Clostridium perfringens
Encyclopedia
Clostridium perfringens (formerly known as C. welchii) is a Gram-positive
, rod-shaped, anaerobic, spore-forming
bacterium of the genus Clostridium
. C. perfringens is ever present in nature and can be found as a normal component of decaying vegetation, marine sediment, the intestinal tract
of human
s and other vertebrate
s, insect
s, and soil
.
C. perfringens is the third most common cause of food poisoning in the United Kingdom and the United States though it can sometimes be ingested and cause no harm.
Infections due to C. perfringens show evidence of tissue necrosis
, bacteremia
, emphysema
tous cholecystitis
, and gas gangrene
, which is also known as clostridial myonecrosis. The toxin involved in gas gangrene
is known as α-toxin
, which inserts into the plasma membrane of cells, producing gaps in the membrane that disrupt normal cellular function. C. perfringens can participate in polymicrobial anaerobic infection
s. Clostridium perfringens is commonly encountered in infection
s as a component of the normal flora
. In this case, its role in disease is minor.
The action of C. perfringens on dead bodies is known to mortuary workers as tissue gas
and can be halted only by embalming
.
(CPE) mediating the disease is heat-labile (inactivated at 74 °C) and can be detected in contaminated food, if not heated properly, and feces.
Incubation time is between six and 24 (commonly 10-12) hours after ingestion of contaminated food. Often, meat is well prepared, but too far in advance of consumption. Since C. perfringens forms spores that can withstand cooking temperatures, if let stand for long enough, germination ensues and infective bacterial colonies develop. Symptoms typically include abdominal cramping and diarrhea
; vomiting and fever are unusual. The whole course usually resolves within 24 hours. Very rare, fatal cases of clostridial necrotizing enteritis
(also known as pigbel) have been known to involve "Type C" strains of the organism, which produce a potently ulcerative β-toxin
. This strain is most frequently encountered in Papua New Guinea
.
Many cases of C. perfringens food poisoning likely remain subclinical, as antibodies
to the toxin are common among the population. This has led to the conclusion that most of the population has experienced food poisoning due to C. perfringens.
Despite its potential dangers, C. perfringens is used as the leavening agent
in salt rising bread
. The baking process is thought to reduce the bacterial contamination, precluding negative effects.
, which is necrosis, putrefaction of tissues, and gas production. It is caused primarily by Clostridium perfringens alpha toxin
. The gases form bubbles in muscle (crepitus) and the characteristic smell in decomposing tissue. After rapid and destructive local spread (which can take hours), systemic spread of bacteria and bacterial toxins may result in death. This is a problem in major trauma and in military contexts. C. perfringens grows readily on blood agar plate in anaerobic conditions and often produces a zone of hemolysis.
that interacts with the lipids in egg yolk to produce a characteristic precipitate around the colonies. One-half of the plate is inoculated with antitoxin
to act as a control in the identification.
Gram-positive
Gram-positive bacteria are those that are stained dark blue or violet by Gram staining. This is in contrast to Gram-negative bacteria, which cannot retain the crystal violet stain, instead taking up the counterstain and appearing red or pink...
, rod-shaped, anaerobic, spore-forming
Endospore
An endospore is a dormant, tough, and temporarily non-reproductive structure produced by certain bacteria from the Firmicute phylum. The name "endospore" is suggestive of a spore or seed-like form , but it is not a true spore . It is a stripped-down, dormant form to which the bacterium can reduce...
bacterium of the genus Clostridium
Clostridium
Clostridium is a genus of Gram-positive bacteria, belonging to the Firmicutes. They are obligate anaerobes capable of producing endospores. Individual cells are rod-shaped, which gives them their name, from the Greek kloster or spindle...
. C. perfringens is ever present in nature and can be found as a normal component of decaying vegetation, marine sediment, the intestinal tract
Intestine
In human anatomy, the intestine is the segment of the alimentary canal extending from the pyloric sphincter of the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine...
of human
Human
Humans are the only living species in the Homo genus...
s and other vertebrate
Vertebrate
Vertebrates are animals that are members of the subphylum Vertebrata . Vertebrates are the largest group of chordates, with currently about 58,000 species described. Vertebrates include the jawless fishes, bony fishes, sharks and rays, amphibians, reptiles, mammals, and birds...
s, insect
Insect
Insects are a class of living creatures within the arthropods that have a chitinous exoskeleton, a three-part body , three pairs of jointed legs, compound eyes, and two antennae...
s, and soil
Soil
Soil is a natural body consisting of layers of mineral constituents of variable thicknesses, which differ from the parent materials in their morphological, physical, chemical, and mineralogical characteristics...
