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Weakly beta-haemolytic human intestinal spirochaetes antagonize the haemolytic activity of Clostridium perfringens alpha-toxin producer.

The production of haemolytic antagonism between weakly beta-haemolytic human intestinal spirochaetes (wbetaHIS) related to human intestinal spirochaetosis and Clostridium perfringens alpha-toxin producer was investigated. A reduction of the clostridial haemolytic activity and a distortion of the haemolytic halo of clostridial alpha-toxin surrounded by a small zone of poorly cooperative haemolysis was clearly observed on the level of the spirochaetal growth area when 40 out of 41 wbetaHIS were cultivated in sheep blood agar plates together with Clostridium perfringens alpha-toxin producer. This phenomenon of haemolytic antagonism was observed only when wbetaHIS grew 72-96 hours sooner than C. perfringens and after the inoculum of the latter at a distance of 0 to 10 mm from wbetaHIS the plates were anaerobically incubated for an additional 48 hours and the bacteria were used at concentrations ranging from 10(7) to 10(4) CFU/ml. These results were also observed between C. perfringens and weakly beta-haemolytic intestinal spirochaetes related to animal intestinal spirochaetosis including avian strains and Brachyspira (Serpulina) pilosicoli of porcine origin.

Animals↗

Foal diarrhoea between 1991 and 1994 in the United Kingdom associated with Clostridium perfringens, rotavirus, Strongyloides westeri and Cryptosporidium spp.

A case control study of foal diarrhoea in the United Kingdom was carried out over a 3-year period. Clostridium perfringens was significantly associated with foal diarrhoea (Odds Ratio (OR) = 3.0), being isolated from 57% of 421 animals with diarrhoea but from only 27% of 223 healthy foals. Also, C. perfringens was significantly associated with fatal diarrhoea (OR = 4.5). About half of diarrhoea with a fatal outcome was attributable to this organism. The other pathogens significantly associated with diarrhoea were rotavirus (OR = 5.6), Cryptosporidium spp. (OR = 3.2) and the nematode Strongyloides westeri, which was significant only when present in large numbers (> 2000 eggs/g of faeces: OR = 6.1). Salmonella spp. (OR = 14.2) and Cryptosporidium spp. (OR = 3.0) were the only other pathogens associated with fatal illness. Overall, C. perfringens, rotavirus, and large numbers of Cryptosporidium spp. or S. westeri were isolated from 80% of foals with diarrhoea. Thermophilic Campylobacter spp., Yersinia enterocolitica, Escherichia coli and other parasites were not associated with diarrhoea. Carriage of C. perfringens, rotavirus and Cryptosporidium spp. was significantly greater in healthy foals in contact with cases of diarrhoea than in foals that were not in contact with diarrhoea (P < 0.05). There were no statistical interactions between any of the pathogens associated with diarrhoea although separate cases from one location often involved more than one pathogen.

Animals↗

The effect of antibiotics, primary and secondary closure on clostridial contaminated open fracture wounds in rats.

In a study of experimentally induced open tibial or femoral fractures in rats, after either closing or leaving the wounds open, the animals were given: no antibiotic, cephalothin (Keflin), or penicillin. The rats with wounds closed primarily and receiving no antibiotics had the highest mortality rate (11 of 25) from experimentally produced clostridial myonecrosis. The lowest overall mortality rate (5 of 99) was found in the penicillin-treated groups. The higher mortality rate in the femur fracture groups was probably because of the large muscle mass of the thigh. The importance of ideal anaerobic conditions for producing experimental clostridial myonecrosis is emphasized.

Animals↗

Fulminant puerperal sepsis associated with aplastic anemia: the case for prophylactic antibiotic therapy.

Fulminant puerperal sepsis due to Clostridium perfringens occurred in a primiparous 19-year-old woman who developed aplastic anemia during pregnancy. Although the risk of infectious complications among pregnant women with compromised host defenses has not been accurately determined, it appears to be increased, particularly in patients with granulocytopenia. It therefore seems reasonable to give antibiotic prophylaxis during the intrapartum period to immunosuppressed women who come to term. Consideration of the bacterial pathogens most likely to cause acute endometritis in the early puerperium has led us to recommend a short course (72 hours) of penicillin G, 4 million units q4h, and gentamicin, 1,5 mg/kg q8h, as an appropriate regimen for such patients.

Adult↗

Evaluation of immunosuppressants and dietary mechanisms in an experimental disease model for necrotic enteritis.

Clostridium perfringens (CP) is the etiologic agent of necrotic enteritis (NE). Clinical signs of this disease include depression, decreased appetite, diarrhea, and severe necrosis of the intestinal tract. Understanding the disease progression of NE has been difficult due to its complexity and the involvement of multiple factors (dietary components, immunosuppression, and mechanical irritation of the gut) that appear to contribute to this syndrome. In the present investigation, day-of-hatch broilers were fed a 55% wheat diet and randomly assigned to 1 of 8 groups. Treatments included positive control (CP challenge only), commercial coccidia vaccine (CCV), commercial bursal disease vaccine (CBDV), or the combination of CCV and CBDV, and an appropriate negative control for each (vaccinated and not challenged). Challenged treatment groups received 10(7) cfu of CP twice daily. When compared with controls, broilers in each treatment group had increased (P < or = 0.05) lesion scores, with mean scores of 1.05 and 2.05 in the CP and CBDV + CP treatments, respectively. When compared with controls, the incidence of CP increased (P < or = 0.05) in all treatment groups (73 and 100% in the CCV + CP and CBDV + CP treatment groups, respectively). Compared with controls, percentage mortality increased (P < or = 0.05) from 2% to 26 and 34% in the CP and CBDV + CP treatment groups, respectively. Results of this study indicate that the methodology used provides a good model for studying NE.

