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1.
Pediatr Infect Dis J ; 40(2): 159-161, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33006876

RESUMO

We report a 1-day-old girl who was affected by peritonitis and bacteremia caused by Clostridium tertium following perforation of congenital intestinal atresia. Splenic infarction was also suspected during C. tertium bacteremia. C. tertium was identified by using mass spectrometry and 16S rRNA sequencing. This patient was successfully treated with emergency laparotomy and broad-spectrum antibiotics.


Assuntos
Bacteriemia/microbiologia , Infecções por Clostridium/microbiologia , Clostridium tertium/isolamento & purificação , Peritonite/microbiologia , Vancomicina/uso terapêutico , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Infecções por Clostridium/patologia , Feminino , Humanos , Recém-Nascido , Meropeném/administração & dosagem , Meropeném/uso terapêutico , Infarto do Baço/patologia , Infarto do Baço/cirurgia , Vancomicina/administração & dosagem
2.
Infect Dis (Lond) ; 52(3): 196-201, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31778089

RESUMO

Introduction: Clostridium perfringens and other gas gangrene-forming clostridia are commensals of the human gut and vaginal microbiota, but can cause serious or even fatal infections. As there are relatively few published studies on antibiotic susceptibility of these bacteria, we decided to perform a 10-year retrospective study in a South-Eastern Hungarian clinical centre.Methods: A total of 372 gas gangrene-forming Clostridium spp. were isolated from clinically relevant samples and identified with rapid ID 32A (bioMérieux, France) and MALDI-TOF MS (Bruker Daltinics, Germany) methods. Antibiotic susceptibility was determined with E-tests.Results: We identified 313 C. perfringens, 20 C. septicum, 10 C. sordellii, 10 C. sporogenes, 9 C. tertium, 6 C. bifermentans, 4 C. histolyticum isolates. In C. perfringens isolates, the rate of penicillin resistance was 2.6% and the rate of clindamycin resistance 3.8%. Penicillin resistance was found in 6.8% and clindamycin resistance in 8.5% of the non-perfringens Clostridium spp. isolates.Conclusion: The antibiotic susceptibility of C. perfringens isolates was in good agreement with previous publications. The rates of resistance to penicillin and clindamycin were very low. The resistance rates of non-perfringens Clostridium spp. isolates were higher than those of C. perfringens strains, but lower than those published in the literature.


Assuntos
Antibacterianos/farmacologia , Clindamicina/farmacologia , Clostridium/efeitos dos fármacos , Gangrena Gasosa/microbiologia , Penicilinas/farmacologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Cefoxitina/farmacologia , Criança , Pré-Escolar , Clostridium/isolamento & purificação , Clostridium bifermentans/efeitos dos fármacos , Clostridium bifermentans/isolamento & purificação , Clostridium histolyticum/efeitos dos fármacos , Clostridium histolyticum/isolamento & purificação , Clostridium perfringens/efeitos dos fármacos , Clostridium perfringens/isolamento & purificação , Clostridium septicum/efeitos dos fármacos , Clostridium septicum/isolamento & purificação , Clostridium sordellii/efeitos dos fármacos , Clostridium sordellii/isolamento & purificação , Clostridium tertium/efeitos dos fármacos , Clostridium tertium/isolamento & purificação , Farmacorresistência Bacteriana , Feminino , Gangrena Gasosa/tratamento farmacológico , Humanos , Hungria , Imipenem/farmacologia , Lactente , Concentração Inibidora 50 , Masculino , Meropeném/farmacologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Tigeciclina/farmacologia , Adulto Jovem
3.
Virulence ; 10(1): 657-676, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31304854

RESUMO

Some well-known Clostridiales species such as Clostridium difficile and C. perfringens are agents of high impact diseases worldwide. Nevertheless, other foreseen Clostridiales species have recently emerged such as Clostridium tertium and C. paraputrificum. Three fecal isolates were identified as Clostridium tertium (Gcol.A2 and Gcol.A43) and C. paraputrificum (Gcol.A11) during public health screening for C. difficile infections in Colombia. C. paraputrificum genomes were highly diverse and contained large numbers of accessory genes. Genetic diversity and accessory gene percentage were lower among the C. tertium genomes than in the C. paraputrificum genomes. C. difficile tcdA and tcdB toxins encoding homologous sequences and other potential virulence factors were also identified. EndoA interferase, a toxic component of the type II toxin-antitoxin system, was found among the C. tertium genomes. toxA was the only toxin encoding gene detected in Gcol.A43, the Colombian isolate with an experimentally-determined high cytotoxic effect. Gcol.A2 and Gcol.A43 had higher sporulation efficiencies than Gcol.A11 (84.5%, 83.8% and 57.0%, respectively), as supported by the greater number of proteins associated with sporulation pathways in the C. tertium genomes compared with the C. paraputrificum genomes (33.3 and 28.4 on average, respectively). This work allowed complete genome description of two clostridiales species revealing high levels of intra-taxa diversity, accessory genomes containing virulence-factors encoding genes (especially in C. paraputrificum), with proteins involved in sporulation processes more highly represented in C. tertium. These finding suggest the need to advance in the study of those species with potential importance at public health level.


