Clostridium

Dr. Charles Davis, MD, PhD, writing for MedicineNet.com explains the deadly nature of Clostridium bacteria:
“These bacteria can cause myonecrosis (muscle fiber death) with its exotoxins and produce gas bubbles in the dead
and dying tissues (gas gangrene). This leads to localized swelling with compression and loss of blood flow to tissue,
allowing bacteria to extend the infection to the connective tissue of muscle, skin, and other areas, causing necrotizing
fasciitis (death of connective tissue). Necrotizing fasciitis, in turn, allows the infection to spread, frequently with speed,
out of the locally infected site to adjacent areas or to the bloodstream (sepsis). Although this cascade of events is seen
with Clostridium perfringens often as the single infecting organism type, it can be caused by many other organisms such
as Streptococcus, Staphylococcus, Bacteroides, and Escherichia.”
http://www.medicinenet.com/gangrene/article.htm


C. difficile, which can cause diarrhea and a potentially fatal inflammation in older patients and those with weaker immune
systems, said Jarvis, a former
U.S. Centers for Disease Control and Prevention epidemiologist. Every day, more than
7,000 patients are being treated for the disease at a cost of $18 million to $52 million, he said.

2010
Deaths from C-diff traditionally have been rare, but a more dangerous form has emerged in the last 10 years. Still,
MRSA is generally considered a more lethal threat, causing an estimated 18,000 deaths annually in the United States.
The new study looked at infection rates from community hospitals in Georgia, North Carolina, South Carolina and
Virginia in 2008 and 2009. It found the rate of hospital-acquired C-diff infections was 25 percent higher than MRSA
infections.
The hospitals counted 847 infections of hospital-acquired C-diff, and 680 cases of MRSA.
Dr. Miller also reported that C-diff was increasing at the hospitals since 2007, while MRSA has been declining since
2005.
http://www.nytimes.com/2010/03/21/health/21bug.html

2009 May;
Clostridium difficile in Retail Meat Products, USA, 2007
To determine the presence of Clostridium difficile, we sampled cooked and uncooked meat products sold in Tucson,
Arizona. Forty-two percent contained toxigenic C. difficile strains (either ribotype 078/toxinotype V [73%] or
027/toxinotype III [NAP1 or NAP1-related; 27%]). These findings indicate that food products may play a role in
interspecies C. difficile transmission.
http://www.marlerblog.com/uploads/file/08-1071.pdf

Clostridium difficile in Ready-to-Eat Salads, Scotland
Of 40 ready-to-eat salads, 3 (7.5%) were positive for Clostridium difficile by PCR. Two isolates were PCR ribotype 017
(toxin A–, B+), and 1 was PCR ribotype 001. Isolates were susceptible to vancomycin and metronidazole but variably
resistant to other antimicrobial drugs. Ready-to-eat salads may be potential sources for virulent C. difficile.
http://www.marlerblog.com/uploads/file/08-1186.pdf

2008
C. diff sickens about a half million Americans every year, and every year the epidemic gets about 10% bigger, CDC
medical epidemiologist L. Clifford McDonald, MD, tells WebMD.

Bigger -- and more deadly. The death rate is soaring by 35% a year.

From 1999 to 2004, the bug became four times more lethal, with death rates increasing from 5.7 per million Americans
to 23.7 per million Americans in 2004. During one hospital outbreak in Quebec, Canada, the one-year death rate hit
17%.

There are actually three ongoing C. diff epidemics. One is in hospitals. Another is in the community. And a third is in
livestock.

Another reason for the epidemic is the rise of community-acquired C. diff infection. C. diff usually is thought of as a
hospital infection, and community cases were thought to come from people who got C. diff during a hospital stay but who
didn't develop symptoms until they got home.

A 2006 study in Connecticut showed that community-acquired C. diff disease struck seven people out of 100,000. One
in four cases did not have the risk factors normally associated with C. diff. Moreover, a third of these cases had no
exposure to antimicrobial drugs.

C. diff bacteria are very sensitive to oxygen. But C. diff spores are another matter. They are nearly indestructible and
can survive for months on dry surfaces. The CDC recommends disinfecting surfaces with bleach, because the usual
hospital disinfectants don't affect it.

People with C. diff infection have millions of C. diff spores in their feces. These spores carry the infection to others via
what experts indelicately call fecal-oral contact. Careful hand washing rinses the spores from contaminated hands, but
alcohol gels won't do the trick.

But community-acquired C. diff does not depend on antibiotics. The CDC's McDonald says there's evidence that 30% to
40% of community-acquired cases are in people not suffering a current or recent medical problem.

If the diarrhea stops after severe colitis, it does not necessarily mean you're getting better. It could be a sign of bowl
paralysis and a life-threatening condition called toxic megacolon. Most patients with toxic megacolon need surgery --
and 32% to 50% of patients who undergo surgery for C. diff disease die.

Patients with symptoms of C. diff infection should seek immediate medical attention. Mild C. diff disease can progress
quickly to severe disease.

