Displaying publications 1 - 20 of 91 in total

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  1. Fulltext 2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients
    Sartelli M, Di Bella S, McFarland LV, Khanna S, Furuya-Kanamori L, Abuzeid N, et al.
    World J Emerg Surg, 2019 02 28;14:8.
    PMID: 30858872 DOI: 10.1186/s13017-019-0228-3
    In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.
    Matched MeSH terms: Clostridium Infections/diagnosis; Clostridium Infections/therapy*; Clostridium difficile/pathogenicity*
  2. Fulltext Diversity, Dynamics and Therapeutic Application of Clostridioides difficile Bacteriophages
    Nale JY, Thanki AM, Rashid SJ, Shan J, Vinner GK, Dowah ASA, et al.
    Viruses, 2022 Dec 12;14(12).
    PMID: 36560776 DOI: 10.3390/v14122772
    Clostridioides difficile causes antibiotic-induced diarrhoea and pseudomembranous colitis in humans and animals. Current conventional treatment relies solely on antibiotics, but C. difficile infection (CDI) cases remain persistently high with concomitant increased recurrence often due to the emergence of antibiotic-resistant strains. Antibiotics used in treatment also induce gut microbial imbalance; therefore, novel therapeutics with improved target specificity are being investigated. Bacteriophages (phages) kill bacteria with precision, hence are alternative therapeutics for the targeted eradication of the pathogen. Here, we review current progress in C. difficile phage research. We discuss tested strategies of isolating C. difficile phages directly, and via enrichment methods from various sample types and through antibiotic induction to mediate prophage release. We also summarise phenotypic phage data that reveal their morphological, genetic diversity, and various ways they impact their host physiology and pathogenicity during infection and lysogeny. Furthermore, we describe the therapeutic development of phages through efficacy testing in different in vitro, ex vivo and in vivo infection models. We also discuss genetic modification of phages to prevent horizontal gene transfer and improve lysis efficacy and formulation to enhance stability and delivery of the phages. The goal of this review is to provide a more in-depth understanding of C. difficile phages and theoretical and practical knowledge on pre-clinical, therapeutic evaluation of the safety and effectiveness of phage therapy for CDI.
    Matched MeSH terms: Clostridium difficile*
  3. Molecular epidemiology of Clostridium difficile isolated from piglets
    Putsathit P, Neela VK, Joseph NMS, Ooi PT, Ngamwongsatit B, Knight DR, et al.
    Vet Microbiol, 2019 Oct;237:108408.
    PMID: 31585650 DOI: 10.1016/j.vetmic.2019.108408
    Information on the epidemiology of C. difficile infection (CDI) in South-East Asian countries is limited, as is data on possible animal reservoirs of C. difficile in the region. We investigated the prevalence and molecular epidemiology of C. difficile in piglets and the piggery environment in Thailand and Malaysia. Piglet rectal swabs (n = 224) and piggery environmental specimens (n = 23) were collected between 2015 and 2016 from 11 farms located in Thailand and Malaysia. All specimens were tested for the presence of C. difficile with toxigenic culture. PCR assays were performed on isolates to determine the ribotype (RT), and the presence of toxin genes. Whole genome sequencing was used on a subset of isolates to determine the evolutionary relatedness of RT038 (the most prevalent RT identified) common to pigs and humans from Thailand and Indonesia. C. difficile was recovered from 35% (58/165) and 92% (54/59) of the piglets, and 89% (8/9) and 93% (13/14) of the environmental specimens from Thailand and Malaysia, respectively. All strains from Thailand, and 30 strains from Malaysia (23 piglet and 7 environmental isolates) were non-toxigenic. To our knowledge, this is the first and only report with a complete lack of toxigenic C. difficile among piglets, a feature which could have a protective effect on the host. The most common strain belonged to RT038 (ST48), accounting for 88% (51/58) of piglet and 78% (7/9) of environmental isolates from Thailand, and all 30 isolates tested from Malaysia. Piglet RT038 isolates from Thailand and Malaysia differed by only 18 core-genome single nucleotide variants (cgSNVs) and both were, on average, 30 cgSNVs different from the human strains from Thailand and Indonesia, indicating a common ancestor in the last two decades.
