Clostridium perfringens was first described in 1892 by Welch and Nutall. It is a Gram-positive, sporulating, obligate anaerobe, and is unusual among the pathogenic clostridia by being non-motile. Clostridium perfringens is widely distributed in the environment and foods, and forms part of the normal gut flora in man and animals.

TOXINS

Strains of C. perfringens are classified as 5 biotypes A – E depending on the differential production of four major (i.e. lethal) exotoxins (alpha, beta, epsilon and iota). In addition, strains of C. perfringens may also produce a number of other toxins, including: neuraminidase and enterotoxin (Cpe).

FOOD POISONING

In the United Kingdom and United States C. perfringens is the third most common cause of food poisoning, with poorly prepared meat and poultry the main culprits. Spores survive cooking and, during slow cooling and unrefrigerated storage, germinate to form large numbers of cells which are then ingested.

Incubation time is between 8 and 16 hours after ingestion of contaminated food. The bacterial enterotoxins cause intense abdominal cramps and diarrhoea which last about 24 hours.

It is likely that many cases of C. perfringens food poisoning remain sub clinical, as antibodies to the toxin are common amongst the population. This has led to the conclusion that most, if not all, of the population has experienced food poisoning due to C. perfringens.

PIG-BEL

Pig-bel is a rare and often fatal enterotoxaemia of humans caused by the beta-toxin of C. perfringens type C. This condition is characterised by acute abdominal pain, bloody diarrhoea, vomiting, ulceration of the small intestine, perforation of the intestinal wall and acute toxaemia.

GAS GANGRENE

Gas-gangrene is a deep wound infection most often associated with the alpha-toxin of C. perfringens type A. It is characterised by rapid inflammation at the site of infection, extreme swelling, acute pain, and, eventually, necrosis of the infected tissue. In addition to the damaging toxins, the bacteria also generate a gas: a composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical case.

Treatment usually involves excision/amputation, and antibiotics. Hyperbaric oxygen therapy (HBOT) may also be used to inhibit the growth of and kill the anaerobic C. perfringens.

VETERINARY IMPORTANCE

A range of veterinary enterotoxaemias are caused by toxins absorbed from the intestinal bacteria. These include; necrotic enteritis in poultry and fowl (type A), an enterotoxaemic jaundice in lambs (type A), lamb dysentery (type B), an enterotoxaemia in neonatal calves and foals (type B), a hemorrhagic enterotoxaemia in piglets, calves and foals (type C), Struck in adult sheep (type C), Pulpy kidney disease in sheep, goats and calves (type D) and a rare enterotoxaemia in calves and lambs (type E).