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poisoning can also lead to another disease known as enteritis necroticans or clostridial necrotizing enteritis also known as pigbel this is caused by c perfringens type c this infection is often fatal large numbers of c perfringens grow in the intestines and secrete exotoxin this exotoxin causes necrosis of the intestines varying levels of hemorrhaging and perforation of the intestine inflammation usually occurs in sections of the jejunum midsection of the small intestine 62 symptoms cover a wide range and can vary in severity the clinical signs range from mild diarrhea to more severe manifestations such as intense abdominal pain vomiting bloody stools and even septic shock 63 perfringolysin o pfoa positive c perfringens strains were also associated with the rapid onset of necrotizing enterocolitis in preterm infants 50 other clinical manifestations edit c perfringens is most commonly known for foodborne illness but can translocate from a gastrointestinal source into the bloodstream and cause bacteremia c perfringens bacteremia can lead to toxin mediated intravascular hemolysis and septic shock 64 this is rare as it makes up less than 1 of bloodstream isolates but is highly fatal with a reported mortality rate of 27 to 58 65 a strain of c perfringens might be implicated in multiple sclerosis ms nascent pattern iii lesions 66 tests in mice found that two strains of intestinal c perfringens that produced epsilon toxins etx caused ms like damage in the brain and earlier work had identified this strain of c perfringens in a human with ms 67 68 ms patients were found to be 10 times more likely to be immune reactive to the epsilon toxin than healthy people 69 greatly increased rates of gut colonization by type b and d c perfringens are seen in ms patients 68 tissue gas occurs when c perfringens infects corpses it causes extremely accelerated decomposition and can only be stopped by embalming the corpse tissue gas most commonly occurs with those who have died from gangrene large decubitus ulcers necrotizing fasciitis or those who had soil feces or water contaminated with c perfringens forced into an open wound 70 diagnosis edit the diagnosis of clostridium perfringens food poisoning relies on laboratory detection of the bacterium or its toxin in either a patient s stool sample or contaminated food linked to the illness a positive stool culture would have growth of at least 10 cfu g of c perfringens stool studies include wbcs ova and parasites in order to rule out other potential etiologies elisa testing is used to detect the cpa toxin diagnosis of c perfringens food poisoning is relatively uncommon for several reasons 71 most individuals with this foodborne illness do not seek medical care or submit a stool sample for testing and routine testing for c perfringens is not typically performed in clinical laboratories additionally public health laboratories generally conduct testing for this pathogen only in the event of an outbreak 72 the diagnosis of gas gangrene typically involves several methods to confirm the infection imaging techniques such as x rays ct scans or mris can reveal gas bubbles or tissue changes indicative of muscle damage additionally bacterial staining or culture of fluid taken from the wound helps identify clostridium perfringens and other bacteria responsible for the infection in some cases a biopsy is performed where a sample of the affected tissue is analyzed for signs of damage or necrosis 61 the diagnosis of clostridial necrotizing enteritis is primarily based on the patient s clinical symptoms which can include severe abdominal pain vomiting and bloody diarrhea additionally confirmation of the presence of clostridium perfringens type c toxin in stool samples is crucial for accurate diagnosis 63 epidemiology edit clostridium perfringens is responsible for an estimated 966 000 cases annually or about 10 3 of all foodborne illnesses in which a pathogen is identified 73 transmission typically occurs when food contaminated with c perfringens spores is consumed allowing the bacteria to produce a toxin in the intestines that causes diarrhea outbreaks are often associated with foods cooked in large batches such as poultry meat and gravy and held at unsafe temperatures