Assuntos
Clostridioides difficile/genética , Clostridium tertium/genética , Genômica , Fatores de Virulência/genética , Proteínas de Bactérias/genética , Infecções por Clostridium/microbiologia , Colômbia , Variação Genética , Genoma Bacteriano , Humanos
4.
Genome Biol Evol ; 9(10): 2707-2714, 2017 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-29044436

RESUMO

Clostridium species (particularly Clostridium difficile, Clostridium botulinum, Clostridium tetani and Clostridium perfringens) are associated with a range of human and animal diseases. Several other species including Clostridium tertium, Clostridium cadaveris, and Clostridium paraputrificum have also been linked with sporadic human infections, however there is very limited, or in some cases, no genomic information publicly available. Thus, we isolated one C. tertium strain, one C. cadaveris strain and three C. paraputrificum strains from preterm infants residing within neonatal intensive care units and performed Whole Genome Sequencing (WGS) using Illumina HiSeq. In this report, we announce the open availability of the draft genomes: C. tertium LH009, C. cadaveris LH052, C. paraputrificum LH025, C. paraputrificum LH058, and C. paraputrificum LH141. These genomes were checked for contamination in silico to ensure purity, and we confirmed species identity and phylogeny using both 16S rRNA gene sequences (from PCR and in silico) and WGS-based approaches. Average Nucleotide Identity (ANI) was used to differentiate genomes from their closest relatives to further confirm speciation boundaries. We also analysed the genomes for virulence-related factors and antimicrobial resistance genes, and detected presence of tetracycline and methicillin resistance, and potentially harmful enzymes, including multiple phospholipases and toxins. The availability of genomic data in open databases, in tandem with our initial insights into the genomic content and virulence traits of these pathogenic Clostridium species, should enable the scientific community to further investigate the disease-causing mechanisms of these bacteria with a view to enhancing clinical diagnosis and treatment.


Assuntos
Clostridium tertium/classificação , Clostridium tertium/genética , Clostridium/classificação , Clostridium/genética , Clostridium/isolamento & purificação , Clostridium/patogenicidade , Clostridium tertium/isolamento & purificação , Clostridium tertium/patogenicidade , Fezes/microbiologia , Genoma Bacteriano , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Filogenia
5.
Int J Infect Dis ; 51: 44-46, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27575937

RESUMO

OBJECTIVE: Clostridium tertium is considered an uncommon pathogen in humans, but is a cause of bacteremia in patients with underlying hematological malignancies and neutropenia. A case series highlighting 10 years of experience with C. tertium as a cause of bacteremia in this population is presented; the cases were seen at a National Cancer Institute designated cancer center. METHODS: Institutional review board approval was obtained prior to the start of the study. All cases of C. tertium bacteremia seen at H. Lee Moffitt Cancer Center and Research Institute from 2005 to 2015 were reviewed. The study population was identified by positive blood cultures obtained from the microbiology laboratory over the same time period. RESULTS: Seven patients were found to have had C. tertium bacteremia. These patients had a temperature of >38.3°C at the time of diagnosis and severe neutropenia. All patients had a history of hematological malignancy, five having acute myeloid leukemia and two having myelodysplastic syndrome. All of the patients' blood cultures cleared within ≤3 days of antibiotic therapy. CONCLUSIONS: The unusual susceptibility pattern of C. tertium, with resistance to beta-lactams and clindamycin, likely explains its presence in immunosuppressed patients. Vancomycin remains the drug of choice. The pathogen continues to have a low virulence and a low mortality when treated appropriately.


