Clostridium perfringens

Background

Microbiology

• Often encapsulated short Gram-variable bacilli of varying length
• Found in soil and human (and animal) gut flora
• Makes necrotizing extracellular toxins
• Four types:
  • Type A: foodborne outbreaks associated with poorly heated food and meat; gas gangrene in patients with necrotic bowel
  • Type C: pork product ingestion followed by enteritis necroticans (hemorrhagic necrosis of the jejunum)
  • Type B & D: no disease in humans

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