.
C. perfringens is the third most common cause of food poisoning in the United Kingdom and the United States though it can sometimes be ingested and cause no harm.
Infections due to C. perfringens show evidence of tissue necrosis
Necrosis
Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...
, bacteremia
Bacteremia
Bacteremia is the presence of bacteria in the blood. The blood is normally a sterile environment, so the detection of bacteria in the blood is always abnormal....
, emphysema
Emphysema
Emphysema is a long-term, progressive disease of the lungs that primarily causes shortness of breath. In people with emphysema, the tissues necessary to support the physical shape and function of the lungs are destroyed. It is included in a group of diseases called chronic obstructive pulmonary...
tous cholecystitis
Cholecystitis
-Signs and symptoms:Cholecystitis usually presents as a pain in the right upper quadrant. This is known as biliary colic. This is initially intermittent, but later usually presents as a constant, severe pain. During the initial stages, the pain may be felt in an area totally separate from the site...
, and gas gangrene
Gas gangrene
Gas gangrene is a bacterial infection that produces gas tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. It is a medical emergency....
, which is also known as clostridial myonecrosis. The toxin involved in gas gangrene
Gas gangrene
Gas gangrene is a bacterial infection that produces gas tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. It is a medical emergency....
is known as α-toxin
Clostridium perfringens alpha toxin
Clostridium perfringens alpha toxin is a toxin produced by the bacterium Clostridium perfringens and is responsible for gas gangrene and myonecrosis in infected tissues. The toxin also possesses hemolytic activity....
, which inserts into the plasma membrane of cells, producing gaps in the membrane that disrupt normal cellular function. C. perfringens can participate in polymicrobial anaerobic infection
Anaerobic infection
Anaerobic infections are caused by anaerobic bacteria. Anaerobic bacteria do not grow on solid media in room air ; facultative anaerobic bacteria can grow in the presence as well as in the absence of air. Microaerophilic bacteria do not grow at all aerobically or grow poorly, but grow better under...
s. Clostridium perfringens is commonly encountered in infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
s as a component of the normal flora
Flora (microbiology)
In microbiology, flora refers to the collective bacteria and other microorganisms in an ecosystem . While the term microflora is widely used, it is technically a misnomer since the word root flora pertains to the kingdom plantae...
. In this case, its role in disease is minor.
The action of C. perfringens on dead bodies is known to mortuary workers as tissue gas
Tissue gas
Tissue gas is the name given to the action of the bacteria Clostridium perfringens in dead bodies. Its effect on the deceased is that of an extremely accelerated decomposition. It is only halted by embalming the body and special additive chemicals must be employed...
and can be halted only by embalming
Embalming
Embalming, in most modern cultures, is the art and science of temporarily preserving human remains to forestall decomposition and to make them suitable for public display at a funeral. The three goals of embalming are thus sanitization, presentation and preservation of a corpse to achieve this...
.
Food poisoning
In the United Kingdom and United States, C. perfringens bacteria are the third-most-common cause of food-borne illness, with poorly prepared meat and poultry the main culprits in harboring the bacterium. The clostridium perfringens enterotoxinClostridium perfringens enterotoxin
Clostridium enterotoxins are toxins produced by Clostridium species.Clostridial species are one of the major causes of food poisoning/gastro-intestinal illnesses. They are anaerobic, gram-positive, spore-forming rods that occur naturally in the soil...
(CPE) mediating the disease is heat-labile (inactivated at 74 °C) and can be detected in contaminated food, if not heated properly, and feces.
