Clostridium argentinense sp. nov.: A Genetically Homogeneous Group Composed of All Strains of Clostridium botulinum Toxin Type G and Some Nontoxigenic Strains Previously Identified as Clostridium subterminale or Clostridium hastiforme

Suen, Jane; Hatheway, Charles L.; Steigerwalt, Arnold G.; Brenner, Don J.

doi:10.1099/00207713-38-4-375

Cited by 107 publications

(77 citation statements)

References 17 publications

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“…Group IV has not generally been associated with illness. Based on its phenotypic and genetic traits, group IV C. botulinum has been proposed to be renamed Clostridium argentinense (203). Of the human pathogenic strains, group I cultures produce toxin A, B, or F and group II cultures produce toxin B, E, or F. Dual-toxin-producing strains have also been reported (72,80,121), as have those producing only one type of toxin but carrying a silent gene for another (73,74,121).…”

Section: Introductionmentioning

confidence: 99%

Laboratory Diagnostics of Botulism

2006

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SUMMARY Botulism is a potentially lethal paralytic disease caused by botulinum neurotoxin. Human pathogenic neurotoxins of types A, B, E, and F are produced by a diverse group of anaerobic spore-forming bacteria, including Clostridium botulinum groups I and II, Clostridium butyricum, and Clostridium baratii. The routine laboratory diagnostics of botulism is based on the detection of botulinum neurotoxin in the patient. Detection of toxin-producing clostridia in the patient and/or the vehicle confirms the diagnosis. The neurotoxin detection is based on the mouse lethality assay. Sensitive and rapid in vitro assays have been developed, but they have not yet been appropriately validated on clinical and food matrices. Culture methods for C. botulinum are poorly developed, and efficient isolation and identification tools are lacking. Molecular techniques targeted to the neurotoxin genes are ideal for the detection and identification of C. botulinum, but they do not detect biologically active neurotoxin and should not be used alone. Apart from rapid diagnosis, the laboratory diagnostics of botulism should aim at increasing our understanding of the epidemiology and prevention of the disease. Therefore, the toxin-producing organisms should be routinely isolated from the patient and the vehicle. The physiological group and genetic traits of the isolates should be determined.

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Section: Introductionmentioning

confidence: 99%

Laboratory Diagnostics of Botulism

2006

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“…Moreover, other species are known to harbor BoNT genes, such as Clostridium butyricum (BoNT/E) (2,30), Clostridium baratii (BoNT/F) (16), and Clostridium argentinense (BoNT/G) (43). Previous 16S rRNA gene analysis of many different Clostridium species has shown that C. botulinum strains form four distinct clusters, with each cluster representing one of the four different physiological groups (groups I to IV) (8,22).…”

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Genetic Diversity among Botulinum Neurotoxin-Producing Clostridial Strains

et al. 2007

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Clostridium botulinum is a taxonomic designation for many diverse anaerobic spore-forming rod-shaped bacteria that have the common property of producing botulinum neurotoxins (BoNTs). The BoNTs are exoneurotoxins that can cause severe paralysis and death in humans and other animal species. A collection of 174 C. botulinum strains was examined by amplified fragment length polymorphism (AFLP) analysis and by sequencing of the 16S rRNA gene and BoNT genes to examine the genetic diversity within this species. This collection contained representatives of each of the seven different serotypes of botulinum neurotoxins (BoNT/A to BoNT/G). Analysis of the16S rRNA gene sequences confirmed previous identifications of at least four distinct genomic backgrounds (groups I to IV), each of which has independently acquired one or more BoNT genes through horizontal gene transfer. AFLP analysis provided higher resolution and could be used to further subdivide the four groups into subgroups. Sequencing of the BoNT genes from multiple strains of serotypes A, B, and E confirmed significant sequence variation within each serotype. Four distinct lineages within each of the BoNT A and B serotypes and five distinct lineages of serotype E strains were identified. The nucleotide sequences of the seven toxin genes of the serotypes were compared and showed various degrees of interrelatedness and recombination, as was previously noted for the nontoxic nonhemagglutinin gene, which is linked to the BoNT gene. These analyses contribute to the understanding of the evolution and phylogeny within this species and assist in the development of improved diagnostics and therapeutics for the treatment of botulism.Clostridium botulinum is a taxonomic collection of several distinct species of anaerobic gram-positive spore-forming bacteria that produce the most poisonous substance known, botulinum neurotoxin (BoNT) (1,8). These organisms, along with related neurotoxin-producing species that, for a variety of reasons, were not included under the C. botulinum taxon, pose global health problems that affect both infant and adult humans and can also affect wildlife, waterfowl, and domestic animals. They cause intoxication through ingestion of the neurotoxin in contaminated foods. Toxicoinfections can also occur after contact with bacteria or bacterial spores (6, 17). These pathogens are ubiquitous and can be found in soils and sedi-

