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This bacterium produces two toxins, Clostridium difficile toxin A (TcdA) and Clostridium difficile toxin B (TcdB). These toxins inactivate small GTP-binding proteins, resulting in actin condensation and cell rounding, followed by cell death. Infections begin with focal necrosis, then ulceration with exudate, and can progress to pseudomembranous colitis , which involves inflammation of the colon and the development of a pseudomembrane of fibrin containing dead epithelial cells and leukocytes ( [link] ). Watery diarrhea, dehydration, fever, loss of appetite, and abdominal pain can result. Perforation of the colon can occur, leading to septicemia, shock, and death. C. difficile is also associated with necrotizing enterocolitis in premature babies and neutropenic enterocolitis associated with cancer therapies.

A diagram showing the lining of the stomach. At the very bottom is a blood vessel with red blood cells, neutrophils, and monocytes. At the top is a wavy layer of epithelial cells covered in mucous. A variety of bacteria (different shapes and colors to indicate different species) are seen on the mucus. In one region is a cluster of rod shaped cells labeled Clostridium difficile that release small dots labeled TcdA and TcdB. These create a pseudomembrane that is a swelling above destroyed epithelial cells. In response neutrophils and monocytes released.
Clostridium difficile is able to colonize the mucous membrane of the colon when the normal microbiota is disrupted. The toxins TcdA and TcdB trigger an immune response, with neutrophils and monocytes migrating from the bloodstream to the site of infection. Over time, inflammation and dead cells contribute to the development of a pseudomembrane. (credit micrograph: modification of work by Janice Carr, Centers for Disease Control and Prevention)

Diagnosis is made by considering the patient history (such as exposure to antibiotics), clinical presentation, imaging, endoscopy, lab tests, and other available data. Detecting the toxin in stool samples is used to confirm diagnosis. Although culture is preferred, it is rarely practical in clinical practice because the bacterium is an obligate anaerobe. Nucleic acid amplification tests, including PCR, are considered preferable to ELISA testing for molecular analysis.

The first step of conventional treatment is to stop antibiotic use, and then to provide supportive therapy with electrolyte replacement and fluids. Metronidazole is the preferred treatment if the C. difficile diagnosis has been confirmed. Vancomycin can also be used, but it should be reserved for patients for whom metronidazole was ineffective or who meet other criteria (e.g., under 10 years of age, pregnant, or allergic to metronidazole).

A newer approach to treatment, known as a fecal transplant , focuses on restoring the microbiota of the gut in order to combat the infection. In this procedure, a healthy individual donates a stool sample, which is mixed with saline and transplanted to the recipient via colonoscopy, endoscopy, sigmoidoscopy, or enema. It has been reported that this procedure has greater than 90% success in resolving C. difficile infections. Faith Rohlke and Neil Stollman. “Fecal Microbiota Transplantation in Relapsing Clostridium difficile Infection,” Therapeutic Advances in Gastroenterology 5 (2012) 6: 403–420. doi: 10.1177/1756283X12453637.

  • How does antibiotic use lead to C. difficile infections?

Foodborne illness due to Bacillus cereus

Bacillus cereus , commonly found in soil, is a gram-positive endospore-forming bacterium that can sometimes cause foodborne illness. B. cereus endospores can survive cooking and produce enterotoxins in food after it has been heated; illnesses often occur after eating rice and other prepared foods left at room temperature for too long. The signs and symptoms appear within a few hours of ingestion and include nausea, pain, and abdominal cramps. B. cereus produces two toxins: one causing diarrhea, and the other causing vomiting. More severe signs and symptoms can sometimes develop.

