Enteric Clostridia. C. perfringens: general

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1 Enteric Clostridia C. perfringens: general Formerly called C. welchii Thick rods, forming spores Non motile Grow fast Habitats: Soil and sewage and in the intestines of animals and humans Toxins More than 15 have been reported 4 toxins (α, β, ε, ι) are major their functions are described in Table 33-4 Five types (A to E) C. perfringens based on production of 4 toxins (α, β, ε, ι) 1

2 C. perfringens: Types & toxins Type A Major toxins α β ε ι X B X X X C X X D X X Diseases Myonecrosis and gas gangrene (humans and domestic animals) * Lamb enterotoxemia (yellow lamb disease) Necrotic enteritis (chickens) Necrotizing enterocolitis (pigs) Hemorrhagic diarrhea (dogs) Lamb dysentery Hemorrhagic diarrhea (calves and foals) Hemorrhagic nectrotic enteritis and enterotoxemia (Neonatal pigs, calves, lambs, and goats) Enterotoxemia called struck (adult sheep) Necrotic enteritis (chickens) Enterotoxemia known as overeating disease or pulpy kidney disease (sheep) Enterotoxemia (sucking claves) E X X Enterotoxemia (lambs, calves, and rabbits) *Type A is histotoxic & enteric C. perfringens: Types & toxins 2

3 C. perfringens type A : Histotoxic & Enteric Toxin: α-toxin (produces large amounts of α-toxin, compared to other types) Histotoxic: Myonecrosis and gas gangrene in humans and animals (a frequent cause of human myonecrosis) Enteric Lambs: Enterotoxemia (Yellow lamb disease) - High mortality in lambs during the first week of life Type A - Ingestion of contaminated colostrum Icterus - Affected animals exhibit anemia, icterus, of the gums and hemoglobinuria - Dying rapidly Neonatal piglets: Necrotizing enterocolitis Neonatal foals: Hemorrhagic diarrhea Icterus Domestic poultry: Necrotic enteritis of the eyes Dogs: Hemorrhagic gastroenteritis (watery to bloody diarrhea) C. perfringens type A: Gas gangrene (histotoxic) 3

4 C. perfringens types B&C Type B (α, β, ε toxins) Lamb dysentery - Bacterial multiplication enterotoxemia - Severe abdominal pain, bloody diarrhea, sudden death - Very rare in Canada Calves, foals and goats: hemorrhagic enteritis Type C (α, β toxins) Newborn animals are typically susceptible due to the absence of normal intestinal flora - Neonatal pigs, calves, lambs, foals and goats: hemorrhagic necrotic enteritis and enterotoxemia Older animals: alteration of flora (e.g. by sudden dietary change) Adult sheep: enterotoxemia (called struck ), sudden death Chickens: Necrotic enteritis C. perfringens type C 4

5 C. perfringens types D&E Type D (α, ε toxins) Sheep: enterotoxemia known as overeating disease or pulpy kidney disease Excess dietary starch (by overeating) Rapid multiplication of type D Increases production of the ε toxin results in toxemia Suddenly die without obvious symptoms Suckling calves: enterotoxemia Rare in adult cattle, deer, and horses Type E (α, ι toxins) Lambs, calves, and rabbits: enterotoxemia Toxin: ι-toxin is the major C. perfringens from jejunum In pulpy kidney C. perfringens type D Patchy congestion Enterotoxemia of pulpy kidney disease caused by C. perfringens type D 5

6 C. perfringens: Treatment Vaccination Toxoids are routinely used Type C or D toxoids: newborns of several species Type D: used routinely in lambs Toxoids of C. perfringens (type D) C. septicum C. tetani C. novyi (type B) C. chauvoei Pulpy kidney Malignant edema Tetanus Black disease Blackleg Intervet Treatment: Dogs:Tylosin or Metronidazole Rapid course little benefit to treatment C. perfringens: Humans Gas gangrene (histotoxic) C. perfringens type A is the major cause of gas gangrene in humans Food poisoning C. perfringens type A causes a mild form of food poisoning Multiplication of bacteria to high numbers in foods The toxin can be ingested to cause the onset of clinical symptoms Necrotizing enteritis C. perfringens type C is responsible for this disease The disease is similar to necrotizing enteritis seen in animals Occurs in adults as well as children More severe than food poisoning High mortality in less developed countries 6