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“…C. argentinense is genetically distinct from other clostridial species but phenotypically diverse, subsuming both the toxinogenic C. botulinum type G and the nontoxinogenic strains previously identified as C. subterminale and C. hastiforme (13). The significant homology of the 16S rRNA gene sequences of C. botulinum type G and C. subterminale prevents us from definitively identifying this isolate and implicating it as the causative agent of clinical botulism, but several aspects make C. argentinense an unusual suspect in this case of wound botulism.…”

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confidence: 96%

Wound Botulism Complicating Internal Fixation of a Complex Radial Fracture

Taylor

Wolfe

Dixon³

et al. 2010

J Clin Microbiol

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Botulism developed in a patient following surgical repair of an open radial fracture. Symptoms resolved after treatment with antitoxin and antibiotics, and hardware excision was deferred. Subsequent osteomyelitis necessitated hardware exchange, and wound cultures grew Clostridium argentinense. This case highlights the management of botulism associated with orthopedic hardware. CASE REPORTA 34-year-old man without significant past medical history presented with double vision. Three weeks prior to admission he suffered a compound fracture of his right radius and ulna during a soccer game. He was admitted to the orthopedic service for open reduction and internal fixation with a midulnar and radial plate (see Fig. 1). During the procedure, grass and dirt were noted in the surgical bed. He was treated perioperatively with cefazolin and gentamicin, was discharged, and completed 10 days of cephalexin treatment. Eighteen days following surgical repair he noted both double vision and difficulty opening both eyes. He presented three days later after worsening of symptoms and the development of slurred speech and difficulty swallowing.On admission, he denied fevers or chills, wound breakdown, paresthesias, or any other symptoms and asserted adherence to his postoperative antibiotics. The patient had no significant past medical history, took no other medications, and denied recreational drug use. His speech was dysphonic, and he had bilateral ptosis with notable diplopia. There was severe upper and lower bifacial weakness, and only trace extraocular movement was seen. His pupils were large and minimally reactive to light or accommodation. There was notable tongue and pharyngeal weakness. His right arm showed a healing surgical wound on the volar surface of his forearm. The results of the rest of his examination were unremarkable, as were his laboratory results.A nerve conduction study and electromyogram procedure were conducted, and the interpretation documented "low baseline amplitudes, especially in proximal musculature, with significant facilitation"; the interpreting neurologist noted that in the appropriate clinical context, the features were consistent with wound botulism. The patient was promptly administered a dose of botulinum antitoxin obtained from the CDC (7,500 units of antitoxin A and 5,500 units of antitoxin type B in 100 ml of normal saline solution over 1 h). Infectious disease consultants recommended commencing high-dosage intravenous penicillin G treatment and planning for surgical debridement and removal of the implanted hardware. After receiving botulinum antitoxin, his clinical symptoms improved overnight, and surgical excision was deferred. A blood sample obtained prior to the administration of botulinum antitoxin was negative for Clostridium botulinum toxin when tested by the CDC after trypsinization by use of a mouse bioassay. His symptoms improved, and he was discharged to complete 6 weeks of oral metronidazole and clindamycin treatment.Radiographs obtained 6 weeks after discharge were indicative o...

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Clostridium argentinense sp. nov.: A Genetically Homogeneous Group Composed of All Strains of Clostridium botulinum Toxin Type G and Some Nontoxigenic Strains Previously Identified as Clostridium subterminale or Clostridium hastiforme

Cited by 107 publications

References 17 publications

Laboratory Diagnostics of Botulism

Laboratory Diagnostics of Botulism

Genetic Diversity among Botulinum Neurotoxin-Producing Clostridial Strains

Wound Botulism Complicating Internal Fixation of a Complex Radial Fracture

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