    Matched MeSH terms: Clostridium Infections/microbiology; Clostridium Infections/epidemiology; Clostridium Infections/veterinary*; Clostridium difficile/genetics*
  4. Fulltext A standardised model for stool banking for faecal microbiota transplantation: a consensus report from a multidisciplinary UEG working group
    Keller JJ, Ooijevaar RE, Hvas CL, Terveer EM, Lieberknecht SC, Högenauer C, et al.
    United European Gastroenterol J, 2021 Mar;9(2):229-247.
    PMID: 33151137 DOI: 10.1177/2050640620967898
    BACKGROUND: Faecal microbiota transplantation is an emerging therapeutic option, particularly for the treatment of recurrent Clostridioides difficile infection. Stool banks that organise recruitment and screening of faeces donors are being embedded within the regulatory frameworks described in the European Union Tissue and Cells Directive and the technical guide to the quality and safety of tissue and cells for human application, published by the European Council.

    OBJECTIVE: Several European and international consensus statements concerning faecal microbiota transplantation have been issued. While these documents provide overall guidance, we aim to provide a detailed description of all processes that relate to the collection, handling and clinical application of human donor stool in this document.

    METHODS: Collaborative subgroups of experts on stool banking drafted concepts for all domains pertaining to stool banking. During a working group meeting in the United European Gastroenterology Week 2019 in Barcelona, these concepts were discussed and finalised to be included in our overall guidance document about faecal microbiota transplantation.

    RESULTS: A guidance document for all domains pertaining to stool banking was created. This document includes standard operating manuals for several processes involved with stool banking, such as handling of donor material, storage and donor screening.

    CONCLUSION: The implementation of faecal microbiota transplantation by stool banks in concordance with our guidance document will enable quality assurance and guarantee the availability of donor faeces preparations for patients.

    Matched MeSH terms: Clostridium Infections/immunology; Clostridium Infections/therapy; Clostridium difficile
  5. Fulltext Recommendations for the adjuvant use of the poly-antibiotic-resistant probiotic Bacillus clausii (O/C, SIN, N/R, T) in acute, chronic, and antibiotic-associated diarrhea in children: consensus from Asian experts
    De Castro JA, Kesavelu D, Lahiri KR, Chaijitraruch N, Chongsrisawat V, Jog PP, et al.
    Trop Dis Travel Med Vaccines, 2020;6:21.
    PMID: 33110611 DOI: 10.1186/s40794-020-00120-4
    This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Evidence-based recommendations and randomized controlled trials in the region are included. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by utilizing a modified Delphi process and applying the Likert scale in an electronic voting process. Bacillus clausii was recommended as an adjunct treatment with oral rehydration solution for acute viral diarrhea. B. clausii may also be considered for prevention of antibiotic-associated diarrhea, Clostridium difficile-induced diarrhea, and as adjunct treatment of Helicobacter pylori. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations currently apply to most Asia-Pacific countries. Ideally, these need to be validated with local randomized-controlled trials.
    Matched MeSH terms: Clostridium difficile
  6. Fulltext Determination of toxinotypes of environmental Clostridium perfringens by Polymerase Chain Reaction
    Florence L CH, Hakim SL, Kamaluddin MA, Thong KL
    Trop Biomed, 2011 Apr;28(1):171-4.
    PMID: 21602783
    Toxinotype of Clostridium perfringens (CP) isolates collected from the Bernam River, Selangor River and Tengi Canal between April 2007 and January 2008 were determined by Polymerase Chain Reaction (PCR) using published primers. All the 147 isolates were toxinotype Type A, harbouring the alpha toxin gene. In addition, 5 of the isolates also had the enterotoxin (CPE) gene.