Questions & Answers

with the aid of a well labeled diagram describe the conducting system
Maridad Reply
what is cellular immunity
namugenyi Reply
Cellular Immunity. -Lymphocytes act against target cell. -Acts directly by killing infected cells.
abdinor
What are NK cells
Peter
Natural killer cells
Rahaba
what are Antigen determinant
mary
cellular immunity is the state where the lymphocytes destroy the infected or targeted cell
cynthia
any examples of oedema
cynthia
introduction of microbial diversity-1
Bhavanimangali Reply
List the type of micro organism arround us and how they can be seen and with what kind of instrument
clinton Reply
how is the arrangements of bacteria in bacilli
Vaidah Reply
Provide some examples of bacterial structures that might be used as antibiotic targets and explain why.
Vaidah
Coccobacilli, Club-Shaped bacilli, Bacilli with rounded ends, Fuilform bacilli, Bacilli with ends square.
Enoch
three main antibiotic targets in bacteria: The cell wall or membranes that surrounds the bacterial cell. The machineries that make the nucleic acids DNA and RNA. The machinery that produce proteins
Rushikesh
The bacterial cell wall. Protein production. and DNA synthesis. Why, this is because most drugs (antibiotics) affects the cell wall of the bacteria, which makes the bacteria weak or susceptible in human body.
Enoch
UV rays affecting the..
Mali Reply
what is microbiology
Baba Reply
Microbiology is the study of microorganisms, which are prokaryotic and eukaryotic cell which includes bacteria, fungi, viruses and pathogenic protozoa.
Enoch
Microbiology is the branch of Life science which deals with scientific study of many Microorganisms.
Rushikesh
what is types of microbiology
Alsheikh
Immunology, Bacteriology, Virology, Mycology, Algology etc
Enoch
Virology, Immunology, Bacteriology, Algology, Mycology, Protoozology etc
Enoch
and what is mycology
Alsheikh
Immunology, Serology, Virology, Microbial Genetics, Parasitology, Bacteriology, Mycology, Molecular, Cell Biology, Agricultural, Water,Soil, Food Industrial ,Pharmaceutical, Applied, Environmental, Clinical, Medical,Marine Microbiology, Microbial Systematics, Etc, are & many types of Microbiology.
Rushikesh
study of fungi is called mycology
Munna
Mycology is the branch of Microbiology which deals with scientific study of Fungi.
Rushikesh
Study of microorganisms,which we can't see with our naked eye is called microbiology
Munna
Mycology is the scientific study of Fungi.
Enoch
virology is the study of viruses
Oppah
what is microbiology? microbiology is the study of small microorganisms that we can not with our naked eyes.
Leticia
what is taxonomical classification of microbiology
Bami
The algae, protozoa, slime moulds, fungi, bacteria, archaea and viruses ,are taxonomic classification of Microorganisms
Rushikesh
We have Bacteria, Archaea, Protozoa, Algae, Fungi, Viruses.
Enoch
microbiology is the study of microbes too small to be seen by naked eyes
Maridad
microbiology is a branch of biology which deals with study of smallest living microrganisms such as bacteria protozoa fungi and viruses
Chaitra
microbiology is the study of microorganisms which can't be seen by our naked eyes
Nakaweesi
Micro - Minute Bio - Life Logus - Study
Roshan
what is the meaning of antimicrobial susceptibility testing
Devshree Reply
seven gram positive bacteria
Okocha Reply
seven examples of gram negative bacteria
Okocha
seven examples of gram negative bacteria
Okocha
Physical conditions that would enable selective Isolation of staphylococcus epidermis
shongile Reply
Nutritional requirements that would enable selective Isolation of staphylococcus epidermis
shongile
Nutritional requirements that would enable selective Isolation of staphylococcus epidermis
shongile
what is constant flux but
Jane Reply
Digestion of food is completed in __
Amina Reply
Small Intestine
Enoch
large inteatine
Abdiwali
small intestine
Betelhem
Small intestine
Abdirisaq
small intestine
Marah
small intestine specific in illum
Mariam
difference btwn hausteria and appears
Raviha Reply
numerical and molecular taxanomy
Dhanshri Reply
difference btwn hausteria and appesorium
Raviha
full life cycle of plasmodium parasite
Emmah Reply

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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