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<big><center>[[Infectious agents and parasites|'''BACK TO INFECTIOUS AGENTS AND PARASITES''']]</center></big>
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#REDIRECT[[:Category:Clostridium species]]
<big><center>[[Bacteria|'''BACK TO BACTERIA''']]</center></big>
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===Overview===
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*Organisms present in the soil, alimentary tract and faeces
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*Endospores may be present in liver and may be reactivated to cause disease
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*Neurotoxic clostridia, ''Clostridium tetani'' and ''Clostridium botulinum'' affect neuromuscular function but cause no tissue damage
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*Histotoxic clostridia cause localised lesions in tissues and may cause toxaemia
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*''C. perfringens'' cause inflammatory lesions in the gastrointestinal tract and enterotoxaemias in sheep
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===Characteristics===
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*Large Gram-positive rods
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*Obligate anaerobes
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*Fermentative, catalase negative, oxidase negative
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*Straight or slightly curved
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*Motile by flagellae
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*Require enriched media for growth
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*Produce endospores which vary in shape and location and cause bulging of mother cell
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===Pathogenesis and pathogenicity===
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*Produce extracellular digestive enzymes and toxic substance known as exotoxins
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*Exotoxins cause necrosis, haemolysis and death
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*Collagenase, hyaluronidase and DNase enymes facilitate spread through tissues
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===Neurotoxic clostridia===
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===''Clostridium tetani''===
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*Causes [[Tremors and Movement Disorders - Nervous System#Tetanus|tetanus]]
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*Acute, potentially fatal intoxication affecting many species
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*Horses and man particularly susceptible; carnivores fairly resistant
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*Found in horse faeces
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*Characteristics:
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**Terminal, spherical endospores give mother cells a drumstick appearance
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**Enodospores resistant to boiling and chemicals but susceptible to autoclaving
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**Swarming growth and haemolytic on blood agar
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**Many serotypes but all produce same neurotoxin, tetanospasmin, therefore antibodies neutralise all
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*Pathogenesis:
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**Endospores introduced via damaged tissues e.g. penetrating wounds
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**Damaged tissue creates an anaerobic environment, allowing germination of spores
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**Tetanospasmin made by bacteria replicating in damaged tissue
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**Absorbed toxin affects neuromuscular junction distant from site of toxin production
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**Neurotoxin binds irreversibly to ganglioside receptors on motor neurons and is transported to nerve cell body
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**Toxins transported across synapse to terminals of inhibitory neurons where they block transmission of signals
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**Spastic paralysis by constant tensing of muscles results
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**Toxin can be blood-borne and bind to motor terminals throughout the body as well as in the CNS
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*Clinical signs:
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**Incubation period 5-10 days
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**Stiffness, localised spasms, altered heart and respiratory rates, dysphagia, altered facial expression, lock-jaw from mastigatory muscle spasm
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**Tonic muscle contraction easily stimulated
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*Treatment:
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**Antitoxin IV or into subarachnoid space on 3 consecutive days
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**Toxoid subcutaneously to promote active immune response
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**Penicillin to kill vegetative cells
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**Debridement and flushing of wound with hydrogen peroxide
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**Fluids, sedatives, muscle relaxants
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*Control:
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**Toxoid vaccine for farm animals
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**Debridement of wounds in horses
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===''Clostridium botulinum''===
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*Ubiquitous organism
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*Oval, subterminal endospores; spores survive boiling for hours
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*Causes [[Muscles - degenerative#Botulism|botulism]], a potentially fatal intoxication
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*Germination of endospores, growth of bacterial cells and toxin production in anaerobic conditions e.g. decaying carcasses and vegetation
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*Disease in animals consuming rotting carcasses and in herbivores through contamination of feed
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*Pathogenesis:
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**Intoxication on ingestion and absorbtion of toxin from GIT into the blood
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**Occasionally germination of spores in wounds or GIT
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**Neurotoxin carried to peripheral nervous system
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**Toxin binds gangliosides irreversibly at the neuromuscular junction
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**Blocks release of acetylcholine
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*Clinical signs:
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**Dilated pupils, dry mucus membranes, decreased salivation, tongue flacidity, dysphagia in farm animals
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**Incoordination and knuckling followed by flacid paralysis and recumbency
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**Paralysis of respiratory muscles leads to death
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**Flacid paralysis of legs and wings in birds
