clostridium difficile vaccine and serum immunoglobulin G antibody response to toxin A. Infect Immun 2003;71 (3): 1608–1610.
   PubMed Web of Science ®Google Scholar
• Sougioultzis S, Kyne L, Drudy D, Keates S, Maroo S, Pothoulakis C, Giannasca PJ, Lee CK, Warny M, Monath TP, Kelly CP. Clostridium difficile toxoid vaccine in recurrent C. difficile–associated diarrhea. Gastroenterology 2005;128 (3): 764–770.
   Web of Science ®Google Scholar
• Salcedo J, Keates S, Pothoulakis C, Warny M, Castagliuolo I, LaMont JT, Kelly CP. Intravenous immunoglobulin therapy for severe Clostridium difficile colitis. Gut 1997;41 (3): 366–370.
   PubMed Web of Science ®Google Scholar
• Fekety R; American College of Gastroenterology, Practice Parameters Committee. Guidelines for the diagnosis and management of Clostridium difficile–associated diarrhea and colitis. Am J Gastroenterol 1997;92 (5): 739–750.
   PubMed Web of Science ®Google Scholar
• Bartlett JG. Pseudomembranous enterocolitis and antibiotic-associated diarrhea. In Feldman M, Freidman LS, Sleisenger MH, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease Pathophysiology/Diagnosis/Management, 7th ed. Philadelphia: Saunders, 2002: 1914–1931.
   Google Scholar
• Johal SS, Hammond J, Solomon K, James PD, Mahida YR. Clostridium difficile associated diarrhoea in hospitalised patients: onset in the community and hospital and role of flexible sigmoidoscopy. Gut 2004;53 (5): 673–677.
   PubMed Web of Science ®Google Scholar
• McFarland LV, Mulligan ME, Kwok RY, Stamm WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989;320 (4): 204–210.
   PubMed Web of Science ®Google Scholar
• Centers for Disease Control and Prevention. Clostridium difficile: information for healthcare providers. Atlanta, GA: CDC, updated July 22, 2005. Available at http://www.cdc.gov/ncidod/hip/gastro/ClostridiumDifficileHCP_print.htm; accessed October 12, 2005.
   Google Scholar
• National Clostridium difficile Standards Group. Report to the Department of Health. J Hosp Infect 2004;56 (Suppl 1): 1–38.
   Google Scholar
• Gurian L, Ward TT, Katon RM. Possible foodborne transmission in a case of pseudomembranous colitis due to Clostridium difficile: influence of gastrointestinal secretions on Clostridium difficile infection. Gastroenterology 1982;83 (2): 465–469.
   PubMed Web of Science ®Google Scholar
• Waldum HL, Brenna E, Sandvik AK. Long-term safety of proton pump inhibitors: risks of gastric neoplasia and infections. Expert Opin Drug Saf 2002;1 (1): 29–38.
   PubMedGoogle Scholar
• Tryba M, Cook D. Current guidelines on stress ulcer prophylaxis. Drugs 1997;54 (4): 581–596.
   Web of Science ®Google Scholar
• Spechler SJ. Peptic ulcer disease and its complications. In Feldman M, Freidman LS, Sleisenger MH, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease Pathophysiology/Diagnosis/Management, 7th ed. Philadelphia: Saunders, 2002: 747–781.
   Google Scholar
• Dial S, Alrasadi K, Manoukian C, Huang A, Menzies D. Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies. CMAJ 2004;171 (1): 33–38.
   PubMed Web of Science ®Google Scholar
• Shah S, Lewis A, Leopold D, Dunstan F, Woodhouse K. Gastric acid suppression does not promote clostridial diarrhoea in the elderly. QJM 2000;93 (3): 175–181.
   PubMedGoogle Scholar
• Cunningham R, Dale B, Undy B, Gaunt N. Proton pump inhibitors as a risk factor for Clostridium difficile diarrhoea. J Hosp Infect 2003;54 (3): 243–245.
   PubMed Web of Science ®Google Scholar
• Muto CA, Pokrywka M, Shutt K, Mendelsohn AB, Nouri K, Posey K, Roberts T, Croyle K, Krystofiak S, Patel-Brown S, Pasculle AW, Paterson DL, Saul M, Harrison LH. A large outbreak of Clostridium difficile– associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 2005;26 (3): 273–280.
   PubMed Web of Science ®Google Scholar
• Noble DW. Proton pump inhibitors and stress ulcer prophylaxis: pause for thought? Crit Care Med 2002;30 (5): 1175–1176.
   Web of Science ®Google Scholar
• Bliss DZ, Johnson S, Savik K, Clabots CR, Willard K, Gerding DN. Acquisition of Clostridium difficile and Clostridium difficile–associated diarrhea in hospitalized patients receiving tube feeding. Ann Intern Med 1998;129 (12): 1012–1019.
   Web of Science ®Google Scholar
• Department of Health and Public Health Laboratory Service Joint Working Party. Clostridium difficile infection: prevention and management. London: Department of Health, 1994. Quoted in reference 11.
   Google Scholar
• Eggertson L. C. difficile: by the numbers. CMAJ 2004;171 (11): 1331–1332.
   Web of Science ®Google Scholar
• Eggertson L. C. difficile strain 20 times more virulent. CMAJ 2005;172 (10): 1279.
   Web of Science ®Google Scholar
• Warny M, Pépin J, Fang A, Killgore G, Thompson A, Brazier J, Frost E, McDonald LC. Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 2005;366 (9491): 1079–1084.
   PubMed Web of Science ®Google Scholar
• Pépin J, Valiquette L, Alary ME, Villemure P, Pelletier A, Forget K, Pépin K, Chouinard D. Clostridium difficile–associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity. CMAJ 2004;171 (5): 466–472.
   PubMed Web of Science ®Google Scholar
• Gerding DN. Metronidazole for Clostridium difficile–associated disease: is it okay for mom? Clin Infect Dis 2005;40 (11): 1598–1600.
   Web of Science ®Google Scholar
• Beaugerie L, Metz M, Barbut F, Bellaiche G, Bouhnik Y, Raskine L, Nicolas JC, Chatelet FP, Lehn N, Petit JC; Infectious Colitis Study Group. Klebsiella oxytoca as an agent of antibiotic-associated hemorrhagic colitis. Clin Gastroenterol Hepatol 2003;1 (5): 370–376.
   PubMed Web of Science ®Google Scholar
• Borek AP, Aird DZ, Carroll KC. Frequency of sample submission for optimal utilization of the cell culture cytotoxicity assay for detection of Clostridium difficile toxin. J Clin Microbiol 2005;43 (6): 2994–2995.
   Web of Science ®Google Scholar
• Delmee M, Van Broeck J, Simon A, Janssens M, Avesani V. Laboratory diagnosis of Clostridium difficile-associated diarrhoea: a plea for culture. J Med Microbiol 2005;54 (2): 187–191.
   Web of Science ®Google Scholar
• Eggertson L, Sibbald B. Hospitals battling outbreaks of C. difficile. CMAJ 2004;171 (1): 19–21.
   Web of Science ®Google Scholar
• Eggertson L. C. difficile hits Sherbrooke, Que., hospital: 100 deaths. CMAJ 2004;171 (5): 436.
   Web of Science ®Google Scholar

Other Articles that Were Consulted