Assuntos
Bacteriemia/microbiologia , Infecções por Clostridium/imunologia , Clostridium tertium , Neutropenia/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bacteriemia/etiologia , Infecções por Clostridium/diagnóstico , Feminino , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/imunologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Neutropenia/etiologia
9.
Am J Case Rep ; 16: 4-7, 2015 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-25577783

RESUMO

BACKGROUND: Clostridium tertium is distributed in the soil and in animal and human gastrointestinal tracts. C. tertium has been isolated from patients with blood diseases, immune disorders, and abdominal surgeries. Glyphosate is toxic, causing cause eye and skin irritation, gastrointestinal pain, and vomiting. Ingestion of herbicides modifies the gastrointestinal environment, which stresses the living organisms. However, there has been little attention to cases of bacteremia in patients recovering from suicide attempt by ingesting herbicide. CASE REPORT: Clostridium tertium was identified in a 44-year-old female who attempted suicide by glyphosate (a herbicide) ingestion. The 16S rRNA sequences from all colonies were 99% identical with that of C. tertium (AB618789) found on a BLAST search of the NCBI database. The bacterium was cultured on TSA under aerobic and anaerobic conditions. Antimicrobial susceptibility tests performed under both aerobic and anaerobic conditions showed that the bacterium was susceptible to penicillin, a combination of ß-lactamase inhibitor and piperacillin or amoxicillin, and first- and second- generation cephalosporins. However, it was resistant to third- and fourth-generation cephalosporins. CONCLUSIONS: Glyphosate herbicide might be a predisposing factor responsible for the pathogenesis of C. tertium. The results highlight the need for careful diagnosis and selection of antibiotics in the treatment of this organism.


Assuntos
Bacteriemia/etiologia , Infecções por Clostridium/etiologia , Clostridium tertium/isolamento & purificação , Glicina/análogos & derivados , Adulto , Bacteriemia/diagnóstico , Infecções por Clostridium/diagnóstico , Deglutição , Feminino , Glicina/envenenamento , Herbicidas/envenenamento , Humanos
10.
Int J Infect Dis ; 17(11): e1062-3, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23823278

RESUMO

Clostridium tertium is rare in a human clinical specimen and its pathogenicity is often uncertain. However, the organism has been increasingly recognized as a cause of bacteremia and other infections in immunocompromised patients, especially those with hematologic malignancies. The diagnosis and treatment of C. tertium are difficult due to its growth pattern, micromorphology, and antibiotic resistance. The organism can easily be misidentified as Gram-positive aerobic rods such as Bacillus species, usually considered as a contaminant. Furthermore, it is not covered by empirical treatment with many broad-spectrum antibiotics. Here we report a case of breakthrough bacteremia due to C. tertium that occurred in a patient with acute leukemia and neutropenic fever, who was treated with an empirical regimen of ceftazidime and amikacin. The bacterium was rapidly identified by new mass spectrometry technology (MALDI-TOF MS) and the patient recovered under meropenem and vancomycin treatment, without complications.


Assuntos
Bacteriemia/complicações , Infecções por Clostridium/complicações , Clostridium tertium , Neutropenia Febril/etiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/tratamento farmacológico , Neutropenia Febril/diagnóstico , Neutropenia Febril/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Resultado do Tratamento
11.
Rinsho Byori ; 60(8): 753-7, 2012 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-23198534

RESUMO

We have recently detected Abiotrophia defectiva (A. defectiva) from postoperative blood culture of a patient with diffuse peritonitis. Pleomorphic Gram positive rod appearance and no growth on a standard sheep blood agar led us to suspect aerotolerant anaerobe. From the test results of simplified identification kit for anaerobes, we tentatively reported Clostridium tertium (C. tertium) to the clinician. However, the analysis of 16SrRNA sequence proved it to be A. defectiva. When Gram positive coccus or pleomorphic Gram positive rod are observed on blood culture, it is recommended to incubate Brucella HK (RS) blood agar plates for 24 hours at 35 degrees C both aerobically and anaerobically. The growth both aerobically and anaerobically suggests A. defectiva and Satellitism test and Rapid ID 32 STREP(SYSMEX) testing should be performed to identify the responsible bacteria. A. defectiva is Gram positive streptococcus and requires pyridoxal hydrochloride or L-cysteine to grow. It could be unidentified or misidentified and its particularity often leads incomplete report to the clinician. Our study shows that more careful examination will increase the detection of A. defectiva.


