Cl.perfringes (formal name Cl. Welchii) Perfringens means breaking through or breaking in pieces'.

. causes a wide range of symptoms, from food poisoning to gas gangrene. Also responsible for enterotoxemia (also known as "overeating disease" or "pulpy kidney disease") in sheep and goats. Gram-positive, rod-shaped, anaerobic, spore-forming Natural habitat soil, water, decomposing plant, gut of animal & human ( normal commensel) Morphological feature Gm+ve bacilli Capsulated Non motile ( all Cl. Are motile except perfringes) Spore forming (subterminal) 2 types of spore - Heat stable spore Food poisoning [food staff /s stable] - Heat labile spore Gas gangrene [ Glass / l labile] Diseases: Gas gangrene (myonecrosis) Food poisoning Enteritis necroticans/necrotizing enteritis Anaerobic cellulites Clostridial endometritis Other causes of gas gangrene C. histolyticum C. septicum C. novyi type A C. oedematicus C. sordellii C. sporogens

Lab diagnosis: Specimen: exudates from Wound Necrotic tissue Muscle fragment Direct microscopy Gm stained large no. of regularly shaped Gm+ve bacilli without spore Culture Blood agar : haemolysis ( A zone of double haemolysis) Robertson cooked meat medium : -medium turbidity with gas production -meat pink colour without digestion Identification test Nagler reaction:

(Nagler agar plates, containing 5-10% egg yolk - identify strains that produce - toxin) Lecithinase + lipids in egg yolk = characteristic stromy precipitate around the colonies. One-half of the plate is inoculated with antitoxin to act as a control in the identification. Biochemical properties: Ferments glucose, lactose, sucrose, maltose with production of acid & gas Produces abundant H2S Indole :- ve VP :- ve MR : +ve Resistence to physical & chemical agents: Boiling spores destroyed within 5 min. Food poisoning resist 1-3hr Autoclave spore destroyed at 121C for 15 min Antiseptic & disinfectant resistant Toxin production 4 major toxin alpha, beta, epsilon, iota Type A alpha Type B alpha, beta, epsilon Type C alpha, beta Type D alpha, epsilon Type E alpha, iota Alpha toxin responsible for toxaemia of gas gangrene heat stable, lethal, dermonecrotic & haemolytic splits lecithin into phosphoryl choline & diglyceride by lecithinase enzyme neuraminidase, haemagglutin, fibrinolysin,haemolysin Treatment 1. Surgery damaged, clots, necrotics, foreign materials should be removed 2. Metro,penicillin,gentamycin,amoxacillin 3. passive immunization with anti sera
Transmission: spores are located in the soil vegetative cells are members of the normal flora of the colon and vagina. gas gangrene is associated with war wounds, automobile and motorcycle accident septic abortion Pathogenesis organisms grow in traumatized tissue (especially muscle) produce variety of toxins Toxins elaborated by C. perfringens

1) Exotoxin 12 exotoxins designated by Greek letters. toxin the most important, a lecithinase

2) Enterotoxin (heat labile protein) acts on the lower portion of the small intestine o enterotoxin producing strain are heat resistant (spores remain viable for ova an hour at 100C) 3) Degradative enzymes
Clinical significance: 1) Myonecrosis (gas gangrene)

introduced into tissue by contaminated with dirt or endogenous transfer from the intestinal tract o severe open wound (compound features, crushing injuries are prime predisposing conditions) o fermentation of tissue carbohydrates fields gas and accumulations of gas bubbles produce crinkling sensation on palpation (crepitation) o exudates are copious and foul smelling o increased capillary permeability leads to hematogenous spread of exotoxin resulting in shock, renal failure, and intravascular hemolysis

2) o

Anaerobic cellulites o affects connective tissue o does not involve muscle invasion surgical intervention is generally unsuccessful because of rapidity of spread of the infection 3) Food poisoning o symptoms occur 8-18 hours after ingestion of contaminated foods (meat, chicken, fish and their by-products)

o requires a large inoculum of 108 organism or quarts o nausea, abdominal cramps, and diarrhea o afebrile patient o self-limited (recovery within 1-2 days) 4) Enteritis necroticans o
necrotizing bowel disease with high mortality o Other names: pigbel in New Guinea, darmbrand in Germany 5) Clostridial endometritis o gangrenous infection of uterine tissue followed by bacteremia and toxemia o grave complication of incomplete abortion or use of inadequately sterilized instruments.