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[An outbreak of enterocolitis due to Clostridium perfringens in a hospital for the severely disabled]
Abstract:
We had an outbreak of 14 cases of enterocolitis due to Clostridium perfringens (Cl. perfringens) in a hospital for the severe multiply-disabled, where the 100 disabled were admitted, in summer in 1985. The signs and symptoms shown by this enterocolitis were primarily diarrhea without fever and loss of appetite. The feces of 10 cases were examined bacteriologically. The test showed 10(3) to 10(6) cells of Cl. perfringens per one gram of their feces and all the strains isolated were untypable by the classification of Hobbs. Nine out of 10 cases were randomly selected and all of the 9 cases were proved to have enterotoxin producing strains. All the strains were highly sensitive to many kinds of antibiotics except kanamycin and gentamicin. Eleven out of the 14 cases were admitted in the same ward and the 7 out of the 11 cases were in the same room of this ward. Considering the spreading route of this infection, it is unlikely that this outbreak occurred due to food supplied from kitchen in this hospital, because all of the disabled, admitted in this hospital, had little chance by which some of the disabled only in a specific ward or room were supplied with bacteriologically contaminated meals from the point of view of cooking and supplying system of this hospital. Adding to this fact, if this outbreak was due to food-born infection, the symptoms of most patients should occur within 1-2 days, because the incubation period of this disease is within a day, however, the patients increased day by day for more than a week.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
An outbreak of Clostridium perfringens (Cl. perfringens) enterocolitis affected 14 multiply-disabled patients. The untypable strains produced enterotoxin, suggesting person-to-person spread within the hospital ward.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Context:
- A hospital for the severely multiply-disabled experienced an outbreak of enterocolitis.
- The outbreak involved 14 cases of Clostridium perfringens (Cl. perfringens) infection during the summer of 1985.
- Patients presented with diarrhea and loss of appetite, but typically without fever.
Purpose:
- To investigate an outbreak of enterocolitis caused by Clostridium perfringens (Cl. perfringens) in a hospital setting.
- To characterize the isolated strains of Cl. perfringens and determine their enterotoxin-producing capabilities.
- To explore the potential transmission routes of the infection within the hospital.
Summary:
- Bacteriological examination of fecal samples revealed high concentrations of Cl. perfringens (10^3 to 10^6 cells/gram).
- All tested strains were untypable using the Hobbs classification and demonstrated enterotoxin production.
- Antibiotic sensitivity testing showed high sensitivity to most antibiotics, except kanamycin and gentamicin.
- The epidemiological data, with cases concentrated in a specific ward and room, suggested person-to-person transmission rather than a foodborne source.
Impact:
- The findings suggest Clostridium perfringens (Cl. perfringens) can cause outbreaks in institutionalized, multiply-disabled populations.
- Understanding transmission routes is crucial for implementing effective infection control measures in healthcare settings.
- The study highlights the importance of identifying enterotoxin-producing strains for accurate outbreak investigation.