Cause Of Gas Gangrene Research Articles

PERFORATED GANGRENE UTERUS: A Case Report

Perforated gangrene uterus is a rare condition with high mortality rate, which is difficult and unable to diagnose in first instance without specific history. A 48 year old woman P3L3 with normal vaginal deliveries, not tubectomised came with clinical features of perforation with peritonitis and underwent emergency exploratory laparotomy and found perforated gangrene uterus. Total Abdominal Hysterectomy with Salpingectomy done and specimen shows necrosis of the tissue. Awareness of many etiologies for peritonitis is of great importance when a fatal infection may be the cause of the condition. The most common cause of gas gangrene is clostridium perfringens.

Amentoflavone Attenuates Clostridium perfringens Gas Gangrene by Targeting Alpha-Toxin and Perfringolysin O

Clostridium perfringens (C. perfringens) type A strains are the main cause of gas gangrene in humans and animals. Treatment of this lethal disease is limited, and the prognosis is not good. Alpha-toxin (CPA) and perfringolysin O (PFO) secreted by C. perfringens play irreplaceable roles in cytotoxicity to host cells, persistence in host tissues, and lethality of gas gangrene pathology. This work determined the influence of amentoflavone, a biflavonoid isolated from Selaginella tamariscina and other plants, on hemolysis and cytotoxicity mediated by CPA and PFO and evaluated the in vivo therapeutic effect on gas gangrene. Our data showed that amentoflavone could block the hemolysis and cytotoxicity induced by CPA and PFO in vitro, thereby mediating significant protection against mortality of infected mice in a mouse gas gangrene model, efficient bacterial clearance in tissues and alleviation of histological damage in vivo. Based on the above results, amentoflavone may be a potential candidate against C. perfringens infection by reducing CPA and PFO-mediated virulence.

Malignant Edema in Horse by Clostridium perfringens Type A

Background: Malignant edema is one of the terms used to designate severe necrotizing syndromes in soft tissues by Clostridium spp. which are potentially fatal in farm animals. These species are responsible for myonecrosis, belonging to the group of histotoxic clostridia, and may also culminate in toxemia with the worsening of the lesions. These clostridia and their spores require a gateway such as wounds on mucous membranes or skin, which may occur due to shear, tail cut, injuries during delivery, castration or injections by contaminated needles. This report aims to describe the clinical-pathological findings of a case of malignant edema caused by C. perfringens type A in an equine.Case: A female equine, undefined breed, used as traction animal, had a history of abdominal pain. According to the requisitioning veterinary, the tutor reused needles for medication. On palpation, a compact mass was noticed in the pelvic flexure, as well as edema on the region of head and neck with crackling areas. After surgical intervention for compactation correction, the animal did not show anesthetic recovery and was submited to euthanasia. Tissue samples were collected, fixed in 10% buffered formalin solution, routinely processed for histopathology and stained with hematoxylin and eosin and Gram stain. Samples of serous-sanguineous edema fluid and fragments of the abdominal muscles and neck were collected. The samples were kept under refrigeration and sent for microbiological culture. Necropsy showed the subcutaneous region of the pectoral was markedly gelatinous and yellowish (edema) and subcutaneous emphysema characterized by accumulation of serous-sanguineous fluid and gas bubbles. In microscopy, we verified fibrous-haemorrhagic, emphysematous, suppurative and diffuse superficial histiocytic necrotizing cellulitis and myositis. Gram-positive bacillary aggregates were observed in spleen and subcutaneous sections. Colony suggestive of Clostridium perfringens were submitted to PCR for confirmation of identity followed by genotyping. Lastly, C. perfringens type A was isolated from the muscle fragments and serosanguinolent liquid collected.Discussion: In the present study, the diagnosis of malignant edema caused by Clostridium perfringens type A in an equine was confirmed by the clinical-pathological findings added to the isolation and genotyping of the agent from fragments of injured muscle. Although C. perfringens has been reported in cases of clostridial myositis in horses in the United States, in Brazil there are only reports of sporadic cases associated with C. septicum, C. novyi and C. chauvoei in this species. In histotoxic cases by C. perfringens, alpha toxin is known to be the main virulence factor involved, causing destruction of the phospholipid membrane of erythrocytes, endothelial cells, leukocytes and muscle fibers. As consequence, there is an increase in the vascular permeability of capillaries and, with the spread of the infection, there is production of inflammatory edema with serosanguineous exudate and gas. Typically, anatomopathological findings are characterized by increased volume of the affected region associated with edema with bloody fluid and rancid odor, gas bubbles in the subcutaneous tissue, and fasciae associated or not with necrotic myositis. It is assumed that a contaminated needle injection, performed during the treatment of colic symptoms on the property has been the gateway to infection. The clinical course of clostridial infection in horses is considered acute, ranging from 24 to 48 h. In this case, was observed the animal with signs of cervical and pectoral edema still in the property, a day before euthanasia. This is the first study to confirm Clostridium perfringens as a cause of gas gangrene in horses in Brazil.