Assuntos
Abiotrophia/isolamento & purificação , Peritonite/microbiologia , Abiotrophia/genética , Idoso , Clostridium tertium/genética , Clostridium tertium/isolamento & purificação , Feminino , Humanos , Peritonite/sangue , Peritonite/diagnóstico , RNA Ribossômico 16S/genética , Streptococcus/genética , Streptococcus/isolamento & purificação
12.
Angiol Sosud Khir ; 18(4): 120-4, 2012.
Artigo em Russo | MEDLINE | ID: mdl-23324641
13.
Int J Infect Dis ; 14 Suppl 3: e335-7, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20598605

RESUMO

We observed two cases of Clostridium tertium bacteremia three months apart in the sterile unit of our department of hematology and oncology. One patient was being treated for first-relapse acute myeloblastic leukemia, while the second was receiving high-dose chemotherapy with hematopoietic stem cell support for non-Hodgkin lymphoma. At the time that C. tertium was identified, the first patient was completely asymptomatic, while the second was highly febrile. Both responded biologically and/or clinically to antibiotherapy. We discuss the epidemiology and pathology of C. tertium in the general and cancer patient population.


Assuntos
Bacteriemia/microbiologia , Infecções por Clostridium/complicações , Clostridium tertium , Antibacterianos/uso terapêutico , Bacteriemia/complicações , Bacteriemia/tratamento farmacológico , Infecções por Clostridium/tratamento farmacológico , Infecções por Clostridium/microbiologia , Clostridium tertium/isolamento & purificação , Clostridium tertium/patogenicidade , Feminino , Humanos , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Linfoma de Células B/complicações , Linfoma de Células B/terapia , Masculino , Pessoa de Meia-Idade , Neutropenia/complicações , Adulto Jovem
14.
Anaerobe ; 13(3-4): 161-5, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17446094

RESUMO

Clostridium tertium has been increasingly reported as a human pathogen. This organism is an aerotolerant Gram-positive rod that is often mistaken for other organisms, such as Lactobacillus or Bacillus species. We describe a case of a patient with a history of intravenous drug use presenting to UCLA-Olive View Medical Center with gas gangrene of both upper extremities. The organism was initially misidentified as a Lactobacillus species on aerobic culture plates. However, terminal spore formation was detected in this isolate on a sub-cultured anaerobic culture plate and this isolate was confirmed as C. tertium biochemically and genetically by 16S rDNA sequencing. Additional DNA cloning libraries made from the formalin-fixed specimen revealed Peptoniphilus species and an uncultured Clostridium clone, but not C. tertium. C. tertium might be a causative organism of gas-producing myonecrosis but such an association has never been described. Clinicians should be aware of the phenomenon of aerotolerance of some anaerobes and need to clarify the identification of organisms if the clinical picture does not fit the isolated organism.


Assuntos
Infecções por Clostridium/microbiologia , Clostridium tertium/isolamento & purificação , Gangrena Gasosa/microbiologia , Bacteriemia , Infecções por Clostridium/diagnóstico , Clostridium tertium/citologia , Diagnóstico Diferencial , Gangrena Gasosa/diagnóstico , Infecções por Bactérias Gram-Positivas/diagnóstico , Humanos , Lactobacillus/citologia , Lactobacillus/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Infecção dos Ferimentos/microbiologia
15.
J Wildl Dis ; 42(3): 709-11, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17092908

RESUMO

Bacteriologic examination of an abscess found between blubber and musculature of a striped dolphin (Stenella coeruleoalba) found dead on 30 March 2002 in the Adriatic Sea, Croatia, was performed and an aerotolerant, nontoxogenic Clostridium tertium was isolated in pure culture. National Collections of Industrial Food and Marine Bacteria (NCIMB Ltd., Aberdeen, Scotland, UK) confirmed the results. Sequencing results showed it to be C. tertium with 100% similarity. The strain was named Clostridium tertium strain Zagreb, acceded to the culture collection and assigned the accession number NCIMB 13970. This is the first record of C. tertium in marine mammals.


