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The importance of clostridia in experimental intestinal strangulation.

Hemorrhagic and ischemic strangulation of closed intestinal segments was sutdied in germ-free rats individually monocontaminated with one of eight separate species of clostridia. Ischemic strangulation was found to be as deadly as hemorrhagic strangulation in the presence of clostridia. Some clostridia were very toxic whereas others were relatively innocuous. The clostridia, ranked in the order of decreasing lethality, were: Clostridium perfringens type A, C. septicum, C. histolyticum, C. haemolyticum, C. bifermantans, C. sporogenes, C. tertium, and C. novyi type A. All species were readily established in the gastrointestinal tract of the nonoperated germ-free rat. The clostridia appear to be one of the most potentially lethal groups of organisms commonly found in the intestinal tract of human beings and animals.

Animals

Pseudomembranous colitis: isolation of two species of cytotoxic clostridia and successful treatment with vancomycin.

Lincomycin-resistant Clostridium sporogenes obtained from the stools of a patient with lincomycin-associated pseudomembranous colitis produced a heat-stable cytotoxin in low titre when grown in chopped meat medium. Vancomycin eradicated this strain and all other clostridia, and controlled the symptoms. When diarrhea recurred 7 days after treatment with vancomycin was stopped, clostridia including C. sporogenes and C. difficile were again isolated. The C. difficile produced a heat-labile cytotoxin in high titre that was unaffected by growth in various media and induced colitis in hamsters. Treatment with vancomycin, to which all the clostridia were sensitive, eradicated both toxic species and controlled the diarrhea. Antibiotic-induced pseudomembranous colitis may be associated with more than one species of toxin-producing clostridia. Vancomycin therapy should be continued for 10 days or more in patients with severe disease to eradicate the responsible organism.

Aged

Clostridia in soil of the Antarctica.

From the soil in the area around the Syowa Station, the East Ongul Island, the Antarctica, a total of 193 strains of clostridia were isolated and identified. It was surprising that the soil samples taken from the places which were considered to be scarcely contaminated by human beings and animals contained many clostridia. One hundred and fifty-five strains were assigned to 11 species, including C. perfringens, C. bifermentans, C. sordellii, C. sporogenes, C. plagarum, C. paraperfringens, C. septicum, C. tertium, C. cadaveris, C. butyricum and C. felsineum, but 38 strains remained unidentified. C. perfringens, C. bifermentans and C. sordellii were isolated very frequently and C. sporogenes less frequently. All the strains of C. sordellii were nonpathogenic and had almost the same characteristics as those of C. bifermentans except for the attitude in the urease test. The peculiar distribution and characteristics of the clostridia in the Antarctic soil were discussed in comparison with those found in the soil in Japan.

Antarctic Regions

[Sensitivity of pathogenic clostridia to antibiotics].

By the sensitivity levels of the gas infection causative agents, i. e. pathogenic Clostridia to antibiotics, the latter were conditionally divided into 4 groups. The 1st group included the most active antibiotics, such as tetracyclines,, penicillins, cephalosporins, rifampicin, 7-chlor-7-desoxylincomycin. Their minimum inhibitory and bactericidal concentrations did not usually exceed 2 gamma/ml. For most of the strains the inhibitory and bactericidal concentrations amounted to the tenth and hundredth fractions of gamma/ml. The antibiotics of the 2nd group, i. e. erythromycin, lincomycin,ristomycin and levomycetin inhibited multiplication and viability of pathogenic Clostridia in concentrations of 20 gamma/ml. Erythromycin was most active among them The 3rd group consisted of oleandomycin, novobiocin, geliomycin and azalomycin, the minimum inhibitory concentrations of them being 20 to 50 gamma/ml. The antibiotics of the 4th group, i. e. neomycin, monomycin, kanamycin, streptomycin, polymyxin and others affected pathogenic Clostridia at very high concentrations, amounting to the hundrenth and thousandth of gamma/ml.

Anti-Bacterial Agents

Antibiotic-induced lethal enterocolitis in hamsters: studies with eleven agents and evidence to support the pathogenic role of toxin-producing Clostridia.