12% to 24% of patients develop a second episode of C. diff disease within two months. Patients who have two or more
relapses have a 50% to 65% chance of yet another recurrence.


http://www.webmd.com/news/20080530/c-diff-epidemic-what-you-must-know

Clostridium difficile associated diarrhea (CDAD) is the most frequent cause of nosocomial
infectious diarrhea in industrialized countries 1-3, affecting more than 300,000 hospitalized
patients yearly in the United States.4-5 Clinical manifestations range from asymptomatic
colonization, to severe diarrhea, pseudomembranous colitis, toxic megacolon and death.6

One of the earliest reports of more severe disease in patients with CDAD, many resulting
in death, was in Pittsburgh, Pennsylvania in 2000.7 Since the last half of 2002, several hospitals
in Quebec have experienced a dramatic increase in the incidence, severity and number of
relapses associated with CDAD.8-12 Similar reports have been seen in other industrialized
countries. 13, 14

An analysis of US hospital discharge data revealed that CDAD rates increased
abruptly beginning in 2001, with a doubling of national rates from 2000 to 2003.15 This increase
was most prominent for patients 65 years of age and older.

Reports also suggested that the attributable mortality rate (or fatality rate) had increased in recent years. Based on the
data from Quebec, the attributable mortality rate for CDAD was estimated at 6.9%. 9

Shortly after the appearance of reports of more severe disease in patients with CDAD, a
previously unknown strain of C.difficile was identified. 9, 16
http://www.phac-aspc.gc.ca/nois-sinp/pdf/c-difficile_cnisp-pcsin-eng.pdf


Clostridium:  A genus of rod-shaped, spore-forming, chiefly anaerobic bacteria including the nitrogen-fixing bacteria
found in soil and those causing botulism and tetanus.
Clostridium bifermen´tans  a species common in feces, sewage, and soil and associated with gas gangrene.
Clostridium botuli´num  the causative agent of botulism, divided into six types (A through F) which elaborate
          immunologically distinct toxins.
Clostridium diffi´cile  a species often occurring transiently in the gut of infants, but whose toxin causes
          pseudomembranous enterocolitis in those receiving prolonged antibiotic therapy.
Clostridium histoly´ticum  a species found in feces and soil.
Clostridium kluy´veri  a species used in the study of both microbial synthesis and microbial oxidation of fatty acids.
Clostridium no´vyi  an important cause of gas gangrene.
Clostridium oedema´tiens  C. novyi.
Clostridium perfringens:  the most common etiologic agent of gas gangrene, distinguishable as several
different types;  type A causes human gas gangrene (necrotizing --  flesh eating), colitis, and food poisoning
and type C causes enteritis.
Clostridium ramo´sum  a species found in human and animal infections and feces and commonly isolated from clinical
          specimens.
Clostridium sporo´genes  a species widespread in nature, reportedly associated with pathogenic anaerobes in
          gangrenous infections.
Clostridium ter´tium  a species found in feces, sewage, and soil and present in some gangrenous infections.
Clostridium te´tani  a common inhabitant of soil and human and horse intestines, and the cause of tetanus in humans
          and domestic animals.
Clostridium wel´chii  British name for C. perfringens.
http://medical-dictionary.thefreedictionary.com/Clostridium

When the environment becomes stressed,  the bacteria produce spores that tolerate the extreme
conditions that the active bacteria cannot. In their active form, these bacteria secrete powerful exotoxins that are
responsible for such diseases as tetanus, botulism, and gas gangrene.  This non-motile bacterium is an invasive
pathogen that can be contracted from dirt via large cuts are wounds. C. perfringens cells proliferate after spore
germination occurs and they release their exotoxin. The toxin causes necrosis [death] of the surrounding tissue
(Clostridial myonecrosis destroys muscular tissus). The bacteria themselves produce gas which leads to a bubbly
deformation of the infected tissues. C. perfringens is capable of necrotizing intestinal tissues and can release an
enterotoxin that may lead to severe diarrhea.  Clostridium difficile is a motile bacterium that can be part of the natural
intestinal flora. Infection can occur through the use of broad-spectrum antibiotics which lower the relative amount of
other normal gut flora. When this situation occurs, C. difficile proliferates and infects the large intestine. The bacterium
then releases two enterotoxins that destroy the intestinal lining and cause diarrhea.

Baby Calf Health: Common Diarrheal Diseases

Clostridium perfringens -
Clostridial infections are manifested by acute deaths or severe diarrhea with abdominal pain.
Calves may be bloated causing them to bellow and kick at their abdomen. Sudden death of vigorous fast-growing calves
is typical. Calves surviving 4-5 hours after onset of colic may develop bloody stool. Under conditions where rich protein
and carbohydrate substrate are fed (such as abrupt changes in diet), Clostridium can proliferate and produce toxins.
Rapid feed changes disturbs the normal adaptive pattern of intestinal microbes. Overeating can lead to gut stasis,
preventing the normal flushing of toxins. Viral infections may predispose calves to clostridial diarrhea due to altered
intestinal flora and overgrowth of the organism. Clostridium perfringens Type A has been associated with abomasal
ulcers in calves.