Clostridium perfringens: Difference between revisions

Latest revision as of 14:15, 22 June 2023

Background

Microbiology

Often encapsulated short Gram-variable bacilli of varying length
Found in soil and human (and animal) gut flora
Makes necrotizing extracellular toxins
Multiple types, based on production of major toxins, though only type A (and rarely type C) cause disease in humans
- Toxins include alpha-toxin (CPA), beta-toxin (CPB), epsilon-toxin (ETX), iota-toxin (ITX), enterotoxin (CPE), and necrotic enteritis B-like toxin (NetB)

Type	Toxins	Clinical Notes
A	CPA only	foodborne illnesses associated with poorly heated food and meat; gas gangrene in patients with necrotic bowel
C	CPA and CPB ±CPE	pork product ingestion followed by enteritis necroticans (hemorrhagic necrosis of the jejunum), particularly in Papua New Guinea
all others	Various	do not cause disease in humans

Epidemiology

Spores can survive cooking at normal temperatures
Foodborne illness is usually associated with improperly heated or reheated gravy, beef, poultry, or other meat

Clinical Manifestations

Acute infectious diarrhea
Abdominal sepsis
Cellulitis and myonecrosis

Management

For gas gangrene, typically requires surgical debridement and penicillin G
- Consider adding clindamycin for theoretical decreased toxin production in toxic shock syndrome
Otherwise, generally susceptible to erythromycin, chloramphenicol, cefazolin, cefoxitin, ceftriaxone, piperacillin, carbapenems, metronidazole, vancomycin, and linezolid

@@ Line 1: / Line 1: @@
-==Microbiology==
+== Background ==
+===Microbiology===
 *Often encapsulated short Gram-variable bacilli of varying length
-*Found in soil and humans and animals intestines
+*Found in soil and human (and animal) [[Gut microbiota|gut flora]]
 *Makes necrotizing extracellular toxins
+*Multiple types, based on production of major toxins, though only type A (and rarely type C) cause disease in humans
-*Four types:
+**Toxins include alpha-toxin (CPA), beta-toxin (CPB), epsilon-toxin (ETX), iota-toxin (ITX), enterotoxin (CPE), and necrotic enteritis B-like toxin (NetB)
-**Type A: foodborne outbreaks associated with poorly heated food and meat; gas gangrene in patients with necrotic bowel
+{| class="wikitable"
-**Type C: pork product ingestion followed by enteritis necroticans (hemorrhagic necrosis of the jejunum)
+!Type
-**Type B & D: no disease in humans
+!Toxins
+!Clinical Notes
+|-
+|A
+|CPA only
+|foodborne illnesses associated with poorly heated food and meat; gas gangrene in patients with necrotic bowel
+|-
+|C
+|CPA and CPB ±CPE
+|pork product ingestion followed by enteritis necroticans (hemorrhagic necrosis of the jejunum), particularly in Papua New Guinea
+|-
+|all others
+|Various
+|do not cause disease in humans
+|}
+=== Epidemiology ===
+* Spores can survive cooking at normal temperatures
+* Foodborne illness is usually associated with improperly heated or reheated gravy, beef, poultry, or other meat
+== Clinical Manifestations ==
+* Acute infectious diarrhea
+* Abdominal sepsis
+* Cellulitis and myonecrosis
+== Management ==
+* For gas gangrene, typically requires surgical debridement and [[penicillin G]]
+** Consider adding [[clindamycin]] for theoretical decreased toxin production in [[toxic shock syndrome]]
+* Otherwise, generally susceptible to [[erythromycin]], [[chloramphenicol]], [[cefazolin]], [[cefoxitin]], [[ceftriaxone]], [[piperacillin]], [[carbapenems]], [[metronidazole]], [[vancomycin]], and [[linezolid]]
 {{DISPLAYTITLE:''Clostridium perfringens''}}
 [[Category:Gram-positive bacilli]]