between 40 and 140 f which allows the bacteria to thrive each year c perfringens infections result in approximately 438 hospitalizations and 26 deaths accounting for 0 8 of foodborne illness related hospitalizations and 1 9 of associated deaths 73 the economic burden of c perfringens is significant estimated at 342 7 million annually including 53 2 million in medical costs 64 3 million in productivity loss and 225 million related to fatalities 73 74 prevention edit c perfringens spores can multiply within a temperature range of 59 f 15 c to 122 f 50 c 75 to prevent bacterial growth leftovers should be refrigerated within two hours of preparation with their temperature chilled down to below 40 f 4 c large portions of food that contain meat should be divided into smaller containers before refrigeration to ensure even cooling before serving leftovers they should be reheated to at least 165 f 74 c to destroy any bacteria that may have grown during storage 76 canned vegetables smoked or cured meats and salted or smoked fish require additional attention 77 preventing gas gangrene involves taking precautions to avoid bacterial infections healthcare providers follow strict protocols to prevent infections including those caused by clostridium perfringens to reduce the risk of gas gangrene individuals should clean wounds thoroughly with soap and water and seek medical attention for deep or difficult to clean wounds it is also essential to monitor injuries for changes in skin condition or the onset of severe pain additionally working with healthcare providers to manage underlying conditions that affect circulation or weaken the immune system can further reduce the risk of infection 61 treatment edit the treatment of clostridium perfringens infections depends on the type and severity of the condition for severe infections such as gas gangrene clostridial myonecrosis the primary approach involves surgical debridement of the affected area this procedure removes devitalized tissue where bacteria grow which limits the spread of the infection antimicrobial therapy is usually started at the same time with penicillin being the most commonly used drug 78 however c perfringens shows different resistance patterns with about 20 of strains being resistant to clindamycin and 10 being resistant to metronidazole 79 c perfringens is often more susceptible to vancomycin when compared to other pathogenic clostridia making it an alternative option for treatment in some cases 78 therapies such as hyperbaric oxygen therapy hbot may also be used for severe clostridial tissue infections hbot increases oxygen delivery to infected tissues creating an environment that inhibits the growth of anaerobic bacteria like c perfringens while not commonly used hbot can be beneficial in certain cases 80 for foodborne illness caused by c perfringens treatment is typically unnecessary most people who suffer from food poisoning caused by c perfringens usually fight off the illness without the need of any antibiotics extra fluids should be drunk consistently until diarrhea dissipates 81 research edit c perfringens has shown increasing multidrug resistance particularly in strains from humans and animals high resistance levels were found with antibiotics such as tetracycline erythromycin and sulfonamides genetic factors misuse of antibiotics and bacterial evolution are the cause of this issue 82 multilocus sequence typing mlst and whole genome sequencing wgs have been used to find the genetic diversity of c perfringens these methods have identified 195 distinct sequence types grouped into 25 clonal complexes from 322 genomes phylogenetic groups were also found in multiple different hosts and environmental sources this highlights the bacteria s transmission potential and adaptability across species 83 while the majority of research of pathogenic c perfringens has been on avian species there is some research into aquatic species previous research into aquatic species containing the bacterium has shown that spores of c perfringens were detected in the sludge where fish and shellfish live explaining that it should theoretically be possible to contaminate aquatic species in this new research it is found that out of 141 fish and healthy aquatic samples there were 80 positive