Description
Clostridium perfringens bacteria, like all other Clostridia, are ubiquitous, spore-forming, Grampositive, anaerobic bacteria which are regularly found among the flora of the large intestine in humans. These differ from other Clostridia, because they lack the peritrichous flagella. Five strains of Clostridium perfringens are distinguished as Types A to E. The Type A strain has the greatest significance for humans, along with Type C, the cause of necrotic enteritis, under certain conditions (diet, trypsin deficiency), while all five types are seen in animals.
These groups are classified according to the production of four major toxins (Alpha, Beta, Epsilon, Iota), all of which have cytotoxic and necrotizing effects. Besides these four major toxins, certain strains of C. perfringens produce a number of other toxins, among which the enterotoxin (a polypeptide 35 kDa in size) is of pathogenic significance for humans.
With the consumption of improperly stored foods, and then pre-cooked foods in particular, C. perfringens may be imbibed in large amounts. They, in turn, form large amounts of C. perfringens enterotoxins (CPE) and these are the cause of intestinal diseases with diarrhea and stomach cramps. The signs and symptoms begin about 8–24 hours after the intake of contaminated food, and they recede after another 24 hours. Vomiting, fever, and headache are only seldomly seen to accompany the illness. In addition to food poisoning, C. perfringens causes about 10% of all cases of antibiotic-associated diarrhea (AAD) as well as 5–20% of the cases of sporadic diarrhea (SPOR) that are not caused by food poisoning. This form of diarrhea ranges as far as pseudomembranous colitis (PMC) with courses of illness that are much more severe and longer in duration (10–30 days), often with findings of blood and mucous in the stool. On histological examination of biopsies from lower sections of the large intestine and the rectum, one finds edematous areas stemming from the lesions caused by CPE.
Recent investigations have shown that the enterotoxin code may be chromosomal (food poisoning) and it may be episomal (in AAD and SPOR).
The Clostridium perfringens Enterotoxin Test is available parallel to the Clostridium difficile Toxin A/B Test, providing a significant identification system for clarification of the causes of antibiotic-associated diarrhea and sporadic diarrhea. Allowing fast and reliable diagnosis, this tool is a valuable aid in the treatment decision process