Clostridia are bacteria that commonly reside in the intestine of healthy adults and newborns.
Clostridia also reside in animals, soil, and decaying vegetation. These bacteria do not require oxygen to live. That is, they are anaerobes.
There are many different species of clostridia.
The most common clostridial infection is gastroenteritis (Clostridium perfringens
food poisoning), a usually mild infection that typically resolves on
its own. Serious clostridial infections are relatively rare but can be
fatal.
Clostridia cause disease in different ways, depending on the species:
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The bacteria may produce a toxin in food, which is then consumed, as occurs in food-borne botulism.
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The bacteria may be consumed in food, then multiply and produce a toxin in the intestine, as occurs in Clostridium perfringens food poisoning.
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Clostridia spores—inactive (dormant) forms of the bacteria—may enter the body through a wound and produce a toxin, as occurs in tetanus. Spores enable bacteria to survive when environmental conditions are difficult. When conditions are favorable, each spore germinates into an active bacterium.
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Use of antibiotics may enable clostridia, which may already be present in the intestine, to overgrow and produce two toxins, as occurs in antibiotic-associated Clostridium difficile—induced colitis.
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Clostridial bacteria may enter through a wound, multiply, and produce a toxin that destroys tissue, as occurs in gas gangrene.
Clostridia can infect the gallbladder, colon, and female reproductive organs. If clostridia infect the colon of people with a low white blood cell count (such those who have leukemia or who are being treated with cancer chemotherapy), it can cause a life-threatening disease called neutropenic enterocolitis.
Rarely, one species, Clostridium sordellii, causes toxic shock syndrome
in women who have an infection of the reproductive organs. Such
infections may occur after a miscarriage, an abortion, or childbirth.
Clostridium perfringens food poisoning
Clostridium perfringens food poisoning (a type of gastroenteritis)
can develop when people eat food (usually beef) that contains
clostridia. Clostridia develop from spores, which can survive the heat
of cooking. If food that contains spores is not eaten soon after it is
cooked, the spores develop into clostridia, which then multiply in the
food. If the food is served without adequate reheating, the clostridia
are consumed. They multiply in the small intestine and produce a toxin
that causes watery diarrhea and abdominal cramping.
Clostridium perfringens food poisoning is usually mild and
resolves within 24 hours. But rarely, it is severe, particularly in the
very young and in older people.
To prevent food poisoning, people should promptly refrigerate leftover cooked meat and reheat it thoroughly before serving.
Treatment of Clostridium perfringens food poisoning includes drinking lots of fluids and resting. Antibiotics are not used.
Clostridial abdominal and pelvic infections
Clostridia bacteria, usually Clostridium perfringens, are often involved in abdominal infections, usually with other bacteria (called mixed anaerobic infections).
Clostridial infections can develop when the intestine is torn.
Clostridia can also infect the gallbladder and organs in the pelvis,
such as the uterus, fallopian tubes, and ovaries. Clostridia usually
infect the uterus after delivery of a baby or after an abortion done in
conditions that are not sterile.
Clostridial infections of the abdomen and pelvis are serious and
sometimes fatal. Clostridia produce large amounts of gas, which can form
bubbles and blisters in the infected tissue. Often, the infection
blocks small blood vessels, and the infected tissue dies, leading to gas gangrene.
Symptoms include pain and fever. The abdomen is tender to the
touch. If the uterus is infected, women may have a foul-smelling, bloody
discharge from the vagina.
To diagnose clostridial abdominal and pelvic infections, doctors
take samples of blood or infected tissue. These samples are examined and
sent to a laboratory where bacteria, if present, can be grown
(cultured) and identified. Doctors may take x-rays to check for gas
produced by clostridia.
Treatment of clostridial abdominal and pelvic infections involves
surgery to remove the infected and dead tissue (called debridement).
Antibiotics, such as penicillin, are given for at least 1 week.
Sometimes, if an organ (such as the uterus) is badly infected, it is
removed. Such treatment can be lifesaving.
Clostridia in the bloodstream
Clostridia may also spread to the blood (causing bacteremia). Widespread bacteremia (sepsis)
can cause fever and serious symptoms such as low blood pressure,
jaundice, and anemia. Sepsis can develop after a clostridial infection
and be rapidly fatal.
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