Evidence for antibiotic induced Clostridium perfringens diarrhoea

Modi, Nitu; Wilcox, M. H.

doi:10.1136/jcp.54.10.748

Cited by 50 publications

(32 citation statements)

References 26 publications

(28 reference statements)

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“…Together, these results led us to hypothesize that biofilm formation by C. perfringens in the small intestine can contribute to AAD by aiding in bacterial persistence through antibiotic treatment. However, as the C. perfringens enterotoxin is the causative effect of the symptoms of AAD (33) and C. perfringens enterotoxin is expressed only by sporulating cells (21), for biofilms to play a role in AAD, the cells must either be sporulating in the biofilm, as has been observed in B. subtilis (20,25) and Bacillus cereus (54), or at the cessation of antibiotic treatment, they must escape the biofilm and begin sporulating.…”

Section: Vol 76 2008 Biofilm Formation By C Perfringens 4949mentioning

confidence: 99%

Type IV Pili and the CcpA Protein Are Needed for Maximal Biofilm Formation by the Gram-Positive Anaerobic Pathogen Clostridium perfringens

2008

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The predominant organizational state of bacteria in nature is biofilms. Biofilms have been shown to increase bacterial resistance to a variety of stresses. We demonstrate for the first time that the anaerobic gram-positive pathogen Clostridium perfringens forms biofilms. At the same concentration of glucose in the medium, optimal biofilm formation depended on a functional CcpA protein. While the ratio of biofilm to planktonic growth was higher in the wild type than in a ccpA mutant strain in middle to late stages of biofilm development, the bacteria shifted from a predominantly biofilm state to planktonic growth as the concentration of glucose in the medium increased in a CcpA-independent manner. As is the case in some gram-negative bacteria, type IV pilus (TFP)-dependent gliding motility was necessary for efficient biofilm formation, as demonstrated by laser confocal and electron microscopy. However, TFP were not associated with the bacteria in the biofilm but with the extracellular matrix. Biofilms afforded C. perfringens protection from environmental stress, including exposure to atmospheric oxygen for 6 h and 24 h and to 10 mM H 2 O 2 for 5 min. Biofilm cells also showed 5-to 15-fold-increased survival over planktonic cells after exposure to 20 g/ml (27 times the MIC) of penicillin G for 6 h and 24 h, respectively. These results indicate C. perfringens biofilms play an important role in the persistence of the bacteria in response to environmental stress and that they may be a factor in diseases, such as antibiotic-associated diarrhea and gas gangrene, that are caused by C. perfringens.

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Section: Vol 76 2008 Biofilm Formation By C Perfringens 4949mentioning

confidence: 99%

Type IV Pili and the CcpA Protein Are Needed for Maximal Biofilm Formation by the Gram-Positive Anaerobic Pathogen Clostridium perfringens

2008

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“…lostridium perfringens is a Gram-positive spore-forming anaerobic bacterium that causes gas gangrene, food-borne and non-food-borne poisoning, and antibiotic-associated diarrhea (1)(2)(3). Although this organism is an obligate anaerobe, C. perfringens is widely distributed throughout many environments, such as soil, sewage, and the intestine of humans and animals, since this organism produces endospores.…”

mentioning

confidence: 99%

“…Moreover, due to the resistance of these cells to antibiotics, microbial biofilm formation is involved in the pathogenesis of diseases such as nosocomial and chronic infections by this bacterium (6). C. perfringens causes antibiotic-associated diarrhea (AAD) (2) and survives the intestinal environment through biofilm formation and/or sporulation even when antibiotics are administered to the patient.…”

mentioning

confidence: 99%

A Sporulation Factor Is Involved in the Morphological Change of Clostridium perfringens Biofilms in Response to Temperature

2014

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Biofilm formation has been associated with bacterial pathogenesis, such as nosocomial and chronic infections, as the resistance of biofilms to environmental stresses has increased. Clostridium perfringens is a Gram-positive spore-forming anaerobic pathogen. This organism survives antibiotic treatment through the formation of biofilms or spores, but the environmental and regulatory factors involved in the biofilm formation remain unclear. Here, we observed that temperature regulates C. perfringens biofilm morphology. At 37°C, C. perfringens adhered to the substrate surface and formed a flat, thin biofilm, herein referred to as adhered biofilm. However, at 25°C, this bacterium did not adhere and produced a threadlike extracellular matrix, forming a viscous, thick biofilm, herein referred to as pellicle biofilm. Pellicle biofilm formation requires the sporulation master regulator, Spo0A, and the toxin regulator, CtrAB, and is enhanced in the absence of the global repressor, AbrB. These transcriptional regulator genes are regulated by each other and temperature. Adhered-biofilm formation requires AbrB and pilA2, which encodes a component of type IV pili (TFP). TFP expression was activated at 37°C and regulated through Spo0A, AbrB, and CtrAB. These results indicate that the morphology of C. perfringens biofilm is dependent on temperature through the differential production of extracellular matrix and the activity of TFP. Moreover, pellicle biofilm formation is involved in sporulation and toxin production. Here, we demonstrated that clostridial biofilm formation is closely associated with sporulation and that the morphological change of the biofilms could play an important role in the pathogenesis of this organism.

