Clostridium species is a topic covered in the Johns Hopkins Antibiotic (ABX) Guide.

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  • 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 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:
  • Non toxigenic strains are often often component of mixed infections or bacteremia; pathogenic role often unclear.
Clostridia + Clostridial toxins*




Gastrointestinal tract

  • C. perfringens


Food intoxication, diarrhea, sudden infant death

Beta toxin

Necrotic enteritis

  • C. difficile

Ted A + Ted B

Antibiotic-associated diarrhea + colitis

  • C. septicum


Intestinal myonecrosis

  • C. botulinum 

BoNT/A, B, E

Human botulism

Wound-related diseases

  • C. perfringens

alfa toxin

Gangrene, Puerperal sepsis

  • C. sordellii

Tcsl, Tcstl


  • C. tetani



  • C. novyi



  • C. botulinum 

BoNT/A + B

Wound botulism

* Adapted from Popoff MR, Bouvel P; Future Microbio 2009; 4: 1021 [7]

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

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Last updated: November 1, 2015