    Matched MeSH terms: Clostridium perfringens/classification; Clostridium perfringens/genetics*; Clostridium perfringens/pathogenicity
  7. Evaluation of the therapeutic effect of propolis on Fasciola gigantica and Clostridium novyi type B infections in sheep
    Fouad EA, Toaleb NI, Hassan SE, El Shanawany EE, Keshta HG, Abdel-Rahman EH, et al.
    Trop Biomed, 2021 Jun 01;38(2):102-110.
    PMID: 34172697 DOI: 10.47665/tb.38.2.041
    The use of natural products for disease control is a promising approach to solving the problem of drug resistance. The aim of the research reported here was to evaluate the fasciolicidal and anti-Clostridium novyi type B activities of propolis administered orally to sheep infected with Fasciola gigantica and C. novyi type B. Sheep infected with both pathogens were divided into two groups: an infected treated group and an infected non-treated group. The treatment was oral administration of 50 mg propolis extract/kg daily for 15 days. The body weight of the sheep, fecal egg counts of F. gigantica, serum levels of F. gigantica IgG, concentrations of cytokines (IL-2, IL-10, and IL-17), and bacterial counts of C. novyi were evaluated. Following treatment, the sheep had increased body weight and a significant decrease in the egg count, which was reduced by 54.54% at 15 days post treatment. The level of anti- Fasciola IgG increased, whereas levels of IL-2, IL-10, and IL-17 decreased in propolistreated sheep. Treatment of sheep with propolis produced a significant reduction in fecal count of C. novyi, from 8 × 109 to 3 × 103 colony units per gram at 15 days post treatment. This research highlights the therapeutic potential of Egyptian propolis extract as a treatment against F. gigantica and C. novyi type B infections, and investigated its mode of action through its effect on some cellular and humoral responses in sheep with both infections.
    Matched MeSH terms: Clostridium/drug effects; Clostridium Infections/drug therapy; Clostridium Infections/veterinary*
  8. A non-toxic recombinant protein rSUMO-CPBm4 as a potential vaccine candidate against Clostridium perfringens type C beta enterotoxemia
    Goa Y, Du JG, Jirapattharasate C, Galon E, Ji SW, Ran ZG, et al.
    Trop Biomed, 2023 Dec 01;40(4):400-405.
    PMID: 38308826 DOI: 10.47665/tb.40.4.004
    Beta toxin (CPB) is a lethal toxin and plays a key role in enterotoxemia of ruminants caused by Clostridium perfringens type C strain. The existing vaccines based on crude CPB need time-consuming detoxification and difficult quality control steps. In this study, we synthesized the rCPBm4 of C. perfringens type C strain and small ubiquitin-like modifier (SUMO)-tag CPBm4 (rSUMO-CPBm4) by introducing four amino acid substitutions: R212E, Y266A, L268G, and W275A. Compared with rCPBm4, rSUMO-CPBm4 was expressed with higher solubility in Escherichia coli BL21 (DE3). Neither rCPBm4 nor rSUMO-CPBm4 was lethal to mice. Although rCPBm4 and rSUMO-CPBm4 were reactogenic with polyclonal antibodies against crude CPB, rabbits vaccinated with rSUMO-CPBm4 developed significant levels of toxin-neutralizing antibody (TNA) titers that conferred protection against crude toxin challenge. These data suggest that genetically detoxified rSUMO-CPBm4 is a promising subunit vaccine candidate for C. perfringens type C beta enterotoxemia.
    Matched MeSH terms: Clostridium perfringens/genetics
  9. The pigbel story of Papua New Guinea
    Murrell TG, Walker PD
    Trans R Soc Trop Med Hyg, 1991 1 1;85(1):119-22.
    PMID: 2068739
    Enteritis necroticans (EN), known as pigbel in Papua New Guinea (PNG), may be the important predisposing lesion to mid-gut volvulus, jejunal and ileal ileus and other forms of small bowel strangulation in communities where protein deprivation, poor food hygiene, epochal meat feasting and staple diets containing trypsin inhibitors co-exist. Such human habitats occur in Africa, Central and South America, western Pacific, Asian and south-east Asian cultures. Isolated outbreaks of necrotizing enteritis have been reported from Uganda, Malaysia and Indonesia but as yet no systematic epidemiological study of the prevalence of small bowel strangulations has been described in the surgical literature of 'third world' countries. Now that enteritis necroticans is preventable by vaccination, such studies should be undertaken. This paper outlines the story of pigbel and its control in PNG.
