Clostridium species

Paul G. Auwaerter, M.D., John G. Bartlett, M.D.
Clostridium species is a topic covered in the Johns Hopkins ABX Guide.

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MICROBIOLOGY

  • Clostridia produce the largest number of toxins of any bacterial class.
  • The common source of entry in humans is the gastrointestinal tract or trauma.
  • Obligate anaerobic bacteria with unusual features: spore formation, toxin production and normally reside in the environment or the gastrointestinal tract of humans and animals. Dominant form in the human intestinal flora.
  • Belongs to phylum Firmicutes, which is the dominant component of the fecal microbiome. Clostridia spp. account for 50% or about 1013/gm stool.
  • Species-specific toxin expression:
    • Botulism (C. botulinum)
    • Colitis (C. difficile)
    • Tetanus (C. tetani)
    • Septic abortion (C. sordellii)
    • Gas gangrene (C. perfringens, C. novyi, C. septicum, C. sordellii, C. histolyticum)
    • Clostridial food poisoning (C. perfringens)
  • Non-toxigenic strains are often components of mixed infections or bacteremia; pathogenic role often unclear.
Clostridia + Clostridial toxins*

Clostridia

Toxin

Disease

Gastrointestinal tract

  • C. perfringens 

Enterotoxin

Food intoxication, diarrhea, sudden infant death

Beta toxin

Necrotic enteritis

  • C. difficile 

Ted A + Ted B

Antibiotic-associated diarrhea + colitis

  • C. septicum 

Alpha

Intestinal myonecrosis

  • C. botulinum

BoNT/A, B, E

Human botulism

Wound-related diseases

  • C. perfringens 

alfa toxin

Gangrene, Puerperal sepsis

  • C. sordellii 

Tcsl, Tcstl

Gangrene

  • C. tetani 

TeNT

Tetanus

  • C. novyi 

Alpha-novyi

Gangrene

  • C. botulinum

BoNT/A + B

Wound botulism

* Adapted from Popoff MR, Bouvel P; Future Microbio 2009; 4: 1021[9]

TeNT - Tetanus toxin; BoNT - Botulinum neurotoxin; TcsH - C. sordellii hemorrhagic toxic; TcsL - C. sordellii lethal toxin; TcdA, alpha-toxin; TedB - Beta toxin

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MICROBIOLOGY

  • Clostridia produce the largest number of toxins of any bacterial class.
  • The common source of entry in humans is the gastrointestinal tract or trauma.
  • Obligate anaerobic bacteria with unusual features: spore formation, toxin production and normally reside in the environment or the gastrointestinal tract of humans and animals. Dominant form in the human intestinal flora.
  • Belongs to phylum Firmicutes, which is the dominant component of the fecal microbiome. Clostridia spp. account for 50% or about 1013/gm stool.
  • Species-specific toxin expression:
    • Botulism (C. botulinum)
    • Colitis (C. difficile)
    • Tetanus (C. tetani)
    • Septic abortion (C. sordellii)
    • Gas gangrene (C. perfringens, C. novyi, C. septicum, C. sordellii, C. histolyticum)
    • Clostridial food poisoning (C. perfringens)
  • Non-toxigenic strains are often components of mixed infections or bacteremia; pathogenic role often unclear.
Clostridia + Clostridial toxins*

Clostridia

Toxin

Disease

Gastrointestinal tract

  • C. perfringens 

Enterotoxin

Food intoxication, diarrhea, sudden infant death

Beta toxin

Necrotic enteritis

  • C. difficile 

Ted A + Ted B

Antibiotic-associated diarrhea + colitis

  • C. septicum 

Alpha

Intestinal myonecrosis

  • C. botulinum

BoNT/A, B, E

Human botulism

Wound-related diseases

  • C. perfringens 

alfa toxin

Gangrene, Puerperal sepsis

  • C. sordellii 

Tcsl, Tcstl

Gangrene

  • C. tetani 

TeNT

Tetanus

  • C. novyi 

Alpha-novyi

Gangrene

  • C. botulinum

BoNT/A + B

Wound botulism

* Adapted from Popoff MR, Bouvel P; Future Microbio 2009; 4: 1021[9]

TeNT - Tetanus toxin; BoNT - Botulinum neurotoxin; TcsH - C. sordellii hemorrhagic toxic; TcsL - C. sordellii lethal toxin; TcdA, alpha-toxin; TedB - Beta toxin

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