Clostridium

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Clostridium

• Members of the genus Clostridium are obligate
  anaerobes bacilli, that produce endospores.
• Diseases caused by members of this genus include
• Tetanus
• Botulism
• Gas Gangrene
• Severe diarrhea

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Tetanus

• Caused by Clostridium tetani.
• Especially common in soil contaminated with
  animal fecal wastes.
• Produces a toxin called tetanospasmin that is
  released upon death and lysis of the growing
  bacteria.
• Toxin blocks relaxation pathways for muscles,
  causes opposing muscles to contract at the same
  time.
• Leads to lockjaw, (a condition that provents the
  mouth from opening.
• In severe cases can lead to opisthotonos, (head
  and heals bow backwards, which can lead to a
  fractured spine.
• Death usually results from spasms of the
  respiratory muscles.

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• Vaccines have been available since the 1940s.
• Vaccine is a toxoid, an inactivated toxin that
  that stimulates the formation of antibodies that
  neutralize the toxin produced by the bacteria.
• If not vaccinated, patient can be treated with
  tetanus immune globulin, antibodies prepared from
  serum of immunized humans.
• Puncture wounds provide the anaerobic bacteria
  the ideal conditions for growth.

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Botulism

• C. botulinum produces an exotoxin that is highly
  specific for the synaptic end of a neuron, where
  it blocks the release of acetylcholine.
• Nausea usually precedes any neurological
  symptoms, which include double or blurred vision,
  difficulty swallowing and general weakness.
• Individuals suffering from botulism undergo a
  progressive flaccid paralysis for 1 to 10 days,
  and may die from respiratory or cardiac failure.

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• Treatment relies heavily on supportive care,
  giving time for nerve endings to regenerate.
• Antibiotics are of little use because the toxin
  is preformed.
• Antitoxins are available, but will not affect the
  toxin already attached to nerve endings.

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Gangrene

• When blood supply is interrupted, a condition
  results known as ischemia.
• The death of soft tissue resulting from ischemia
  is known as gangrene.
• C. perfringens, the most common bacteria involved
  in gas gangrene, will begin to break down the
  necrotic tissue and release gas as a by product.

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• If allowed to spread the bacteria will produce
  toxins that will spread to kill more tissue, and
  eventually lead to death.
• Treatment can involve amputation, or a hyperbaric
  chamber.

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C. difficile

• C. difficile is commonly found in large intestine
  normal flora, however when broad spectrum
  antibiotics disturb the normal flora, the
  antibiotic resistant C. difficile flourishes and
  begins to produce toxins.
• These toxins cause colitis, which results in
  foul-smelling diarrhea, abdominal pain, and fever.

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• Treatment involves stopping whatever antibiotics
  are being used, and switching to ones that are
  affective against C. difficile, like flagyl,
  vanco, or zyvox.
• Treatments that involve the reintroduction of
  normal flora to the intestines have also been
  used.
• Probiotic therapy like this can be as simple as
  eating yogurt, or as complex as using fecal
  bacteria from a healthy donor in an enema on the
  patient to quickly restore balance.