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*Diagnosis:
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**Mouse inoculation with infected serum
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**Toxin detection by PCR, ELISA
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**Toxin neutralisation tests in mice
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*Treatment: polyvalent antiserum neutralises unbound toxin
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*Toxoid vaccine used in endemic regions
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*Implicated in [[Intestines - physical disturbances#Equine dysautonomia, or grass sickness|equine grass sickness]]
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===Histotoxic infections===
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*Exotoxins cause local tissue necrosis and systemic effects which can be fatal - toxaemia
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*''C. chauvei'' and ''C. septicum'' present in muscle as latent spores which can germinate to cause infection
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*''C. novyi'' type B and ''C. haemolyticum'' have latent spores in the liver
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*When inoculated into wounds, cause malignant oedema and gas gangrene
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*Endospores persist in the soil
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*Most ingested spores excreted in faeces, but some become dormant in tissues
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*Tissue injury leads to reduced oxygen tensions allowing germination and replication of bacteria
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*Exotoxins cause local necrosis
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*Activated spores in the liver and muscles cause endogenous infections including blackleg, infectious necrotic hepatitis and bacillary haemoglobinuria
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*Inoculation of wounds causes exogenous infections including malignant oedema and gas gangrene
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===''Clostridium chauvei''===
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*[[Muscles - inflammatory#Black leg|Black leg]]:
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**Acute disease of cattle and sheep
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**Endogenous infection in young cattle with latent spores in muscles, activated by trauma
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**Exogenous infection via wounds in sheep of any age
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**Gangrenous cellulitis and myositis caused by exotoxins leads to rapid death
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**Skeletal muscle damage with lameness, swelling and crepitus due to gas accumilation
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**Dyspnoea due to lesions in tongue and throat muscles
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**Myocardial and diaphragmatic lesions can cause sudden death
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**Fluorescent antibody test for diagnosis
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*Causes [[General Pathology - Necrosis#Gas Gangrene|gas gangrene]], along with [[Clostridium species#Clostridium septicum|''Clostridium septicum'']]
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===Clostridium septicum===
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*Causes malignant oedema:
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**Infection via wounds
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**Cellutis with minimal gangrene and gas formation
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**Tissue swelling die to oedema; coldness and discoloration of overlying skin
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**Toxaemia with depression; death may be rapis if extensive lesions
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*Causes braxy:
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**Abomasitis of sheep
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**Disease occurs during winter
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**Rapidly fatal; anorexia, depression, fever
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*Causes [[General Pathology - Necrosis#Gas Gangrene|gas gangrene]] and [[Muscles - inflammatory#Gas gangrene|myositis]]
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===Clostridium novyi===
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*Infectious necrotic hepatitis/black disease:
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**Acute disease of sheep, occasionally cattle
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**Hepatic necrosis caused by exotoxins of ''C. novyi'' type B in liver damaged by ''Fasciola hepatica''
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**Rapid death
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**Dark discoloration of skin caused by subcutaneous venous congestion
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**Fluorescent antibody test diagnostic
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* Causes [[General Pathology - Necrosis#Gas Gangrene|gas gangrene]] and [[Muscles - inflammatory#Gas gangrene|myositis]].
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*May be involved in [[Bacterial skin infections#Systemic bacterial infections|cutaneous lesions]]
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*Causes big head in rams - oedema of subcutaneous tissues of the head, neck and cranial thorax; necrotising lethal alpha toxin
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===''Clostridium perfringens'' type A===
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*[[General Pathology - Necrosis#Gas Gangrene|Gas gangrene
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**Extensive bacterial invasion of damaged muscle
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**Gas production causing subcutaneous crepitus
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**Similar manifestations as malignant oedema
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===''Clostridium haemolyticum''===
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*Causes bacillary haemoglobinuria in cattle, occasionally sheep
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*Endogenous infection - endospores dormant in liver
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*Fluke migration allows germination
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*Beta toxin causes intravascular haemolysis and hepatic necrosis
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*Haemoglobinuria due to destruction of red blood cells
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===Clostridium sordelli===
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*Causes [[General Pathology - Necrosis#Gas Gangrene|gas gangrene]], [[Muscles - inflammatory#Gas gangrene|myositis]] and abomasitis (lambs)
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===Treatment of histotoxic infections===
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*Early penicillin
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*Vaccination with bacterin or toxoid at 3 months and booster after 3 weeks, then annually
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===Diagnosis===
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*Anaerobic transport medium
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*Culture on blood agar enriched with yeast extract, vitamin K and haemin