    Matched MeSH terms: Clostridium perfringens*
  10. Fulltext Enhanced butanol production by Clostridium acetobutylicum NCIMB 13357 grown on date fruit as carbon source in P2 medium
    Khamaiseh EI, Abdul Hamid A, Abdeshahian P, Wan Yusoff WM, Kalil MS
    ScientificWorldJournal, 2014;2014:395754.
    PMID: 24672315 DOI: 10.1155/2014/395754
    The production of biobutanol was studied by the cultivation of Clostridium acetobutylicum NCIMB 13557 in P2 medium including date fruit as the sole substrate. The effect of P2 medium and the effect of different concentrations of date fruit ranging from 10 to 100 g/L on biobutanol production were investigated. Anaerobic batch culture was carried out at 35 °C incubation temperature and pH 7.0 ± 0.2 for 72 h. Experimental results showed that the lowest yield of biobutanol and acetone-butanol-ethanol (ABE) was 0.32 and 0.35 gram per gram of carbohydrate consumed (g/g), respectively, when an initial date fruit concentration of 10 g/L was utilized. At this fruit date concentration a biobutanol production value of 1.56 g/L was obtained. On the other hand, the maximum yield of biobutanol (0.48 g/g) and ABE (0.63 g/g) was produced at 50 g/L date fruit concentration with a biobutanol production value as high as 11 g/L. However, when a higher initial date fruit concentration was used, biobutanol and ABE production decreased to reach the yield of 0.22 g/g and 0.35 g/g, respectively, where 100 g/L date fruit was used. Similar results also revealed that 10.03 g/L biobutanol was produced using 100 g/L date fruit.
    Matched MeSH terms: Clostridium acetobutylicum/metabolism*
  11. Fulltext Kinetic studies on fermentative production of biofuel from synthesis gas using Clostridium ljungdahlii
    Mohammadi M, Mohamed AR, Najafpour GD, Younesi H, Uzir MH
    ScientificWorldJournal, 2014;2014:910590.
    PMID: 24672390 DOI: 10.1155/2014/910590
    The intrinsic growth, substrate uptake, and product formation biokinetic parameters were obtained for the anaerobic bacterium, Clostridium ljungdahlii, grown on synthesis gas in various pressurized batch bioreactors. A dual-substrate growth kinetic model using Luong for CO and Monod for H2 was used to describe the growth kinetics of the bacterium on these substrates. The maximum specific growth rate (μ(max) = 0.195 h(-1)) and Monod constants for CO (K s,CO = 0.855 atm) and H2 (K(s,H2) = 0.412 atm) were obtained. This model also accommodated the CO inhibitory effects on cell growth at high CO partial pressures, where no growth was apparent at high dissolved CO tensions (P(CO)(∗) > 0.743 atm). The Volterra model, Andrews, and modified Gompertz were, respectively, adopted to describe the cell growth, substrate uptake rate, and product formation. The maximum specific CO uptake rate (q(max) = 34.364 mmol/g cell/h), CO inhibition constant (K(I) = 0.601 atm), and maximum rate of ethanol (R(max) = 0.172 mmol/L/h at P(CO) = 0.598 atm) and acetate (R(max) = 0.096 mmol/L/h at P(CO) = 0.539 atm) production were determined from the applied models.
    Matched MeSH terms: Clostridium/metabolism*
  12. Hospital-acquired Clostridium difficile infection among patients with type 2 diabetes mellitus in acute medical wards
    Hassan SA, Rahman RA, Huda N, Wan Bebakar WM, Lee YY
    J R Coll Physicians Edinb, 2013;43(2):103-7.
