Clostridium perfringens: Difference between revisions
From IDWiki
Clostridium perfringens
mNo edit summary |
No edit summary |
||
Line 6: | Line 6: | ||
*Found in soil and human (and animal) [[Gut microbiota|gut flora]] |
*Found in soil and human (and animal) [[Gut microbiota|gut flora]] |
||
*Makes necrotizing extracellular toxins |
*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) |
||
⚫ | |||
+ | {| class="wikitable" |
||
⚫ | |||
+ | !Type |
||
⚫ | |||
+ | !Toxins |
||
+ | !Clinical Notes |
||
+ | |- |
||
+ | |A |
||
+ | |CPA only |
||
⚫ | |||
+ | |- |
||
+ | |C |
||
+ | |CPA and CPB ±CPE |
||
⚫ | |||
+ | |- |
||
+ | |all others |
||
+ | |Various |
||
⚫ | |||
+ | |} |
||
+ | |||
+ | === Epidemiology === |
||
+ | |||
+ | * Spores can survive cooking at normal temperatures |
||
+ | * Foodborne illness is usually associated with improperly heated or reheated gravy, beef, poultry, or other meat |
||
== Management == |
== Management == |
Revision as of 10:13, 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
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