• Journal of Veterinary Clinics
• /
• v.28 no.2
• /
• pp.232-235
• /
• 2011

Clostridium (C) difficile has been recognized as an important emerging pathogen in both humans and animals. The prevalence of C. difficile in rectal feces and frozen colons of 132 pigs with diarrhea from the Jeju Island was investigated by polymerase chain reaction (PCR) to detect C. difficile toxin A and B genes. PCR findings revealed toxin A and B in 5 pigs (3.8%), including 2 suckling pigs, 2 weaned pigs and 1 growing pig. The result of PCR was closely matched histopathologic lesions of C. difficile in large intestines of pigs. Histopathologically, the cecum and colons of C. difficile toxin-positive pigs had severe submucosal and mesocolonic edema. Mucosal lesions ranged from random single cell necrosis and exfoliation to segmental, transmural necrosis of the cecum and colon. According to bacteriology, 4 C. difficile-positive pigs (80%) were co-infected with Salmonella typhimurium.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.3 no.1
• /
• pp.98-104
• /
• 2000

Pseudomembranous colitis, thought to be uncommon in children, is a bacterial, toxin-mediated inflammatory process resulting in acute or chronic diarrhea and is characterized by colonic pseudomembranes. It is mediated by toxins produced by Clostridium difficile and is increasingly recognized in pediatric population. Diagnosis is based on positive culture of C. difficile in selective media and positive test of C. difficile toxin. Oral metronidazole or vancomycin are the main treatment options but avoidance of further antibiotics should also be encouraged where possible. We have experienced a case of pseudomembranous colitis in a 4-year-old female presented with septic shock and colitis. This case was diagnosed with positive test of C. difficile toxin B and confirmed by isolation of the organism on cultire in selective media. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metronidazole and oral vancomycin, and ICU care.

• Food Science and Biotechnology
• /
• v.15 no.5
• /
• pp.817-819
• /
• 2006

8-Quinolinol and other quinolinol derivatives were evaluated with regard to their growth-inhibitory effects against intestinal bacteria, using the paper disk-agar diffusion method. The observed growth responses varied according to the chemicals and dosages used, as well as the bacterial species tested. 8-Quinolinol showed a significant inhibitory effect against Clostridium difficile, C. perfringens, and Escherichia coli, at 5, 2, 1, and 0.5 mg/disk, and also exhibited a very strong inhibitory effect at 0.25 mg/disk. At low concentrations, 8-quinolinol had strong inhibitory effects against C. perfringens at 0.1 and 0.05 mg/disk; 8-quinolinol also manifested a moderate inhibitory effect against C. perfringens at 0.025 mg/disk. Furthermore, 8-quinolinol revealed moderate and weak growth inhibition against C. difficile and E. coli at concentrations of 0.1 and 0.05 mg/disk, respectively, but 2-quinolinol, 4-quinolinol, and 6-quinolinol evidenced no growth inhibition against B. bifidum, B. longum, C. difficile, C. perfringens, E. coli, or L. casei. The inhibitory effects of 8-quinolinol against C. difficile, C. perfringens, and E. coli lead to its consideration as a possible therapeutic modality for the treatment of diseases associated with harmful intestinal bacteria.

• Journal of Korean Medicine Rehabilitation
• /
• v.31 no.1
• /
• pp.47-57
• /
• 2021

Objectives This study was conducted to confirm the possibility of Clostridium difficile infection (CDI) treatment through natural herbal medicines. Methods After screening a total of 77 herbal medicines through the paper disc agar diffusion method, we selected the herbal medicines that showed a effectiveness compared to the positive control vancomycin. Afterwards, drugs that showed inhibitory effects compared to C. difficile without inhibition of Bifidobacterium bifidum and Lactobacillus plantarum, known as beneficial bacteria, were selected and minimal inhibitory concentration (MIC) was confirmed by applying the Broth microdilution method. Results The Coptidis Rhizoma, well known for its antimicrobial effect, was found to have antimicrobial effects on C. difficile, but also had inhibitory effects on the beneficial bacterium B. bifidum. 30% ethanol extraction Crataegi fructus, Corni fructus and Mume fructus had antimicrobial effects on C. difficile without inhibiting the beneficial bacteria B. bifidum and L. plantarum. The MIC values of 30% ethanol extraction Crataegi fructus, Corni fructus and Mume fructus were found to be 10 mg/mL, 20 mg/mL and 5 mg/mL, respectively. Conclusions Crataegi fructus, Corni fructus and Mume fructus were identified as candidate medicines for C. difficile. Further researchs will need to be done in vivo, and to find an optimal extraction method accompanied by economic evaluation.

• Toxicological Research
• /
• v.29 no.2
• /
• pp.99-106
• /
• 2013

Clostridium difficile infection (CDI) has become a significant threat to public health. Although broad-spectrum antibiotic therapy is the primary treatment option for CDI, its use has evident limitations. Probiotics have been proved to be effective in the treatment of CDI and are a promising therapeutic option for CDI. In this study, 4 strains of lactic acid bacteria (LAB), namely, Lactobacillus rhamnosus (LR5), Lactococcuslactis (SL3), Bifidobacterium breve (BR3), and Bifidobacterium lactis (BL3) were evaluated for their anti-C. difficile activity. Co-culture incubation of C. difficile ($10^6$ and $10^{10}$ CFU/ml) with each strain of LAB indicated that SL3 possessed the highest antimicrobial activity over a 24-hr period. The cell-free supernatants of the 4 LAB strains exhibited $MIC_{50}$ values between 0.424 mg/ml (SL3) and 1.318 (BR3) mg/ml. These results may provide a basis for alternative therapies for the treatment of C. difficile-associated gut disorders.

