Related Experiment Video
Updated: Oct 2, 2026
A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Characterization of Clostridium perfringens strains isolated from Polish patients with suspected
Hanna Pituch1, Nicole van den Braak, Alex van Belkum
1Department of Medical Microbiology, Center of Biostructure Research, The Medical University, Warsaw, Poland.
Background:
The aim of our research was to investigate the role of enterotoxin- producing anaerobic bacteria other than Clostridium difficile in the etiology of antibiotic-associated diarrhea. This article presents data related to C. perfringens.
Material/Methods:
Stool samples taken from 158 patients with suspected antibiotic-associated diarrhea were specifically cultured for Clostridium difficile, Bacteroides fragilis and Clostridium perfringens. In order to associate the presence of virulence factors in the bacterial isolates thus collected with disease features, all strains were genetically and phenotypically analyzed for toxin production. All isolated C. perfringens strains were cultured in Ellner sporulation-promoting medium.
Results:
In 21 of the 158 patients (13%) C. perfringens could be cultivated from the fecal specimen. None of the strains produced enterotoxin, and consequently the cpe gene was not detected by PCR in any of these strains. C. perfringens and C. difficile were cultivated from the same stool samples in 4 cases. Interestingly, in one case toxin A-negative/toxin B positive C. difficile and non-enterotoxigenic C. perfringens were co-cultured. After application of a heat shock (100 degrees C at 30 min.) only two C. perfringens strains producing thermoresistant spores were detected. Pulsed field gel electrophoresis (PFGE) demonstrated genetic heterogenicity among the C. perfringens strains, suggesting that these bacteria were already presented upon hospital admission.
Conclusions:
It seems unlikely that nosocomial transfer has taken place. The relatively low incidence suggests that C. perfringens is not a major primary cause of antibiotic-associated diarrhea.
Insights
Clostridium perfringens is unlikely to be a primary cause of antibiotic-associated diarrhea, as it was not found to produce enterotoxins in most patients studied. This finding suggests limited role in hospital-acquired infections.
Area of Science:
- Microbiology
- Gastroenterology
- Infectious Diseases
Background:
- Investigating anaerobic bacteria, excluding Clostridium difficile, in antibiotic-associated diarrhea (AAD).
- Focusing on Clostridium perfringens (C. perfringens) as a potential contributor to AAD.
- Examining the role of enterotoxin-producing bacteria in AAD etiology.
Purpose of the Study:
- To determine the prevalence and etiological role of C. perfringens in antibiotic-associated diarrhea.
- To investigate the toxin production and genetic characteristics of C. perfringens isolates from patients with AAD.
- To assess the potential for nosocomial transfer of C. perfringens in AAD cases.
Main Methods:
- Culturing stool samples from 158 patients for C. difficile, Bacteroides fragilis, and C. perfringens.
- Genotypic and phenotypic analysis of bacterial isolates for toxin production.
- Specific culturing of C. perfringens in Ellner sporulation-promoting medium and heat shock treatment.
Main Results:
- C. perfringens was isolated from 13% of patients with suspected AAD.
- No C. perfringens strains produced enterotoxin or harbored the cpe gene.
- Genetic analysis (PFGE) indicated strains were likely present before hospital admission, not nosocomially acquired.
Conclusions:
- C. perfringens is unlikely to be a significant primary cause of antibiotic-associated diarrhea.
- The low incidence and lack of enterotoxin production suggest a limited role for C. perfringens in AAD.
- Nosocomial transfer of C. perfringens appears improbable in this patient cohort.