Clindamycin-induced enterocolitis in hamsters was studied, using a tissue culture assay to detect clostridial toxin. It was found that animals with lethal enterocolitis had a cytopathogenic substance in cecal contents and blood that was neutralized by clostridial antitoxins. Cultures of the cecal flora yielded numerous species of clostridia, but only 1 organism was detected which produced a toxin which was cytopathic in tissue culture. This organism, Clostridium difficile, was consistently present in high concentrations, and the cell-free supernate of these strains caused enterocolitis if injected intracecally into hamsters. Ten additional antimicrobials were tested ih hamsters. Ampicillin, vancomycin, erythromycin, cephalosporins, and oral gentamicin caused lethal enterocolitis in most recipients, and all animals which died had evidence of clostridia toxin in cecal contents at necropsy. Tetracycline and metronidazole were well tolerated, and the animals given these antimicrobials had no evidence of the toxin. We conclude that toxin-producing clostridia are responsible for lethal enterocolitis due to a variety of antimicrobials in hamsters.

Ampicillin

Amino acids produced by bifidobacteria and some Clostridia.

A lot of 121 strains of bifidobacteria and 9 strains of clostridia were examined for their ability to release free amino acids in the culture broth. The bifidobacteria studied belong to 18 species or "homology group" and the clostridia to 8 species. The growth in a synthetic medium with ammonium salts as sole nitrogen source was also studied. All the clostridia and the majority of the bifidobacteria produce various amino acids. The possible ecological significance of these findings is suggested.

Amino Acids

[Intensification of the oncolysis by clostridia by means of radio-frequency hyperthermy in experiments on animals--dependence on dosage and on intervals (author's transl)].

The effect of a local pretreatment by radio-frequency hyperthermy upon the capability of germination and, hence, upon the oncolysis by intravenously given spores of oncolytic clostridia (M55) was tested with 2305 NMRI-mice carrying neck tumors. Using two different experimental tumors (Ehrlich adenocarcinoma and Harding-Passey-melanoma) it is possible to show the dependence of the intensification on the thermic dose. Additionally, there is a distinct dependence of the extent of oncolysis on the time interval between the hyperthermy treatment and the administration of clostridia. The intensification effect in both the tumors is mostly marked twelve hours after hyperthermy. The rapidly growing Ehrlich adenocarcinoma regenerates more quickly than the slowly growing Harding-Passey-melanoma. A period of 12 hours between hyperthermy and injection of clostridia represents a favourable interval for the timing of slowly as well as of rapidly growing tumors.

Animals

Fulminant necrotising enterocolitis associated with Clostridia.

5 infants with no growth of bacteria on cultures of blood and peritoneal fluid recovered from necrotising enterocolitis after medical treatment alone. 12 infants with positive cultures required surgery. 5 of these 12, who did not harbour clostridia, had a mild clinical course and all 5 survived segmental bowel resection. The 7 infants who harboured clostridia had a more severe clinical course and 4 died. In 3 of 4 infants with Clostridium perfringens, the necrotising enterocolitis was fulminant, characterised by severe pneumatosis intestinalis, extensive gangrene, early intestinal perforation, and a fatal outcome.

Ascitic Fluid

Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia.

A substance producing cytotoxicity in tissue culture was detected in stool specimens from all of four patients with pseudomembranous colitis due to antibiotics and in one of 54 with antibiotic-associated diarrhea. These stools also caused enterocolitis when injected intracecally into hamsters. On each occasion, cytotoxicity in tissue culture and enterocolitis in hamsters were neutralized by pretreatment with gas-gangrene antitoxin. The toxicity in both tissue cultures and hamsters could be reproduced with broth cultures of clostridia strains isolated from four of the five stools. These results suggest that toxin-producing clostridia are responsible for antibiotic-associated pseudomembranous colitis.

Ampicillin

Quantitative chemical analyses and antigenic properties of peptidoglycans from Clostridium botulinum and other clostridia.

The cell wall peptodoglycans were isolated from Clostridium botulinum and some other species of the genus Clostridium by hot formamide extraction and their quantitative chemical composition and antigenic properties were determined. The petidoglycan of C. botulinum type E was found to be a diaminopimelic acid (DAP)-containing type composed of glucosamine, muramic acid, glutamic acid, alanine and DAP in the molar ratio of 0.76:0.78:1.00:1.88:0.81. All other types of C. botulinum and Clostridium sporogenes also belonged to the same peptidoglycan type. The peptidoglycans of Clostridium bifermentans and Clostridium histoloyticum contained DAP but they differed from those of C. botulinum in the molar ratio of alanine to glutamic acid. The peptidoglycan of Clostridium perfringens was composed of glutamic acid, alanine, DAP and glycine in the molar ratio of 1.00:1.64:0.94:0.90. On the other hand, the peptidoglycan of Clostridium septicum was found to contain lysine instead of DAP and the molar ratio was 1.00:1.41:0.96 for glutamic acid, alanine and lysine. In spite of the difference in amino acid composition of peptidoglycans among the clostridia, the quantitative precipitin test demonstrated that antiserum against C. botulinum type E peptidoglycan cross-reacted with the peptidoglycans from other clostridia as well as various types of C. botulinum.