Incubation time is between six and 24 (commonly 10-12) hours after ingestion of contaminated food. Often, meat is well prepared, but too far in advance of consumption. Since C. perfringens forms spores that can withstand cooking temperatures, if let stand for long enough, germination ensues and infective bacterial colonies develop. Symptoms typically include abdominal cramping and diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
; vomiting and fever are unusual. The whole course usually resolves within 24 hours. Very rare, fatal cases of clostridial necrotizing enteritis
Clostridial necrotizing enteritis
Clostridial necrotizing enteritis -- also called enteritis necroticans and pigbel -- is an often fatal type of food poisoning caused by a β-toxin of Clostridium perfringens, Type C. It occurs in some developing countries, but was also documented in Germany following World War II...
(also known as pigbel) have been known to involve "Type C" strains of the organism, which produce a potently ulcerative β-toxin
Clostridium perfringens beta toxin
Clostridium perfringens beta toxin one of the four major lethal toxins produced by Clostridium perfringens Type B and Type C strains. It is a necrotizing agent and it induces hypertension by release of catecholamine....
. This strain is most frequently encountered in Papua New Guinea
Papua New Guinea
Papua New Guinea , officially the Independent State of Papua New Guinea, is a country in Oceania, occupying the eastern half of the island of New Guinea and numerous offshore islands...
.
Many cases of C. perfringens food poisoning likely remain subclinical, as antibodies
Antibody
An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...
to the toxin are common among the population. This has led to the conclusion that most of the population has experienced food poisoning due to C. perfringens.
Despite its potential dangers, C. perfringens is used as the leavening agent
Leavening agent
A leavening agent is any one of a number of substances used in doughs and batters that cause a foaming action which lightens and softens the finished product...
in salt rising bread
Salt rising bread
Salt rising bread is bread in which the main rising agent is a bacterium Clostridium perfringens, which leavens the bread along with lactobacillus and other wild microbes, as opposed to mainly yeast or baking soda. It is thought that the salt used in the starter is used to suppress yeast growth...
. The baking process is thought to reduce the bacterial contamination, precluding negative effects.
Infection
Clostridium perfringens is the most common bacterial agent for gas gangreneGas gangrene
Gas gangrene is a bacterial infection that produces gas tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. It is a medical emergency....
, which is necrosis, putrefaction of tissues, and gas production. It is caused primarily by Clostridium perfringens alpha toxin
Clostridium perfringens alpha toxin
Clostridium perfringens alpha toxin is a toxin produced by the bacterium Clostridium perfringens and is responsible for gas gangrene and myonecrosis in infected tissues. The toxin also possesses hemolytic activity....
. The gases form bubbles in muscle (crepitus) and the characteristic smell in decomposing tissue. After rapid and destructive local spread (which can take hours), systemic spread of bacteria and bacterial toxins may result in death. This is a problem in major trauma and in military contexts. C. perfringens grows readily on blood agar plate in anaerobic conditions and often produces a zone of hemolysis.
Treatment
If detected on clinical grounds, treatment should begin without waiting for lab results. Traumatic wounds should be cleaned. Wounds that cannot be cleaned should not be stitched shut. Penicillin prophylaxis kills clostridia, and is thus useful for dirty wounds and lower leg amputations. A high infectious dose is required; the carrier state persists for several days.Colony characteristics
On blood agar plates, C. perfringens grown anaerobically produces β-haemolytic, flat, spreading, rough, translucent colonies with irregular margins. A distinguishing charachteristic of C. perfringens is a zone of double beta haemolysis. Nagler agar plates, containing 5-10% egg yolk, are used to identify strains that produce α-toxin, a diffusible lecithinaseLecithinase
Lecithinase is a type of phospholipase that acts upon lecithin.It can be produced by Clostridium perfringens or Listeria Monocytogenes . C. perfringens alpha toxin causes myonecrosis and hemolysis....
that interacts with the lipids in egg yolk to produce a characteristic precipitate around the colonies. One-half of the plate is inoculated with antitoxin
Antitoxin
An antitoxin is an antibody with the ability to neutralize a specific toxin. Antitoxins are produced by certain animals, plants, and bacteria. Although they are most effective in neutralizing toxins, they can kill bacteria and other microorganisms. Antitoxins are made within organisms, but can be...
to act as a control in the identification.
External links
- Clostridium perfringens genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID
- Pathema-Clostridium Resource