Abstract
This chapter focuses on molecular and immunological methods for the diagnosis of clostridial diseases. The majority of work has concentrated on three species, Clostridium difficile, Clostridium botulinum, and Clostridium perfringens. Application of molecular methods that are both more sensitive and more specific than those currently used improve the rapidity and accuracy of diagnosis, and results may challenge dogma regarding the etiology, natural history, epidemiology, and pathogenesis of clostridial diseases. Polymerase chain reaction (PCR), nucleic acid probe-based methods, and immunological assays have been applied to detection of C. botulinum toxin genes and toxins. Immunoassays have also been applied to detection of botulinum toxin. Many of these assays are in a standard enzyme-linked immunoassay (ELISA) format, although some have adopted unique detection systems. The key components in diagnostic systems for diseases caused by C. perfringens are evaluation of clinical signs and gross and microscopic lesions, bacteriologic culture of appropriate specimens, and detection of toxins in pathologic specimens, and in supernatant fluids of pure cultures.
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