Clostridium perfringens

An anaerobic, Gram-positive, sporeforming rod.

C perfringens widely present in nature and can be found as a normal component of decaying vegetation, marine sediment, the intestinal tract of humans and other vertebrates, insects, and soil.

Third most common cause of food poisoning in the United States.

Infections show evidence of tissue necrosis, bacteremia, emphysematous cholecystitis, and gas gangrene, which is also known as clostridial myonecrosis.

The toxin involved in gas gangrene inserts into the plasma membrane of cells, producing gaps in the membrane that disrupt normal cellular function.

In gas gangrene phospholipase C lecithinase alpha toxin hydrolyzes phospholipids in cell membranes, causing lysis and destruction of tissues and cells.

Clinically gas gangrene is associated with severe pain disproportionate to physical signs.

In gas gangrene pain can precede cutaneous findings on 24-48 hours.

in gas gangrene hemorrhagic bullae, crepitus, skin necrosis, and sensory or motor neurologic deficits are made on.

Crepitus is an indicator of gas gangrene, but is often a late finding.

Laboratory findings in gas gangrene include anemia due to hemolysis, leukocytosis, and elevated muscle enzyme levels.

Gas gangrene associated with diabetes, necrotizing enterocolitis, neutropenia, Crohn’s disease, diverticulitis, and bowel infarction.

Distant myonecrosis reported with hematologic and visceral malignancies usually with metastases, this is particularly true of occult carcinomas of the cecum.

Disruption of bowel mucosa by malignancies, inflammatory diseases, chemotherapy agents permit normal flora such as C perfringens to enter the bloodstream and seed distant sites, leading to myonecrosis.

Treatment of gas gangrene should receive immediately as any delay in diagnosis may result in increased morbidity and mortality.

Intravenous antibiotics and surgical treatment of the process are paramount: Surgical debridement of all necrotic tissue is essential because of thrombosis of the supplying blood vessels inhibits antibiotic delivery.

Hyperbaric oxygen may be beneficial.

Can participate in polymicrobial anaerobic infections.

Commonly encountered in infections as a component of the normal flora.

Action on dead bodies creates tissue gas.

Enterotoxin mediating the disease is heat-labile and can be detected in contaminated food and feces.

Incubation time is between six and 24 hours after ingestion of contaminated food.

Many cases of food poisoning remain subclinical, as antibodies to the toxin are common among the population suggesting most of the population has experienced food poisoning due to C. perfringens.

Used as the leavening agent in salt rising bread.

Most common bacterial agent for gas gangrene, which is necrosis, putrefaction of tissues, and gas production caused primarily by Clostridium perfringens alpha toxin.

Traumatic gas gangrene is most commonly associated with motor vehicle accidents, contaminatednmuscle injuries and surgical wounds.

Clostridial contamination occurs in more than 80% of traumatic wounds, but gas gangrene occurs in only 1-2% (Altemeier WA et al).

Clostridium perfringens is responsible for gas gangrene in the percent of cases (Ray D et al).

Systemic spread of bacteria and bacterial toxins may result in death from gas gangrene.

Treatment should begin without waiting for lab results in suspected gas gangrene. Traumatic wounds should be cleaned.

Spontaneous gas gangrene is a less frequent abnormality than traumatically related disease and is caused by Clostridium perfringens or Clostridium septicum, and 60% and 30% of cases, respectively (Burke MP et al).

Penicillin prophylaxis kills clostridia is indicated useful for dirty wounds and lower leg amputations.

C. perfringens grown anaerobically produces β-haemolytic, flat, spreading, rough, translucent colonies on agar plates with irregular margins.

Spores persist in soil, sediments, and areas subject to human or animal fecal contamination.

One of the most commonly reported foodborne illnesses in the U.S., with an estimated 10,000 cases annually.


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Typically associated with outbreaks of illness.

Food poisoning is the common foodborne illness caused by C. perfringens follwing ingestion of foods containing large numbers of C. perfringens bacteria capable of producing the food poisoning toxin.

The foodborne illness is usually over within 24 hours but less severe symptoms may persist in some individuals for 1 or 2 weeks.

The common form of perfringens poisoning is associaed with abdominal cramps and diarrhea which begin 8-22 hours after consumption of contaminated foodstuffs,

Rarely associated with death due to dehydration.

A more serious but rare illness is also caused by ingesting food contaminated with Type C strains is enteritis necroticans.

Symptoms are caused by ingestion of large numbers of organisms cells that produce toxin in the digestive tract.

Diagnosed by its symptoms and the typical delayed onset of illness, and bt the detection of the toxin in the feces.

Bacteriological confirmation can also be done by finding large numbers of the bacteria in implicated foods or in the feces of patients.

Meats, meat products, and gravy are the foods most frequently implicated when not stored properly.

In situations where large quantities of food are prepared several hours before serving is the most common circumstance in which infections occur.

The young and elderly are the most frequenty involved with infection.

Serological assays are available for detecting enterotoxin in the feces.

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