Assuntos
Infecções por Clostridium/veterinária , Clostridium tertium/isolamento & purificação , Stenella/microbiologia , Animais , Infecções por Clostridium/epidemiologia , Infecções por Clostridium/patologia , Evolução Fatal , Imuno-Histoquímica/veterinária , Masculino
17.
Microbiol Immunol ; 49(11): 987-92, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16301809

RESUMO

To determine the composition of Clostridium in the feces of infants approximately 30 days old, we have developed a detection and quantification method of Clostridium paraputrificum, Clostridium perfringens, Clostridium tertium, and Clostridium difficile by species-specific primers. C. perfringens and C. difficile were detected in four fecal samples from 22 infants (18.2%), whereas C. paraputrificum was detected in three samples (16.7%). C. tertium was detected in two samples (9.1%). Moreover, the occurrences of the four species in bottle-and mix-fed infants were relatively higher than in breast-fed infants (P< 0.05). Subsequently, positive samples detected by nested PCR (polymerase chain reaction) were subjected to realtime PCR. The results showed that the numbers of C. paraputrificum, C. perfringens, C. tertium, and C. difficile ranged from about 1x10(5) to 3x10(7) cells/g wet feces.


Assuntos
Clostridium/isolamento & purificação , Fezes/microbiologia , Técnicas de Diagnóstico Molecular , Alimentação com Mamadeira , Aleitamento Materno , Contagem de Células , Clostridioides difficile/genética , Clostridioides difficile/isolamento & purificação , Clostridium/genética , Clostridium perfringens/genética , Clostridium tertium/genética , Clostridium tertium/isolamento & purificação , Primers do DNA , Estudos de Viabilidade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase/métodos , Sensibilidade e Especificidade , Especificidade da Espécie
18.
Presse Med ; 34(6): 446-7, 2005 Mar 26.
Artigo em Francês | MEDLINE | ID: mdl-15902877

RESUMO

INTRODUCTION: Clostridium tertium septicaemia, although usually described in neutropenic patients, can also occur in the absence of neutropenia, as in our case report. OBSERVATION: A 61 year-old woman presented with pain in the right hypochondrium and epigastrium, constipation and vomiting that led to the diagnosis of acute pancreatitis of biliary origin. During septic shock, analysis of the liquid of an intra-abdominal mass and the results of the blood cultures revealed a Gram positive bacillus identified as C. tertium. During laparotomy, necrotic-hemorrhagic acute pancreatitis lesions were found with subtotal colic necrosis. Analysis of the peritoneal fluid revealed C. tertium. The patient died on D 46 after several nosocomial pneumopathies without identification of C. tertium. DISCUSSION: Three factors appear related to the onset of C. tertium septicaemia: neutropenia, lesions of the intestinal mucosa and previous treatment with 3rd generation, broad spectrum, cephalosporins. Such septicaemias are rare in immunocompetent patients and do not appear to have been reported before in a context of acute pancreatitis.


Assuntos
Infecções por Clostridium/etiologia , Clostridium tertium/patogenicidade , Pancreatite/complicações , Sepse/etiologia , Doença Aguda , Infecções por Clostridium/patologia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Sepse/patologia
19.
Scand J Infect Dis ; 37(3): 230-2, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15849058

RESUMO

Clostridium tertium is infrequently isolated from blood in patients with underlying diseases. Laboratory diagnosis is often delayed because Clostridium tertium is aerotolerant and resistant to metronidazole. Clinically it is a problem because it is commonly resistant to metronidazole, clindamycin and cephalosporins. We present 3 cases illustrating these characteristics.


Assuntos
Antibacterianos/uso terapêutico , Bacteriemia , Infecções por Clostridium , Clostridium tertium , Adulto , Antibacterianos/farmacologia , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Sangue/microbiologia , Criança , Infecções por Clostridium/tratamento farmacológico , Infecções por Clostridium/microbiologia , Clostridium tertium/classificação , Clostridium tertium/efeitos dos fármacos , Clostridium tertium/genética , Meios de Cultura , Farmacorresistência Bacteriana , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade
20.
J Infect ; 50(1): 76-80, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15603846

RESUMO

Clostridium tertium septicemia is a rare condition that predominantly occurs in neutropenic patients with concomitant abdominal disease. We report the fatal case of a nonneutropenic, 51-year-old patient with mechanical ileus and post-operative C. tertium septicemia, resulting in widespread pathology with multi-organ failure. As C. tertium is aerotolerant, often gram-variable and mostly resistant to broad-spectrum cephalosporins, differentiation is difficult and empirical therapeutic strategies may fail.


Assuntos
Bacteriemia/microbiologia , Clostridium tertium/isolamento & purificação , Antibacterianos/farmacologia , Infecções por Clostridium/microbiologia , Clostridium tertium/efeitos dos fármacos , Evolução Fatal , Feminino , Humanos , Íleus/cirurgia , Imunocompetência , Intestino Delgado/cirurgia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos
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