7 C. difficile: General General A large rod Spore-forming More oxygen sensitive than C. perfringens Habitats: soil, marine sediment, feces of humans and animals The organism can multiply to large numbers and causes diarrhea primarily in: 1. Unfilled bowel (neonates, infants, gnotobiotic animals) e.g. Neonatal swine 2. Emptied bowel (by antibiotic-therapy) e.g. Antibiotic-treated humans and animals Toxins Toxin A (enterotoxin) causes fluid accumulation in the gut Toxin B (cytotoxin) induces inflammation and necrosis C. difficile: Age & Diarrheal Disease in Pigs Bacterial Diseases Nursing Weaning Growing- Finishing or Breeding C. difficile C. perfringens type C enteritis E. coli Intestinal spirochetosis (Brachyspira pilosicoli) Porcine proliferative enteritis (Lawsonia intracellularis) Salmonella enteritis Swine dysentery (Brachyspira hyodysenteriae)

8 C. difficile: Lesion Distribution Keel M K, Songer J G Vet Pathol 2006;43: C. difficile: Pigs Associated with the diarrhea in neonatal pigs (1 to 7 days of age) Mesocolon Disease: a common cause of mesocolonic edema resulting in diarrhea Clinical signs: difficult breathing, abdominal distention, diarrhea may not be present in all infected pigs Diagnosis Demonstration of either toxin A or B (ELISA, PCR) Culture Histopathology Treatment Based on MIC, erythromycin, tetracycline, tylosin may be useful for treatment of suckling piglets 8

9 C. difficile: Pigs Release of neutrophils into the lumen: volcano lesion in colon; neonatal pig with C. difficile-associated disease. Keel M K, Songer J G Vet Pathol 2006;43: C. difficile: Horses Habitats Infrequently found in feces of normal horses but more often found in young foals Soil Disease Associated with changes in diet and antimicrobial therapy such as erythromycin and β-lactams Neonatal foals: hemorrhagic necrotizing enterocolitis Adult horses: diarrhea Diagnosis History of antibiotic treatment Detection of toxins A and/or B (PCR or ELISA) Vaccination: No vaccine is available Treatment: metronidazole 9

10 C. difficile: Humans and other animals Humans A cause of diarrhea in association with antibiotic treatment - responsible for about 25% of all antibiotic-associated diarrhea Other animals There is some evidence that it may be a problem in hamsters, rabbits and Guinea pigs Colon distended by fluid Congested and distended cecum Adult hamster with C. difficileassociated disease C. colinum Ulcerative enteritis of quail & chickens Often occurring in quail Also seen in a variety of wild and domestic avian species Birds younger than 3 months are commonly infected Disease Oral transmission Cause duodenal hemorrhagic enteritis, cecal necrosis and ulceration Mortality: 10-30% in chickens and 100% in young quail 10

11 C. spiroforme Loosely coiled, spiral morphology Cause enterotoxemia of rabbits and other laboratory rodents - not found normally in the rabbit intestine but acquired from the environment Weaning and antibiotic treatment destabilize cecal flora rapid diarrhea development death The cecum is immensely dilated with watery contents Produce a toxin C. piliforme Gram-negative: the only gram-negative Clostridium Obligate intracellular Enterohepatic disease (Tyzzer's disease) A wide range of animals (such as rabbits, mice, rats, foals, guinea pigs, etc) often in young and stressed animals Necrotic and hemorrhagic enteritis Hepatitis, multifocal hepatic necrosis Severe diarrhea High mortality Diagnosis Obligate intracellular parasite Hard to classify it because of the problems of growing it Histopathology Antibiotics: Penicillin, ampicillin, tetracycline neomycin, erythromycin. 11

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