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Culturing and Maintaining Clostridium difficile in an Anaerobic Environment
Published on: September 14, 2013
Diagnosis and treatment challenges in a rare Clostridium infection: A case report
Bianca Bălaș-Maftei1,2, Carmen-Elena Florea1,2, Maria Obreja2,3
1Doctoral School, 'Grigore T. Popa' University of Medicine and Pharmacy, 00115 Iași, Romania.
Abstract:
The Clostridium genus includes >180 species of Gram-positive, anaerobic, sporulating bacteria. Under certain conditions, these can cause a wide range of invasive infections in humans. Clostridium paraputrificum occurs in the commensal intestinal flora and related bacteremia typically occurs secondary to an injury to the intestinal mucosa and in the presence of predisposing conditions, such as gastrointestinal disorders, malignancies, diabetes, HIV infection or neutropenia. The current study presents the case of a 70-year-old male patient, a rural resident living in poverty, with a history of alchohol consumption and cardiovascular pathology. Several initial and subsequent diagnoses were ruled out by successive investigations (e.g., stroke, meningitis, localized tetanus). Blood cultures were eventually found positive for Clostridium paraputrificum and the patient developed septic shock despite treatment with metronidazole and penicillin G. Once switched to carbapenem, the patient progressed favorably, suggesting that carbapenem could work as a first-line antibiotic treatment for Clostridium paraputrificum infections.
Insights
Clostridium paraputrificum bacteremia can cause severe septic shock. Carbapenem treatment showed promise as a first-line option for these challenging Gram-positive anaerobic infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- The genus *Clostridium* comprises over 180 species of Gram-positive, anaerobic, sporulating bacteria.
- Certain *Clostridium* species can cause severe invasive infections in humans.
- *Clostridium paraputrificum* is a commensal bacterium of the intestinal flora.
Observation:
- Bacteremia due to *C. paraputrificum* typically arises secondary to intestinal mucosal injury and in patients with predisposing conditions.
- A case study involved a 70-year-old male with a history of alcohol consumption and cardiovascular disease.
- Initial diagnoses including stroke, meningitis, and tetanus were ruled out before *C. paraputrificum* bacteremia was identified.
Findings:
- The patient developed septic shock despite treatment with metronidazole and penicillin G.
- Switching antibiotic therapy to carbapenem resulted in a favorable clinical outcome.
- This suggests carbapenem may be an effective first-line treatment for *C. paraputrificum* infections.
Implications:
- The findings suggest carbapenem as a potential first-line antibiotic for *Clostridium paraputrificum* infections.
- This case highlights the importance of considering rare bacterial pathogens in severe sepsis.
- Further research is warranted to establish optimal treatment guidelines for *C. paraputrificum* bacteremia.