Alanine

Recovery of clostridia on catalase-treated plating media.

Four plating media commonly used for culturing clostridia were tested for their ability to support growth of several Clostridium species after storage of the plates for 1 to 10 days at 4 and 25 degrees C with and without subsequent addition of catalase. Liver-veal (LV) agar and brain heart infusion (BHI) agar rapidly became incapable of supporting growth after storage without added catalase, whereas Shahidi Ferguson perfringens agar base and Brewer anaerobic agar were less affected. Plate counts of vegetative cells of nine of the less fastidious Clostridium species on untreated LV and BHI agars, stored for 3 days at 4 degrees C, were 60 to 90% lower than counts on catalase-treated media. Counts on Shahidi Ferguson perfringens agar base were only 1 to 24% lower on untreated medium with the same species. Addition of 500 U of purified beef liver catalase to the surface of the 3-day-old agars before inoculation resulted in substantial restoration of the ability of the media to support colony formation from vegetative cells except with the most strictly anaerobic species (nonproteolytic C. botulinum types B, E, and F, and C. novyii types A and B). A similar response was obtained with spores of the less fastidious species on catalase-treated media. Our results suggest that inhibition of most Clostridium species on LV and BHI agars may be due to accumulation of peroxide during preparation, storage, and incubation of the media, and also suggest that the presence of glucose in these media is a major factor contributing to their inability to support growth. It is believed that the addition of exogenous catalase prevents the accumulation of peroxide(s), thus allowing colony formation from vegetative cells of the clostridia under what would otherwise be unsuitable cultural conditions.

Catalase

Spin-labeling studies on the lipids of psychrophilic, psychrotrophic, and mesophilic clostridia.

Spin-labeling studies were conducted to elucidate the viscosity and phase transition temperatures of lipids isolated from psychrophilic, psychrotrophic, and mesophilic clostridia. Electron spin resonance spectroscopy indicated that the lipids, for all the growth temperatures tested, were in a fluid state and from 13 to 24 C higher than the corresponding lipid transition temperatures. When the organisms were grown at different temperatures, a psychrotropic and two mesophilic clostridia were shown to be able to adjust their lipid-phase transition temperature to the growth temperature. A psychrophilic Clostridium strain, when grown at different temperatures, synthesized lipids that had the same phase transition temperature. It is suggested that this lack of growth temperature-inducible regulation of lipid-phase transition temperature may be a molecular determinant for the psychrophily of this organism. It is proposed that the growth temperature range of an organism is dependent upon the ability of the organism to regulate its lipid fluidity within a specific range.

Clostridium

[The determination of the oncolytic effect of clostridia with the hamster amelanotic Melanoma no.3--a quantitative study utilizing defined criteria of evaluation (author's transl)].

With a view of satisfying the practical demands on a diagnostic tumour clostridium assay the development of a biological tumour test model is of prime importance. We are interested in a safe method for differentiating between oncolytic clostridia and clostridial strains exerting no oncolytic capacity. It was therefore attempted to develop a reproducible assay system using hamster A-Mel-3 as a reference tumour. This was finally attained by quantifying oncolysis taking into account the criterium of spontaneous onconecrosis of this tumour. The proposed oncolytic assay system was submitted to a mathematical regression analysis using different strains of clostridia as well as different batches of cultivated spores of one and the same strain. The results are critically compared with the current literature.

Animals

[On N2-fixing clostridia and bacilli from soils (author's transl)].

In total 30 nitrogen-fixing, saccharolytic Clostridia and 4 nitrogen-fixing bacilli, all freshly isolated from gleyed soils, were screened for sensitivity to 20 antibiotics. The isolates were compared in their sensitivity with 5 type cultures representing the species Clostridium butyricum, C. saccharobutyricum (2 strains) C. multifermentans and C. sporogenes. Generally speaking, both clostridia and bacilli are sensitive to the same antibiotics (Table 2). In addition, the nitrogen-fixing bacilli belonging to Bacillus polymyxa and B. macerans showed sensitivity to neomycin and kanamycin. Except for the species C. tyrobutyricum, none of the various saccharolytic Clostridium species could be distinguished by differences in sensitivity to antibiotics. Differential methods are given in Table 3.

Anaerobiosis

The end products of the metabolism of aromatic amino acids by Clostridia.