Importance of Fibronectin for Clostridium perfringens Adhesion to Host Tissue

Clostridium perfringens, a Gram-positive, spore-forming, obligate anaerobe, is the cause of gas gangrene and food poisoning. Colonization of the host requires adhesion of bacterial cells to injured tissue. We review here recent results regarding the role of fibronectin in the interaction of C. perfringens cells with host collagens.

Deadly combination: Clostridium septicum and colorectal malignancy

Gas gangrene is a life-threatening, necrotising soft tissue infection. Colorectal malignancy-associated Clostridiumsepticum is a rare cause of gas gangrene. This case outlines an initial presentation of colonic malignancy as gas...

Multiple effects on Clostridium perfringens binding, uptake and trafficking to lysosomes by inhibitors of macrophage phagocytosis receptors.

Clostridium perfringens is a Gram-positive, anaerobic bacterium that is the most common cause of gas gangrene (clostridial myonecrosis) in humans. C. perfringens produces a variety of extracellular toxins that are thought to be the major virulence factors of the organism. However, C. perfringens has recently been shown to have the ability to survive in a murine macrophage-like cell line, J774-33, even under aerobic conditions. In J774-33 cells, C. perfringens can escape the phagosome and gain access to the cytoplasm. Since the receptor that is used for phagocytosis can determine the fate of an intracellular bacterium, we used a variety of inhibitors of specific receptors to identify those used by J774-33 cells to phagocytose C. perfringens. It was found that the scavenger receptor and mannose receptor(s) were involved in the phagocytosis of C. perfringens. In the presence of complement, the complement receptor (CR3) was also involved in the binding and/or uptake of C. perfringens. Since the receptor inhibition studies indicated that the scavenger receptor played a major role in phagocytosis, C. perfringens binding studies were performed with a Chinese hamster ovary (CHO) cell line expressing the mouse SR-A receptor. The cell line expressing the SR-A receptor showed a significant increase in C. perfringens binding in comparison to the non-transfected CHO cells. In the absence of opsonizing antibodies, the Fc receptor was not used to phagocytose C. perfringens. Forcing the macrophages to use a specific receptor by using combinations of different receptor inhibitors led to only a slight increase in co-localization of intracellular C. perfringens with the late endosome-lysosome marker LAMP-1. Carbohydrate analysis of C. perfringens strain 13 extracellular polysaccharide confirmed the presence of mannose and negatively charged residues of glucuronic acid, which may provide the moieties that promote binding to the mannose and scavenger receptors, respectively.

The anaerobic pathogen Clostridium perfringens can escape the phagosome of macrophages under aerobic conditions

Clostridium perfringens is the most common cause of gas gangrene (clostridial myonecrosis), a disease that begins when ischaemic tissues become contaminated with C. perfringens vegetative cells or spores. An aerotolerant anaerobe, C. perfringens quickly multiplies in ischaemic tissues and spreads to healthy areas, leading to a high level of morbidity and mortality. As a species, the bacterium can synthesize 13 different toxins, and these are thought to be the major virulence factors of the disease. However, we present evidence here that C. perfringens can also persist inside macrophages, under aerobic conditions, by escaping the phagosome into the cytoplasm. C. perfringens was not killed by the cells of a clone (J774-33) of the macrophage-like murine cell line J774A.1 under aerobic or anaerobic conditions, whereas the non-pathogenic bacterium Bacillus subtilis was killed by J774-33 cells under both conditions. Electron microscopy images showed that C. perfringens cells were intact and resided mostly in the cytoplasm of J774-33 cells, whereas B. subtilis was in the phagosome. Immunofluorescence microscopy showed that intracellular C. perfringens bacteria failed to co-localize with the late endosome-lysosomal marker glycoprotein LAMP-1, whereas B. subtilis did co-localize with LAMP-1. C. perfringens also appeared to escape the phagosome of both activated and unactivated mouse peritoneal macrophages, but not as efficiently as was seen with the J774-33 cell line. In addition, cytochalasin D was used to show that phagocytosis of C. perfringens was dependent on actin polymerization and that the bacteria attach to J774-33 cells at distinct areas of the cell membrane. We propose that the ability to escape the phagosome and persist inside macrophages is an important factor in the early stages of a gangrene infection, when bacterial numbers are low and phagocytic cells are present.