    PMID: 23734349 DOI: 10.4997/JRCPE.2013.203
    Clostridum difficile (C. difficile) infection is increasingly seen among hospitalised patients with type 2 diabetes mellitus but its rate and associated risk factors are not known. We aimed to determine the rate and characteristics of hospital-acquired C. difficile infection in subjects with type 2 diabetes mellitus admitted into acute medical wards.
    Matched MeSH terms: Clostridium Infections/chemically induced*; Clostridium Infections/epidemiology; Clostridium difficile*
  13. Clostridium perfringens and sulphite reducing clostridia densities in selected tropical Malaysian rivers
    Lee FC, Hakim SL, Kamaluddin MA, Thong KL
    Southeast Asian J. Trop. Med. Public Health, 2012 Jan;43(1):129-35.
    PMID: 23082563
    Clostridium perfringens (CP) and sulphite reducing clostridia (SRC) densities in the Selangor River, Bernam River and Tengi River Canal were examined between April 2007 and January 2008. Water samples were taken from two or three locations along each river, using either depth-integration or grab sampling methods. The downstream sampling site of the Selangor River, Rantau Panjang, reported the highest arithmetic mean of CP and SRC densities (583.45 and 8,120.08 cfu/100 ml, respectively). Both CP and SRC densities in the Selangor River increased further downstream, but the reverse was true in the Bernam River. The SRC densities in these rivers were significantly different from each other (p < 0.05) when comparing upstream and downstream results, but CP densities were not significantly different (p > 0.05). SRC densities were significantly correlated (p < 0.05) in different locations along the Selangor River and the Bernam River. The CP densities did not show such pattern (p > 0.05). River discharge had no significant correlation with SRC or CP densities by study site (p > 0.05). Since the Selangor River has a denser human population along its banks, this study confirms CP as a suitable indicator of human fecal contamination. However, tracing CP distribution along the river is more difficult than SRC. To our knowledge, this is the first study of CP and SRC densities from Malaysian rivers. CP densities found in this study were within the range of general water bodies reported from other countries.
    Matched MeSH terms: Clostridium perfringens/isolation & purification*
  14. Fulltext Absence of plasmid in mosquitocidal Clostridium bifermentans serovar malaysia
    Seleena P, Lee HL
    Southeast Asian J. Trop. Med. Public Health, 1994 Jun;25(2):394-6.
    PMID: 7855665
    Matched MeSH terms: Clostridium/classification; Clostridium/genetics*; Clostridium/growth & development
  15. Isolation of indigenous larvicidal microbial control agents of mosquitos: the Malaysian experience
    Lee HL, Seleena P
    Southeast Asian J. Trop. Med. Public Health, 1990 Jun;21(2):281-7.
    PMID: 2237596
    A nationwide screening program searching for microbial control agents of mosquitos was initiated in Malaysia in 1986. A total of 725 samples were collected and 2,394 bacterial colonies were isolated and screened for larvicidal activity. From such screening, 20 Bacillus thuringiensis, 6 B. sphaericus, 1 Clostridium bifermentans and 2 Pseudomonas pseudomallei larvicidal isolates were obtained. Of these, a new B. thuringiensis named as subspecies malaysianensis was found, while the C. bifermentans was also a new anaerobe individualized as serovar malaysia. It was concluded that this screening program was highly successful.
    Matched MeSH terms: Clostridium/isolation & purification*
  16. Fulltext Prevalence of Clostridium difficile toxin in diarhoeal stool samples of patients from a tertiary hospital in North Eastern Penisular Malaysia
    Hassan SA, Othman N, Idris FM, Abdul Rahman Z, Maning N, Abdul Rahman R, et al.
    Med J Malaysia, 2012 Aug;67(4):402-5.
