CLOSTRIDIUM 1

Anaerobic
Sporogenous
Motile – peritrichous flagella (except for C tetani, perfringens)
Non capsulated

CULTURE
Presence of reducing substance in media is important (low redox potential)
Robertson’s cooked meat medium
Unsaturated fatty acids – take up O2
Hematin - catalise the reaction
Sulfhydric component - brings reduced OR potential
RCM medium pink - sacharolytiic
Black - proteolytic

4 types based on spores

Central/ equilateral
Subterminal
Terminal oval
Terminal spherical

C.PERFRINGENS
Capsulated
Non motile

CULTURE
T 37’C
pH 5.5-8
RCM at 45’C for 2-6 hrs servs as Enrichment medium. Subcultures from this to blood
agar give pure cultures

STORMY FERMENTATION- In litmus milk, lactose is converted to acid. This coagulates

casein. The paraffin plug pushed up and shreds of clot sticking to sides of tube

TARGET HEMOLYSIS- theta toxin – complete hemolysis

Alpha toxin – partial hemolysis

CLASSIFICATION
Based on toxins produced (a, b, e, i)
A – Produced by all
Abundantly produced by type a
Responsible for toxemia in gas gangrene
Phospholipidase (lecithinase C) converts lecithin to diglyceride and phosphoryl
choline
 Opalecense in serum/egg yolk due to this

NAEGLER REACTION
Medium - 6% agar, 5% fildes peptic digest of sheep blood, 20% human serum,
antitoxin in half the plate
Observation - zone of opacity in the other half
Use - rapid detection of Cl perfringence in clinical specimen
Problems - other bacteria may produce similar opalescence

TOXINS
B, e, I nectotising and lethal properties
G, n minor lethal
D lethal
Theta like streptolysin O, lethal, cytolytic
Kappa collagenase
Lambda proteinase and gelatinase
Meu hyaluronidase, collagenase
Gamma DNAase

ENZYMES
Enzymes A and H destroy blood group substance
Neuraminidase destroy myxovirus receptors on RBC
Expose T antigen- RBC panagglutination
Hemagglutinin histamine
Fibrinolysin bursting factor- responsible for muscle lesion
Hemolysin circulating factor- increase adrenalin sensitivity

PATHOGENECITY AND DISEASES CAUSED

GAS GANGRENE
Wound contamination

Anaerobic cellulitis

Muscle invasion

Anaerobic myositis (gas gangrene)

FOOD POISONING
Type A
Contaminated cold/warmed meat dish.

Escapes gastric acid due to high protein content.

Reaches intestine.

Produce an enterotoxin similar to V cholerae, E coli

 fluid accumulation in ileal loop

C/F
Abdominal pain, diarrhea
Self limited, recovery within 24-48 hrs

GANGRENOUS APPENDICITIS
Usually C perfringens type A and type D are separated from gangrenous appendicitis
Also the cause of toxemia in intestinal obstruction and peritonitis

NECROTISISNG ENTERITIS
C perfringens type C
Known as pig belly as the condition follows on feasting on pig meat and trypsin
inhibitors like sweet potatoes
B toxin producing mucosal necrosis
Immunization with type C toxoid

BILIARY TRACT INFECTION

Acute emphysematous choycystitis
Post cholecystectomy septicemia

ENDOGENOUS GAS GANGRENE OF ABDOMINAL ORIGIN

Gut bacteria contaminating abdominal wall during surgery

BRAIN ABSCESS
PAN OPTHALMITIS
THORACIC AND UROGENITAL INFECTIONS

C SEPTICUM
Motile
Hemolytic
Transparent irregular colonies
Saccharolytic c
4 distinct toxin and a fibrinolysin
A dermonecrotic and hemolytic
B leucotoxic DNAase
G hyaluronidase
D O labile hemolysin
Can also cause gas gangrene

C NOVYI
4 types
Type A cause a gas gangrene with high mortality rate in which there is little gas and large
amt of edema fluid
 C PROTEOLYTICUM
Aerotolerant
Proteolytic
 GAS GANGRENE
Rapidly spreading edematous myonecrosis associated with severe wounds

CAUSES
Generally mixed culture of bacteria – clostridium, anaerobic strep, facultative anaerobes
Clostridia
C perfringens 60%
C Novyi + C septicum 20-40%
C histolyticum less common

STAGES
Simple wound contamination with clostridia with no invation
Anaerobic cellulitis - clostridium invade fascial planes with minimal toxin production
and no invasion
Anaerobic myositis - abundant exotoxin formation

C/Fs
Increased pain, tenderness, edema, systemic toxemia
Initially – thin watery discharge
Later – profuse, serosanguinous
Crepitant tissue