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Antibiotic-induced lethal enterocolitis in hamsters: Studies with eleven agents and evidence to support the pathogenic role of toxin-producing clostridia

TLDR
It is concluded that toxin-producing clostridia are responsible for lethal enterocolitis due to a variety of antimicrobials in hamsters, and that Tetracycline and metronidazole were well tolerated, and the animals given these antimicroBials had no evidence of the toxin.
Abstract
Clindamycin-induced enterocolitis in hamsters was studied, using a tissue culture assay to detect clostridial toxin. It was found that animals with lethal enterocolitis had a cytopathogenic substance in cecal contents and blood that was neutralized by clostridial antitoxins. Cultures of the cecal flora yielded numerous species of clostridia, but only 1 organism was detected which produced a toxin which was cytopathic in tissue culture. This organism, Clostridium difficile, was consistently present in high concentrations, and the cell-free supernate of these strains caused enterocolitis if injected intracecally into hamsters. Ten additional antimicrobials were tested ih hamsters. Ampicillin, vancomycin, erythromycin, cephalosporins, and oral gentamicin caused lethal enterocolitis in most recipients, and all animals which died had evidence of clostridia toxin in cecal contents at necropsy. Tetracycline and metronidazole were well tolerated, and the animals given these antimicrobials had no evidence of the toxin. We conclude that toxin-producing clostridia are responsible for lethal enterocolitis due to a variety of antimicrobials in hamsters.

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Journal ArticleDOI

Clostridium difficile: its disease and toxins.

TL;DR: There appears to be a cascade of events which result in the expression of the activity of these toxins, and these events, ranging from the recognition of a trisaccharide receptor by toxin A to the synergistic action of the toxins and their possible dissemination in the body, are discussed in this review.
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Antibiotic-Associated Pseudomembranous Colitis

TL;DR: Evidence that supports the etiologic role of this organism in antibiotic-associated PMC comes from both bacteriological studies and tissue culture assays, which demonstrate that the stool supernate from nearly all patients with anatomically confirmed PMC contains a cytotoxin that is neutralized with Clostridium sordellii antitoxin.
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Biological activities of toxins A and B of Clostridium difficile.

TL;DR: Both toxins elicited erythematous and hemorrhagic skin reactions and increased vascular permeability in rabbit skin and did not produce a significant fluid response in either model, although the toxin was more lethal in infant mice.
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Clinical and laboratory observations in Clostridium difficile colitis.

TL;DR: The purpose of the present report is to review some of the recent observations from this laboratory regarding C. d fJIcile and antibiotic-associated pseudomembranous colitis.
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Symptomatic relapse after oral vancomycin therapy of antibiotic-associated pseudomembranous colitis

TL;DR: The experience emphasizes the importance of adequate followup in patients treated with oral vancomycin for antibiotic-associated diarrhea or colitis due to C. difficile despite susceptibility to this agent with in vitro testing.
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