Strain differentiation of Clostridium perfringens by bacteriocin typing, plasmid profiling and ribotyping.

Bacteriocin typing, plasmid profiling and ribotyping were used to type 34 food and patient Clostridium perfringens isolates from 10 food poisoning cases, respectively, outbreaks. In nine cases/outbreaks bacteriocin patterns showed identical main groups. Subgroups differed within all cases/outbreaks. Plasmid profiles were identical for all isolates within each of three outbreaks. In eight food poisoning cases and outbreaks, all the ribotypes of each food and stool isolate were found to be identical. All three typing methods give valuable results for the characterization of C. perfringens beyond the species level. Bacteriocin typing represents a suitable addition to plasmid typing, particularly since the results do not show any correlation between losses of plasmids and changes in bacteriocin sensitivity patterns. Ribotyping was found to be a suitable tool to determine the genetic relationship of C. perfringens isolates in the context of food-borne poisoning.

Quantitative investigations into the elimination of in vitro-obtained spores of the non-pathogenic Clostridium butyricum strain CNRZ 528, and their persistence in organs of different species following intravenous spore administration.

Before the Clostridium tumour assay can be applied to the diagnosis of cancer, we sought to investigate--within the framework of a biopharmaceutical safety test--the organ persistence of test spores of Clostridium butyricum CNRZ 528. We found that non-pathogenic spores obtained in vitro, like pathogenic native spores, escape phagocytosis in various organs up until about 2 years, as tested by anaerobic cultures. The elimination of spores depended on the species of animal, the spore dose and the organs investigated. In rabbits, one week after injection, we recovered clostridial spores from blood and spleen cultures more rarely than from liver and lung. The half-life of blood clearance in patients was one day or, at half the spore dose, two days. That deep tissues of healthy animals are not normally sterile became evident in rabbits after sporadic isolation and characterization of non-administered saccharolytic and proteolytic clostridial species. During a 10-year observation period, the rate of obtainment of viable spores by in vitro cultures lessened; however, for administration of the spores in clinical phase I and phase II studies, the spore quality was acceptable.

[Streptococcus-induced syndrome of toxic shock (streptococcal toxic shock syndrome)]. / Streptokokkenbedingtes Syndrom des toxischen Schocks (Streptococcal Toxic Shock Syndrome).

Report on the first case of streptococcal toxic shock syndrome in the GDR. The patient was a 54-year-old female. One week before admission to the hospital she cut her finger. The day before admission to the hospital she presented with a painful left shoulder. Demarcation followed, and Streptococcus pyogenes (group A streptococci) was isolated from this area. The temperature rose to more than 40 degrees C and she became confused, hypotensive and anuric. There was evidence for disseminated intravascular coagulation. She died 23 h after admission. Clinical course and laboratory parameters resembles staphylococcal toxic shock syndrome, except a diarrhoea. The streptococcal strain produced a large amount of erythrogenic toxin type B (more than 20 ng/ml), but not erythrogenic toxins A or C. Erythrogenic toxins of Streptococcus pyogenes seem to play the same role in the development of streptococcal toxic shock syndrome as the toxic shock syndrome 1 (TSST-1) in staphylococcal toxic shock syndrome.

[Rapid diagnosis in Clostridium perfringens wound infections]. / Schnelldiagnostik bei Clostridium perfringens-Wundinfektionen.

Prompt and early microbiological differential diagnosis is essential for clinical presumptive diagnosis of gas gangrene. The differential diagnosis includes clostridial myositis (gas gangrene), clostridial cellulitis and other gas producing infections. Examination of Gram preparation (bacterioscopy) and detection of the etiologic agent in muscle specimens are necessary for diagnosis. Clostridium perfringens has been shown as the causative organism of gas gangrene. A method is reported which allows the screening and identification of Clostridium perfringens from clinical specimens in a few hours. Using a medium yielding optimal growth and toxin production, pure cultures are centrifuged and subjected to rapid tests (detection of beta-galactosidase, phospholipase C).

[Necrotising enteritis (author's transl)]. / Die Enteritis necroticans.

4 cases of severe necrotising enteritis are dealt with. The small intestine was affected 3 times, the colon once, One patient died after resection of the affected bowel segment. In 2 additional cases a large resection of the small intestine became necessary. One patient was treated conservatively. The bacteriological evidence of Clostridium perfringens type C in the intestinal wall allows the assumption of a primarily bacterial genesis of this disease. Its aetiology, clinical and pathological-anatomic picture and the therapy are being discussed.

[Investigations on the characterization of a clostridial strain for tumour diagnosis (author's transl)]. / Untersuchungen zur Charakterisierung eines Clostridienstammes für die Krebsdiagnostik.

Careful delineation of a clostrial strain for human tumour diagnosis as against oncolytic tissue-active clostridial strains should be obligatory. We investigated the possibility to differentiate Clostridium butyricum CNRZ 528 (Bergère) against three different strains kept in our institute by means of biological, biochemical and by phage typing procedures. In addition, consistency in the control of half-technological spore production is required. It could be confirmed by this study that oncolytic properties of clostridial strains are biologically testable with adequate sensitivity in the hamster A Mel 3 tumour model. By means of typing procedures, we were able to clearly differentiate between Clostridium butyricum CNRZ 528 on one hand and Clostridium oncolyticum M 55 as well as Clostridium butyricum Jena H 8 on the other. The results of the tests are unsuitable for identifying Clostridium butyricum CNRZ 528 or Clostridium butyricum McClung 1672 A, respectively, nor can we distinguish Clostridium oncolyticum M 55 from Clostridium butyricum Jena H 8.