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*Anaerobic culture with hydrogen supplement and 5-10% carbon dioxide for 48 hours
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*Colonies of ''C. perfringens'' are 5mm diameter, circular, flat and grey
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*''C. perfringens'' colonies are surrounded by a zone of double haemolysis
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*Positive cAMP test with ''Sreptococci agalactiae''
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*Biochemical tests
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*Toxins identified in body fluids by toxin neutralisation or protection tests in lab animals
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*Nagler reaction to detect alpha toxin - plate neutralisation test
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*Fluorescent antibody tests for histotoxic clostridia
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*ELISA, PCR for toxin detection
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===Enteropathogenic and enterotoxaemic clostridia===
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*General:
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**''Clostridium perfringens'' types B, C and D
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**Found in soil, feaces and intestinal tract
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**Survive in soil as spores
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**Husbandry, changes in diet and environment predispose to proliferation in the intestine
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*Pathogenesis and pathogenicity:
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**Clostridial replication and overgrowth in the interstinal tract of sheep
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**Production of potent exotoxins which cause local and systemic effects of enterotoxaemia
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**Type of toxins produced determine clinical syndrome
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**Haemolysins, collagenases and hyaluronidases also produced
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*''C. perfringens'' type A:
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**Necrotising enterocolitis in pigs and necrotic enteritis in chickens
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**Canine haemorrhagic gastroenteritis
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**Typhlocolotis in horses, possibly associated with [[Intestines - Fibrinous/ Haemorrhagic Enteritis#Colitis X|Colitis X]]
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*''C. perfringens'' type B:
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**[[Intestines - Fibrinous/ Haemorrhagic Enteritis#Lamb Dysentery (Enterotoxaemia with Blood)|Lamb dysentery]]
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**Up to 30% morbidity and high mortality
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**Affects lambs in first week of life
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**Abdominal distension, pain, bloody faeces, sudden death
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**Bacterial overgrowth in the intestine of the lamb due to immature bacterial flora
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**Lack of proteases in the immature gut prevents cleavage of the beta toxin, allowing it to cause disease
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**Haemorrhagic enteritis and ulceration in the small intestine
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**Fluid in the peritoneal cavity and pericardial sac due to increased capillary permeability
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**Fatal haemorrhagic enteritis in newborn foals, calves and adult goats
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*''C. perfringens'' type C:
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**Acute enterotoxaemia in adult sheep, 'struck'
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**Sudden death or terminal convulsions in sheep at pasture
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**Beta toxin plays major role in pathogenesis of the disease
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**Post mortem: jejunal ulceration; hyperaemia in small intestine; fluid accumulation in peritoneal cavity; congestion of peritoneal vessels; petechial haemorrhages
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**Haemorrhagic enteritis in piglets
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***Peracute enterotoxaemia often of entire litter with mortality rates 80%
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***Infection from sow's faeces
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***Death within 24 hours in young piglets
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***Chronic disease in older piglets
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***Dullness, anorexia, bloody faeces, perianal hyperaemia
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***Post mortem: necrosis of terminal small intestinal mucosa, caecum and colon and blood-stained contents; serosanguinous fluid in pleural and peritoneal cavities
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**Necrotic enteritis in chickens:
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***Broilers under 12 weeks
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***Acute enterotoxaemia, sudden onset and high mortality
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***Necrosis of small intestine
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***Predisposing factors include diet changes, coccidial infection and intestinal hypomotility
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**Acute enterotoxaemia with haemorrhagic enteritis in calves, lambs, foals
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**[[Peritoneal cavity - inflammatory#In cattle|Peritonitis in cattle]]
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*''C. perfringens'' type D:
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**[[Intestines - Catarrhal Enteritis#"Pulpy Kidney" Disease|Pulpy kidney disease]] in well-fed 3-10 week-old lambs
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**Follows overeating high grain diet or luchious pasture
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**Starch from partially digested food enterering the intestine from the rumen allows rapid clostridial proliferation
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**Epsilon toxin activated by proteolytic enzymes causes toxaemia
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**Lambs found dead or with opisthotonos, convulsions, coma in acute phases
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**Blindness and head pressing in subacute disease; bloat in later stages
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**Hyperglycaemia, glycosuria
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**Post mortem: hyperaemia in intestine; fluid in pericardial sac; kidney autolysis with pulpy cortical softening (acute death)
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**Subacute death causes symmetrical encephalomalacia and haemorrhage in basal ganglia and midbrain
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**Enterotoxaemia in kids and adult goats
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**  [[Respiratory system - clinical signs#Dysphagia|Dysphagia in horses]]
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*''C. perfringens'' type E:
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**Enteritis in rabbits, haemorrhagic enteritis in calves
 
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