Animal Feed↗

A hospital outbreak of Clostridium perfringens food poisoning--implications for food hygiene review in hospitals.

An outbreak of Clostridium perfringens (C. perfringens) food poisoning affected 17 of 44 (38.6%) patients interviewed on two hospital wards. A case-control study showed a statistically significant association between the consumption of roast pork and illness (P < 0.01). C. perfringens type A, untypable serotype, was isolated from samples of pre-cooked vacuum sealed pork supplied by a local meat producer. Faults were noted in the food production process at the factory. Cuts of meat were too large and equipment to ensure rapid cooling of cooked meat was not installed. Cost improvements taken by hospitals, such as the use of commercially cooked meat, may not be consistent with the highest standards of food safety. Amendments to the District Catering Policy were implemented to prevent further outbreaks.

Animals↗

Spinal epidural empyema in two dogs.

Extensive, diffuse, epidural spinal cord compression was visualized myelographically in two dogs presented for rapid development of nonambulatory tetraparesis and paraplegia, respectively. Purulent fluid containing bacterial organisms was aspirated percutaneously under fluoroscopic guidance from the epidural space of each dog. One dog responded poorly to aggressive medical therapy, which included installation of an epidural lavage and drainage system. Both dogs were euthanized due to the severe nature of their disorder and the poor prognosis. Spinal epidural empyema (i.e., abscess) is a rare condition in humans and has not been reported previously in the veterinary literature. Spinal epidural empyema should be considered as a differential diagnosis in dogs presenting with painful myelopathies, especially when accompanied by fever.

Animals↗

Management of antibiotic-associated pseudomembranous colitis.

The diagnosis, etiology, epidemiology, and drug therapy of antibiotic-associated pseudomembranous colitis (AAPMC) are reviewed. AAPMC is an uncommon but potentially serious adverse reaction to therapy with almost any oral or injectable antibiotic and certain antineoplastic agents that alter intestinal flora. Proliferation of Clostridium difficile and subsequent release of clostridial cytotoxins cause pseudomembranous lesions and symptoms such as watery diarrhea, cramping abdominal pain, and low-grade fever. Symptoms can appear from four days after the start of antibiotic or antineoplastic therapy to 10 weeks after therapy has been discontinued. Drug therapy of AAPMC is directed at reducing the amount of Cl. difficile in the colon and promoting normalization of intestinal flora. Mild cases of AAPMC may respond to discontinuation of the etiologic agent and replacement of fluid and electrolytes. Therapy with an anticlostridial antibiotic is indicated in severe cases; although a seven- to 10-day course of oral vancomycin hydrochloride is the most widely recognized therapy, the drug is expensive and unpalatable. Good results have been reported with oral metronidazole and with bacitracin, both of which are less expensive than vancomycin. For all of these therapies, relapse rates are 20-39%. Anion exchange resins may be useful in mild cases of AAPMC. Successful management of AAPMC depends on a complex and ill-defined interrelationship between normal intestinal flora, patient immune response, antibiotic therapy, and the infecting clostridium strain. For moderate or severe cases of AAPMC, therapy should begin with metronidazole or bacitracin and vancomycin should be reserved for refractory cases, relapses, or patients with allergies to the other agents.

Anti-Bacterial Agents↗

Molecular variation between the alpha-toxins from the type strain (NCTC 8237) and clinical isolates of Clostridium perfringens associated with disease in man and animals.

The alpha-toxin produced by the type strain of Clostridium perfringens (NCTC 8237) was shown to differ from the alpha-toxins produced by most strains of C. perfringens isolated from man and from calves with respect to reactivity with a neutralizing monoclonal antibody (DY2F5D11). The difference in antibody binding correlated with three differences in the deduced amino acid sequence (Ala174 to Asp174; Thr177 to Ala177; Ser335 to Pro335) of the alpha-toxins. Using octapeptides synthesized on the basis of the amino acid sequences from these regions of variability, it was shown that the Ala174 to Asp174 change had the greatest effect on reducing the binding of monoclonal antibody DY2F5D11 to the alpha-toxin. These differences did not affect the enzymic or toxic properties of the protein. However, the phospholipase C activity of the alpha-toxin produced by strain NCTC 8237 was more susceptible to inactivation by chymotrypsin. The changes in amino acid sequence did not affect the ability of a C-terminal domain vaccine, derived from the alpha-toxin of strain NCTC 8237, to induce protection against the alpha-toxin from a bovine enteric strain of C. perfringens.

Animals↗