Neutralization of Clostridium difficile toxin by Clostridium sordellii antitoxins.
TLDR
The efficacy of antitoxin in preventing cytotoxicity in cultured cells preexposed to toxin decreased rapidly with preexposure time, and a practical diagnostic method for antibiotic-induced colitis is outlined.Abstract:
Neutralization of Clostridium difficile toxin by Clostridium sordellii antitoxin was studied by cytotoxicity assay in tissue culture. The sources of toxin were stools from two patients with pseudomembranous colitis and a culture filtrate of C. difficile isolated from one of the patients. C. sordellii antitoxin was available either in monovalent form or as gas gangrene polyvalent antitoxin. The potency of antitoxins against C. difficile determined by cytotoxicity assay did not correlate with the established values reported for mouse protection tests against C. sordellii toxin. An equivalent zone of optimal neutralization was demonstrated for stool toxin, and a slightly different one for culture toxin. The rate of neutralization appeared to be instantaneous, either at 24 or at 37 degrees C. The efficacy of antitoxin in preventing cytotoxicity in cultured cells preexposed to toxin decreased rapidly with preexposure time. The union between toxin and antitoxin could be readily dissociated by simple dilution or by ammonium sulfate precipitation followed by dissociated by simple dilution or by ammonium sulfate precipitation followed by dilution. Continued incubation of toxin-antitoxin mixture did not increase the firmness of the union; on the contrary, more dissociation occurred. The unusual looseness of the toxin-antitoxin union is probably relatd to lack of serological specificity or affinity. Based on these observations, a practical diagnostic method for antibiotic-induced colitis is outlined.read more
Citations
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Journal ArticleDOI
Clostridium difficile Toxins: Mechanism of Action and Role in Disease
Daniel E. Voth,Jimmy D. Ballard +1 more
TL;DR: There have been major advances in defining the role of these toxins in modulating the inflammatory events involving the disruption of cell junctions, neuronal activation, cytokine production, and infiltration by polymorphonuclear cells.
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European Society of Clinical Microbiology and Infectious Diseases (ESCMID): Data review and recommendations for diagnosing Clostridium difficile-infection (CDI)
TL;DR: To overcome the problem of a low PPV, the present systematic review proposes a two step approach, with a second test or a reference method in case of a positive first test, and emphasizes the need for better diagnostic tests.
Journal ArticleDOI
Cytotoxicity Assay in Antibiotic-Associated Colitis
Te Wen Chang,Te Wen Chang,Michael Lauermann,Michael Lauermann,John G. Bartlett,John G. Bartlett +5 more
TL;DR: Recommendations for performing the tissue culture assay for the toxin found in stools of patients with antibiotic-associated colitis are provided on the basis of these observations.
Journal ArticleDOI
Clostridium sordellii Infection: Epidemiology, Clinical Findings, and Current Perspectives on Diagnosis and Treatment
Michael J. Aldape,Michael J. Aldape,Amy E. Bryant,Amy E. Bryant,Dennis L. Stevens,Dennis L. Stevens +5 more
TL;DR: Eighty-five percent of all patients with fatal cases died within 2-6 days of initial infection, and nearly 80% of fatal cases developed leukemoid reactions.
Journal ArticleDOI
Impact of Clinical Symptoms on Interpretation of Diagnostic Assays for Clostridium difficile Infections
Erik R. Dubberke,Zhuolin Han,Linda D. Bobo,Tiffany Hink,Brenda Lawrence,Susan Copper,Joan Hoppe-Bauer,Carey-Ann D. Burnham,William Michael Dunne +8 more
TL;DR: In this paper, the authors measured how including patient presentation with the C. difficile assay result impacted assay performance to diagnose CDI and found that clinical presentation is important when interpreting C.difficile diagnostic assays.
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TL;DR: This case shows that psittacosis may present with minimal respiratory disturbance and with a clinical picture resembling rheumatic fever with erythema marginatum and polyarthritis, and implicate Cl sordellii, or an organism producing an antigenically similar toxin, as the causal agent.
Journal ArticleDOI
Antibiotic-induced colitis implication of a toxin neutralised by clostridium sordellii antitoxin
TL;DR: One patient improved rapidly after treatment with oral vancomycin, and at the same time the toxin disappeared from the stool, and these characteristics were identical to those of a toxin implicated in the aetiology of antibiotic-induced colitis in the hamster.