Gas Gangrene of Different Origin Associated with Clostridium perfringens Type A in Three Patients Simultaneously Hospitalized in a Single Department of Orthopedics and Traumatology in Poland

Publications

Share / Export Citation / Email / Print / Text size:

Polish Journal of Microbiology

Polish Society of Microbiologists

Subject: Microbiology

GET ALERTS

ISSN: 1733-1331
eISSN: 2544-4646

DESCRIPTION

1
Reader(s)
6
Visit(s)
0
Comment(s)
0
Share(s)

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue / page

Related articles

VOLUME 65 , ISSUE 4 (December 2016) > List of articles

Gas Gangrene of Different Origin Associated with Clostridium perfringens Type A in Three Patients Simultaneously Hospitalized in a Single Department of Orthopedics and Traumatology in Poland

Monika Brzychczy-Włoch * / Dorota Ochońska / Anna Piotrowska / Małgorzata Bulanda

Keywords : Clostridium perfringens, epidemiological investigation, gas gangrene, molecular study

Citation Information : Polish Journal of Microbiology. VOLUME 65 , ISSUE 4 , ISSN (Online) 2544-4646, DOI: 10.5604/17331331.1227665, December 2016

License : (CC BY-NC-ND 4.0)

Received Date : 26-November-2015 / Accepted: 25-March-2016 / Published Online: 28-December-2016

ARTICLE

ABSTRACT

The objective of the study was to perform a comparative analysis of phenotypic and genetic similarity, determination of resistance profiles, detection of toxin-encoding genes and molecular typing of Clostridium perfringens isolates originating from patients with gas gangrene. The study encompassed three patients with a clinical and microbiological diagnosis of gas gangrene who were hospitalized in one of the hospitals of the Kujawsko-Pomorskie province in the same period of time between 8th April 2015 and 20th April 2015. The three C. perfrin­gens isolates studied had identical biochemical profiles. Two isolates had identical resistance patterns, while the third presented a different profile. Using the multiplex PCR method, all isolates showed the presence of cpa gene encoding α-toxin; furthermore, the presence of the cpb2 gene encoding β2-toxin was confirmed in two isolates. Genotyping with the use of pulsed field gel electrophoresis (PFGE) indicated that the isolates originating from the three studied patients represent three genetically different restrictive patterns which correspondedto three different clones – clone A, clone B and clone C. As a result of the study, it is possible to conclude that the studied patients simulta­neously hospitalized in a single Department of Orthopedics and Traumatology developed three different endogenous infections.

Content not available PDF Share

FIGURES & TABLES

REFERENCES

Abella B.S., P. Kuchinic, T. Hiraoka and D.S. Howes. 2003. Atraumatic Clostridial myonecrosis: case report and literature review. J. Emerg. Med. 24(4): 401–405.

 

Brzychczy-Włoch M. and M. Bulanda. 2014. Analysis of genetic similarities between Clostridium perfringens isolates isolated from patients with gas gangrene and from hospital environment conducted with the use of the PFGE method. Pol. J. Surg. 86(3): 141–146.

 

Fielden M.P., E. Martinovic and A.L. Ells. 2002. Hyperbaric oxygen therapy in the treatment of orbital gas gangrene. JAAPOS. 6: 252–254.

 

Fisher D.J, K. Miyamoto, B. Harrison, S. Akimoto, M.R. Sarker and B.A. McClane. 2005. Association of beta2 toxin production with Clostridium perfringens type A human gastrointestinal disease isolates carrying a plasmid enterotoxin gene. Mol. Microbiol. 56(3): 747–762.

 

Fleischer M. and K. Salik. 2006. Procedures in the hospital outbreaks. Training materials for epidemiological nurses (in Polish). Wrocław. http://pspe.pl/files/pliki_old/zaszyt-V.pdf, 2015.11.01.

 

Gilbert M., C. Jolivet-Reynaud and M.R. Popoff. 1997. Beta2 toxin, a novel toxin produced by Clostridium perfringens. Gene 203: 65–73.

 

Knap J. 2004. Gas gangrene, pp. 411–414. In: W. Magdzik, D. Narszewicz-Lesiuk and A. Zieliński (eds.) Infectious and parasitic diseases – epidemiology and prevention (in Polish). α-medica Press, Bielsko-Biała.

 

Martirosian G. 2007. Infections caused by Clostridium perfringens, gas gangrene, food poisoning, pp. 646–649. In: J. Cianciara and J. Juszczyk (eds). Infectious and parasitic diseases (in Polish). Czelej Sp. z o.o., Lublin.

 

Maslanka S.E., J.G. Kerr, G. Williams, J.M. Barbaree, L.A. Carson, J.M. Miller and B. Swaminathan. 1999. Molecular subtyping of Clostridium perfringens by pulsed-field gel electrophoresis to facilitate food-borne-disease outbreak investigations. J. Clin. Microbiol. 37: 2209–2214.

 

Regulation of the Minister of Health of 23 December 2011 on the list of factors alarm registers of hospital infections and factors alarms and reports on the current epidemiological situation of the hospital (in Polish). Dz.U.11.294.1741.

 

Sobel J., C.G. Mixter, P. Kolhe, A. Gupta, J. Guarner, S. Zaki, N.A. Hoffman, J.G. Songer, M. Fremont-Smith, M. Fischer and others. 2005. Necrotizing enterocolitis associated with Clostridium perfringens type A in previously healthy North American adults. J. Am. Coll. Surg. 201: 48–56.

 

Sołtys-Bolibrzuch K. 2012. The new microorganism on the list of alarm factors – Clostridium perfringens. Treatment of the patient in case of suspicion and/or diagnosis of gas gangrene (in Polish). Pielęgniarka Epidemiologiczna 1: 5–7.

 

Stasiak M., J. Lasek, A. Samet, A. Śledzińska, Z. Witkowski, E. Augustynowicz, W. Marks and J. Ślusarczyk. 2007. Gas gangrene of a different origin in trauma patients – report of 2 cases. J. Orthopaedics 4(1): e15.

 

Stevens D.L. and A.E. Bryant. 2002. The role of clostridial toxins in the pathogenesis of gas gangrene. CID. 35: 593–600.

 

Sussmann M., S.P. Boriello and D.J. Taylor. 1998. Gas gangrene and other clostridial infections, pp. 669–684. In: Collier L., A. Balows and M. Sussman (eds). Topley and Wilsons’ microbiology and microbial infections, 9th ed. Arnold, London.

 

The European Committee on Antimicrobial Susceptibility Testing (ECAST). 2015. Breakpoint tables for interpretation of MICs and zone diameters. Version 5.0, 2015. http://www.eucast.org, 2015.11.01.

 

van Asten A.J., C.W. van der Wiel, G. Nikolaou, D.J. Houwers and A. Gröne. 2009. A multiplex PCR for toxin typing of Clostridium perfringens isolates. Vet. Microbiol. 136(3–4): 411–412.

 

van Belkum A., P.T. Tassios, L. Dijkshoorn, S. Haeggman, B. Cookson, N.K. Fry, V. Fussing, J. Green, E. Feil, P. Gerner- Smidt and others. 2007. Guidelines for the validation and application of typing methods for use in bacterial epidemiology. Clin. Microbiol. Infect. 13: 1–46.

 

Wojdat E., K. Kwiatek, H. Zdrojewski and I. Krupa. 2005. Gas gangrene – case diagnosis (in Polish). Przegl. Epidemiol. 59: 859–863.

 

EXTRA FILES

COMMENTS