The end products of the metabolism of phenylalanine, tyrosine and tryptophan by growing cultures of clostridia have been identified. The species used were Clostridium aminovalericum; C. bifermentans; C. botulinum proteolytic type A; C. botulinum proteolytic type B; C. cochlearium; C. difficile; C. ghoni; C. histolyticum; C. lentoputrescens; C. limosum; C. lituseburense; C. malenomenatum; C. mangenoti; C. propionicum; C. putrefaciens; C. sordellii; C. sporogenes; C. sporosphaeroides; C. sticklandii; C. subterminale; C. tetani; C. tetanomorphum. The mixture of aromatic compounds formed, which depended upon the species, included phenyl acetic acid, phenyl propionic acid, phenyl lactic acid, phenol, p-cresol, p-hydroxy phenyl acetic acid, p-hydroxy phenyl propionic acid, indole, indole acetic acid and indole propionic acid.

Amino Acids

The inability of nuclear dehydrogenating clostridia to oxidize bile salt hydroxyl groups.

In a survey of the intracellular bile salt oxidoreductase activity in fecal bacteria, 16 strains of nuclear dehydrogenating clostridia and 2 strains of non-nuclear dehydrogenating C. paraputrificum were demonstrated unable to oxidize cholate at any of the 3 OH groups. Since nuclear dehydrogenation at the delta-1 and delta-4 position requires a 3-oxo precursor steroid, it appears that these organisms require the presence of a 3 alpha-hydroxysteroid dehydrogenating organism for nuclear dehydrogenation.

Bile Acids and Salts

Regulation of the NADH and NADPH-ferredoxin oxidoreductases in clostridia of the butyric group.

NADH and NADPH-ferredoxin oxidoreductases have been studied in Clostridium acetobutylicum, Cl. tyrobutyricum and Cl. pasteurianum. The study of the distribution and regulation of these enzymatic activities in well-defined culture conditions, reveals that the essential function of NADPH-ferredoxin oxidoreductase is to produce NADPH, while NADH-ferredoxin oxidoreductase can, depending on cellular conditions, produce or oxidize NADH. When these Clostridia use glycolysis, regulation of the NADH-ferredoxin oxidoreductase by acetyl-CoA (obligatory activator of NADH-ferroxin reductase activity) and by NADH (competitive inhibitor of ferredoxin-NAD+ reductase activity) allow the enzymes to function correlatively with glyceraldehyde-3-phosphate dehydrogenase and thus control the levels of NAD+ and NADH in the cell. In Cl. tyrobutyricum and Cl. pasteurianum, the ferredoxin-NADP+ reductase activities are regulated by NAD+ and NADH in accordance with the intracellular concentrations of these coenzymes. In Cl. tyrobutyricum growing on pyruvate/acetate, NADH and NADPH-ferredoxin reductase activities cannot be detected; only the ferredoxin-NAD+ and ferredoxin-NADP+ reductase activities are found. In this Clostridium, regulation of the ferredoxin-NADP+ reductase activity is the same whether it is grown on glucose or pyruvate. Contrary to this, the ferredoxin-NAD+ reductase activity undergoes a drastic change, since NADH no longer controls the enzymatic activity. In this case regulation is no longer necessary, since glyceraldehyde-3-phosphate dehydrogenase does not function.

Butyrates

Defined human Clostridia consortia reverse colitis via dual effects of tryptophan metabolites on microbiota and immunity.

Microbial dysbiosis and disrupted mucosal immune homeostasis are integrally involved in the pathogenesis of inflammatory bowel diseases (IBDs). Live biotherapeutic products (LBPs) offer a potential therapeutic strategy to restore beneficial microbes and mitigate disease. We investigated the therapeutic efficacy of 2 LBPs, human Clostridia consortia 17-mix and 11-mix, by treating established colitis in murine models. Both LBPs exhibited therapeutic effects in T cell-mediated chronic colitis models induced by human microbiota and in pathobiont-driven gnotobiotic colitis models established with combinations of IBD-relevant human-derived strains. Metagenomic and metabolomic analyses elucidated mechanisms that go beyond established functions driven by short-chain fatty acids (SCFAs) and interleukin (IL)-10-producing regulatory T cells. Notably, LBPs exerted therapeutic effects by directly inhibiting resident pathobionts and through IL-10-independent activation of host anti-inflammatory aryl hydrocarbon receptor (AhR) pathways by bacterial tryptophan metabolites. These results elucidate SCFA- and IL-10-independent protective mechanisms exerted by defined resident bacterial strains that are depleted in IBD dysbiosis.

Animals