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“…Микроорганизмы, вызывающие ААД, -Clostridium difficile (CD-ААД), Clostridium perfringens [14,15], Staphylococcus aureus [16], Klebsiella oxytoca [17], Salmo nela spp., Salmonella Typhimurium [18], Pseudomonas aeruginosa [19], Candida spp. [20].…”

Section: гастроэнтерологияunclassified

The Clinical Potential of Linex Forte® in Systemic Antibiotic Therapy

2017

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С огласно критериям ВОЗ, антибиотик-ассоцииро-ванная диарея (AAД) -это 3 и более эпизода неоформленного или водянистого стула в тече-ние 2 или более дней подряд, связанных с приемом анти-бактериальных препаратов. ААД развивается у 5-35% пациентов на фоне лечения антибиотиками или в тече-ние 8 нед. после их отмены [1,2]. В отдельных клиниках частота ААД повышается до 62% [3]. В детской популяции уровень ААД колеблется от 11 до 40% [4]. При развитии ААД увеличивается длительность госпитализации паци-ентов, повышается риск развития осложнений и других нозокомиальных инфекций [5,6], при этом стоимость лечения может возрастать в 4 раза [7].Применение использования двух и более антибиоти-ков широкого спектра действия отмечалось в 58% случаев лечения антибиотиками до 2004 г., согласно исследованию ВОЗ. Этот показатель превзошел рекомендуемый уровень (30%) в значительной степени. Кроме того, почти каждый хирургический пациент получает антибиотики, а этот коэф-фициент совместного использования достигает 97% [8].Наиболее часто ААД регистрируется у пациентов, длительно находящихся в стационаре, особенно в пала-тах интенсивной терапии, у лиц пожилого возраста, при использовании антибиотиков широкого спектра дей-ствия [9].Также частота ААД возрастает при иммунодефицитных состояниях, зондовом кормлении, хирургических вмеша-тельствах, приеме антисекреторных препаратов. Практи-чески любой антибактериальный препарат может вызвать ААД, но чаще она развивается при приеме клиндамицина (20-30%), амоксициллина/клавуланата (10-25%), цефало-споринов 2-3-го поколения (9-25,8%), эритромицина (11-16%), кларитромицина и ампициллина (5-10%) [11].Диарея, которая возникает после применения антибио-тиков, может иметь несколько механизмов развития [11]: ■ аллергические, токсические и другие фармакологиче-ские побочные эффекты антибиотиков, ■ осмотическая диарея в результате нарушения метабо-лизма желчных кислот и углеводов в кишечнике, ■ избыточный микробный рост в результате подавления облигатной интестинальной микробиоты [12].Факторы риска возникновения ААД [13]: ■ группа антибиотика, путь его выведения (чаще препа-раты, выводящиеся желчью, -цефтриаксон), длительность лечения, повторные курсы, комбинированная терапия, ■ возраст больных (у пациентов в возрасте до 5 лет и старше 60 лет частота обнаружения Clostridium diffi cile увеличивается), ■ длительная госпитализация больного (прямо пропор-циональна частоте колонизации Clostridium diffi cile), пре-бывание в одной палате с больным, имеющим манифест-ную форму инфекции, ■ наличие тяжелых сопутствующих заболеваний (пато-логия ЖКТ, иммунодефицитные состояния, почечная не-достаточность, онкология), ■ проводимые медицинские манипуляции (инвазивные процедуры), ■ энтеральное питание,

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Evidence for antibiotic induced Clostridium perfringens diarrhoea

Cited by 50 publications

References 26 publications

Type IV Pili and the CcpA Protein Are Needed for Maximal Biofilm Formation by the Gram-Positive Anaerobic Pathogen Clostridium perfringens

Type IV Pili and the CcpA Protein Are Needed for Maximal Biofilm Formation by the Gram-Positive Anaerobic Pathogen Clostridium perfringens

A Sporulation Factor Is Involved in the Morphological Change of Clostridium perfringens Biofilms in Response to Temperature

The Clinical Potential of Linex Forte® in Systemic Antibiotic Therapy

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