Surgical Aspects of Clostridium septicum Septicemia

Clostridium septicum is a virulent cause of gas gangrene and sepsis. Although thought to be rare, a survey of our affiliated hospitals for a recent five-year period disclosed eight cases. Seven of the eight had an occult malignant neoplasm. The eighth patient was thought to be preleukemic. All seven malignant neoplasms involved the gastrointestinal tract. Four patients were admitted with gangrene of an extremity, three with abdominal pain, and one with both. In four patients, C septicum septicemia appeared in an extremity before the underlying gastrointestinal malignant neoplasm was recognized. Four patients had surgical therapy and two survived; four received medical therapy and one survived. Patients who have C septicum septicemia should be assumed to harbor an underlying malignant neoplasm until proved otherwise.

Zur Phagenkonversion von Clostridium novyi Typ A

Clostridium novyi type A, the cause of gas gangrene in man and animal, produces four main toxic components (alpha, gamma, delta, and epsilon). The alpha toxin is a necrotizing toxin produced in lethal amounts by strains of type A. This lethal toxin induces a characteristic subcutaneous colorless gelatineous edema when guinea pigs are infected with C. novyi type A. In this paper we report further evidence on the relationship of bacteriophages to the production of alpha toxin by C. novyi type A. The results showed that five phage-sensitive bacterial strains that did not produce alpha toxin could be isolated from alpha toxin producing stains. These nontoxigenic strains could be infected with specific bacteriophages isolated from the different toxigenic strains of C. novyi type A and converted to alpha toxin production. The toxigenicity of these converted strains depended upon the continued participation of specific bacteriophages. These bacteriophages were shown to be very unstable in culture supernatant fluids.

Bacillus welchii in bread

The Welch bacillus, originally described by Welch and Nuttall1 under the name B. aerogenes capsulatus, is probably the best known of the sporeforming anaerobes. is widely distributed in nature, occurring usually in large numbers in the human intestine and in sewage. is frequently encountered in water supplies, soil, dust, milk and other foodstuffs and, in addition, has been reported from a great variety of miscellaneous sources.2 During the recent wan attention was centered on it as the chief cause of gas gangrene, and as a result the organism has been made the subject of numerous extensive studies, both in this country and abroad, concerning its biology, its biochemical, serologic and toxic properties and especially its relation to wound infection, gas gangrene and the pathology of these infections. should be understood that B. welchii is now usually regarded as representative of a group of similar organisms having in common certain salient characteristics. The recent statement by Kendall, Day and Walker,8 It seems probable that the Welch is the type member of either a group of closely related organisms, or of a series of identifiable variants of the same bacillus expresses our present opinion.

Bacillus Welchii in Bread

The Welch bacillus, originally described by Welch and Nuttall1 under the name B. aerogenes capsulatus, is probably the best known of the sporeforming anaerobes. is widely distributed in nature, occurring usually in large numbers in the human intestine and in sewage. is frequently encountered in water supplies, soil, dust, milk and other foodstuffs and, in addition, has been reported from a great variety of miscellaneous sources.2 During the recent wan attention was centered on it as the chief cause of gas gangrene, and as a result the organism has been made the subject of numerous extensive studies, both in this country and abroad, concerning its biology, its biochemical, serologic and toxic properties and especially its relation to wound infection, gas gangrene and the pathology of these infections. should be understood that B. welchii is now usually regarded as representative of a group of similar organisms having in common certain salient characteristics. The recent statement by Kendall, Day and Walker,8 It seems probable that the Welch is the type member of either a group of closely related organisms, or of a series of identifiable variants of the same bacillus expresses our present opinion.