    PMID: 23082450 MyJurnal
    This study describes the prevalence of Clostridium difficile toxin (CDT) in loose stool samples from inpatients aged more than two years of a tertiary hospital. A total of 175 samples that had been examined were from stool samples that were sent to the Medical Microbiology & Parasitology Laboratory for various clinical indications. The toxin was detected by a commercial immunochromatograhic test, and the patients' demography, clinical features, treatment and outcomes were analyzed from their medical records. Clostridium difficile toxin was positive in 24 (13.7%) of the stool samples. Male and female were 11 (45.8%) and 13 (54.2%) respectively, with the majority of them aged more than 50 years. Most were from medical wards (n = 21, 87.5%), with the rest from surgical wards (n = 2, 8.3%) and intensive care units (n = 1, 3.4%). All the CDT positive patients had history of prior antibiotic usage within 6 weeks before the detection of the toxin. The mean duration of antibiotics usage was 17.75 (+/- 13.75) days, while the mean duration of diarrhea was 5.21((+/- 5.85) days. Eighteen patients had underlying medical illnesses that were diabetes mellitus, chronic renal disease, hypertension, ischaemic heart disease, cerebrovascular disease and malignancy; with seven of them being CDT positive while on chemotherapy. Stool occult blood test was positive in 15 patients whereas presence of pus cells in the CD positive stool samples were detected in 21 patients. The duration of hospitalization among the patients was 27.96 (+/- 23.22) days.
    Matched MeSH terms: Clostridium Infections/microbiology; Clostridium difficile
  17. Pig-bel but no pig: enteritis necroticans acquired in Australia
    Watson DA, Andrew JH, Banting S, Mackay JR, Stillwell RG, Merrett M
    Med J Aust, 1991 Jul 01;155(1):47-50.
    PMID: 2067439
    OBJECTIVE: To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease.

    CLINICAL FEATURES: A 44-year-old diabetic and alcoholic restaurateur of Chinese-Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation of Clostridium perfringens type C from faeces confirmed the diagnosis of enteritis necroticans.

    INTERVENTION AND OUTCOME: He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life-saving procedure. Despite a lengthy convalescence, the patient recovered.

    CONCLUSIONS: Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.

    Matched MeSH terms: Clostridium perfringens*
  18. Fulltext Clostridial aortitis causing ruptured dissecting aneurysm in a young adult female
    Subramaniam K, Hasmi AH, Mahmood MS
    Malays J Pathol, 2014 Dec;36(3):213-6.
    PMID: 25500522 MyJurnal
    Ruptured dissecting aortic aneurysm more commonly occur in men in the 40 to 70 age group, and most commonly is associated with atherosclerosis. Uncommon causes are previous heart surgery, connective tissue disorders and aortitis. Despite its rarity, Clostridium spp aortitis progresses very rapidly with a mortality rate of approximately 79% in adults, typically occurring within 48 hours of infection. We present a case of sudden death due to clostridial aortitis causing ruptured aortic dissection in an apparently healthy adult female, 7 weeks post-spontaneous vaginal delivery. This case highlights the pathology of aortic dissection and cystic media necrosis as presentations of clostridium spp infection in young female adult.
    Matched MeSH terms: Clostridium Infections/complications*
  19. Detection of Clostridium difficile from an enhancement broth by gas-liquid chromatography
    Hassan H, Cheng SC
    Malays J Pathol, 1991 Jun;13(1):29-31.
    PMID: 1795558
    Gas-Liquid chromatography (GLC) was used to detect the presence of isocaproic acid produced by Clostridium difficile from 54 stool samples grown in cycloserine-cefoxitin broth. Isocaproic acid was detected in 12 samples of which 5 were confirmed to be Clostridium difficile by culture and biochemical tests. The detection of isocaproic acid by GLC together with the presence of presumptive colonies on primary selective culture media provides a more rapid laboratory diagnosis for Clostridium difficile.
    Matched MeSH terms: Clostridium difficile/isolation & purification*; Clostridium difficile/metabolism
  20. The occurrence of tetanus spores in gelatin and its bearings on clinical medicine
    Gnoh LT
    The Journal of Pathology and Bacteriology, 1904;9:38-41.
    DOI: 10.1002/path.1700090103
    Matched MeSH terms: Clostridium tetani
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