• Intestinal research
• /
• v.13 no.1
• /
• pp.80-84
• /
• 2015

The rates and severity of Clostridium difficile infections, including pseudomembranous colitis, have increased markedly. However, there are few effective treatments for refractory or recurrent C. difficile infections and the outcomes are poor. Fecal microbiota transplantation is becoming increasingly accepted as an effective and safe intervention in patients with recurrent disease, likely due to the restoration of a disrupted microbiome. Cure rates of >90% are being consistently reported from multiple centers. We cured a case of severe refractory C. difficile infection with fecal microbiota transplantation in a patient colonized by vancomycin-resistant enterococcus.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.5 no.2
• /
• pp.143-149
• /
• 2002

Purpose: The following study was performed to reveal the relationship between Clostridium difficile colitis in childhood and associated antibiotics. Methods: From January 2000 to June 2002 at Seoul National University Children's Hospital, 85 symptomatic pediatric patients who showed positive stool culture for Clostridium difficile were included. The implicated antibiotics within 2 months before stool culture were analyzed. Of the 85 patients, there were 50 males and 35 females, and their average age was 2.5 years. Results: There was a history of implicated antibiotics within 2 months in 55 cases (67%). Forty-three patients (78%) of them showed Clostridium difficile in stool culture during antibiotics treatment. The time interval between the initiation of antibiotics and stool culture ranged from one day to 7 weeks (mean 10 days) in these patients. In the remaining 12 patients, Clostridium difficile was detected after the discontinuation of antibiotics. The time interval between the discontinuation and stool culture ranged from one day to 7 weeks (mean 12 days). The associated antibiotics were cefotaxime (20 cases), amikacin(15 cases), ampicillin (13 cases), cefazolin (8 cases), vancomycin (8 cases), etc. In 31 cases, more than one antibiotics were prescribed. Conclusion: When diarrhea occurred in young children during antibiotic usage or with a past history of recent antibiotic usage, Clostridium difficile should be investigated as a cause of diarrhea for proper management.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.17 no.4
• /
• pp.232-238
• /
• 2014

Purpose: This study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children. Methods: We reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014. Results: Of the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment. Conclusion: This study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.

• Journal of Microbiology and Biotechnology
• /
• v.24 no.5
• /
• pp.696-703
• /
• 2014

Clostridium difficile causes mucosal damage and diarrhea by releasing two exotoxins: toxin A and toxin B. C. difficile colitis is associated with alterations in bowel flora and the failure to mount an effective antibody response. The aim of the current study was to investigate whether antitoxin sera prevent toxin-A-induced apoptosis, cytoskeletal disaggregation, cell detachment, and tight junction loss in cultured colonic epithelial cells. Serum samples were isolated from mice that survived a C. difficile infection following antibiotic treatment, and the antitoxin effects of these samples were investigated in toxin-A-exposed HT29 colonic epithelial cells and a toxin-A-induced animal model of gut inflammation. Unchallenged mice did not produce IgG against toxin A, whereas serum (antiserum) from C. difficile-challenged mice showed significant IgG responses against toxin A. Treatment with the antiserum markedly inhibited mucosal damage and inflammation in the toxin-A-treated mouse model. In contrast to control mouse serum, the antiserum also markedly inhibited toxin-A-induced DNA fragmentation, dephosphorylation of paxillin and Epo receptor (EpoR), deacetylation of tubulin, and upregulation of p21(WAF1/CIP1) and p53. Taken together, these results reveal that the generated antitoxin serum has biotherapeutic effects in preventing various C. difficile toxin-A-induced cellular toxicities.

• Journal of Microbiology and Biotechnology
• /
• v.27 no.6
• /
• pp.1163-1170
• /
• 2017

Clostridium difficile releases two exotoxins, toxin A and toxin B, which disrupt the epithelial cell barrier in the gut to increase mucosal permeability and trigger inflammation with severe diarrhea. Many studies have suggested that enteric nerves are also directly involved in the progression of this toxin-mediated inflammation and diarrhea. C. difficile toxin A is known to enhance neurotransmitter secretion, increase gut motility, and suppress sympathetic neurotransmission in the guinea pig colitis model. Although previous studies have examined the pathophysiological role of enteric nerves in gut inflammation, the direct effect of toxins on neuronal cells and the molecular mechanisms underlying toxin-induced neuronal stress remained to be unveiled. Here, we examined the toxicity of C. difficile toxin A against neuronal cells (SH-SY5Y). We found that toxin A treatment time- and dose-dependently decreased cell viability and triggered apoptosis accompanied by caspase-3 activation in this cell line. These effects were found to depend on the up-regulation of reactive oxygen species (ROS) and the subsequent activation of p38 MAPK and induction of $p21^{Cip1/Waf1}$. Moreover, the N-acetyl-$\text\tiny L$-cysteine (NAC)-induced down-regulation of ROS could recover the viability loss and apoptosis of toxin A-treated neuronal cells. These results collectively suggest that C. difficile toxin A is toxic for neuronal cells, and that this is associated with rapid ROS generation and subsequent p38 MAPK activation and $p21^{Cip1/Waf1}$ up-regulation. Moreover, our data suggest that NAC could inhibit the toxicity of C. difficile toxin A toward enteric neurons.