samples of c perfringens of which 26 samples of raw clam were tested and 22 were found to have a positive result and 15 samples were cooked clam and 14 were found to be positive for the c perfringens pathogen 84 references edit ryan kenneth j ray c george 2004 sherris medical microbiology an introduction to infectious diseases 4th ed new york mcgraw hill p 310 isbn 978 0 8385 8529 0 kiu r hall l j 2018 an update on the human and animal enteric pathogen clostridium perfringens emerging microbes infections 7 141 141 doi 10 1038 s41426 018 0144 8 pmc 6079034 pmid 30082713 bionumber details page bionumbers 1 2 yao phil y annamaraju pavan 2025 clostridium perfringens infection statpearls treasure island fl statpearls publishing pmid 32644475 retrieved 2025 10 28 foodborne illnesses and germs centers for disease control and prevention cdc 2018 02 16 retrieved 18 february 2018 juckett g bardwell g mcclane b brown s 2008 microbiology of salt rising bread the west virginia medical journal 104 4 26 7 pmid 18646681 hendrix nancy mackeen a weiner stuart 2011 01 24 clostridium perfringens sepsis and fetal demise after genetic amniocentesis american journal of perinatology reports 1 1 025 028 doi 10 1055 s 0030 1271221 issn 2157 6998 pmc 3653538 pmid 23705080 lexicon orthopaedic etymology crc press 1999 p 128 isbn 978 90 5702 597 6 1 2 3 hendrix nancy mackeen a weiner stuart 2011 01 24 clostridium perfringens sepsis and fetal demise after genetic amniocentesis american journal of perinatology reports 1 1 025 028 doi 10 1055 s 0030 1271221 issn 2157 6998 pmc 3653538 pmid 23705080 takehara masaya takagishi teruhisa seike soshi ohtani kaori kobayashi keiko miyamoto kazuaki shimizu tohru nagahama masahiro 2016 06 16 clostridium perfringens α toxin impairs innate immunity via inhibition of neutrophil differentiation scientific reports 6 1 28192 bibcode 2016natsr 628192t doi 10 1038 srep28192 issn 2045 2322 pmc 4910053 pmid 27306065 grenda tomasz jarosz aleksandra sapała magdalena grenda anna patyra ewelina kwiatek krzysztof 2023 05 26 clostridium perfringens opportunistic foodborne pathogen its diversity and epidemiological significance pathogens 12 6 768 doi 10 3390 pathogens12060768 issn 2076 0817 pmc 10304509 pmid 37375458 1 2 gulliver emily l adams vicki marcelino vanessa rossetto gould jodee rutten emily l powell david r young remy b d adamo gemma l hemphill jamia solari sean m revitt mills sarah a munn samantha jirapanjawat thanavit greening chris boer jennifer c 2023 04 20 extensive genome analysis identifies novel plasmid families in clostridium perfringens microbial genomics 9 4 doi 10 1099 mgen 0 000995 issn 2057 5858 pmc 10210947 pmid 37079454 s2cid 258238878 1 2 3 elnar arxel g kim geun bae 2021 11 30 complete genome sequence of clostridium perfringens b20 a bacteriocin producing pathogen journal of animal science and technology 63 6 1468 1472 doi 10 5187 jast 2021 e113 issn 2672 0191 pmc 8672250 pmid 34957460 1 2 revitt mills sarah a rood julian i adams vicki 2015 clostridium perfringens extracellular toxins and enzymes 20 and counting microbiology australia 36 3 114 117 doi 10 1071 ma15039 issn 1324 4272 retrieved 2025 08 15 wambui joseph cernela nicole stevens marc j a stephan roger 2021 09 13 whole genome sequence based identification of clostridium estertheticum complex strains supports the need for taxonomic reclassification within the species clostridium estertheticum frontiers in microbiology 12 727022 doi 10 3389 fmicb 2021 727022 issn 1664 302x pmc 8473909 pmid 34589074 1 2 3 4 ohtani kaori shimizu tohru 2016 07 05 regulation of toxin production in clostridium perfringens toxins 8 7 207 doi 10 3390 toxins8070207 issn 2072 6651 pmc 4963840 pmid 27399773 1 2 3 4 kiu raymond caim shabhonam alexander sarah pachori purnima hall lindsay j 2017 probing genomic aspects of the multi host pathogen clostridium perfringens reveals significant pangenome diversity and a diverse array of virulence factors frontiers in microbiology 8 2485 doi 10 3389 fmicb 2017 02485 pmc 5733095 pmid 29312194 kiu raymond hall lindsay j 2018 12 01 an update on the human and animal enteric pathogen clostridium perfringens emerging microbes infections 7 1 141 doi 10 1038 s41426 018 0144 8 pmc 6079034 pmid 30082713 1 2 jaakkola kaisa virtanen kira lahti päivi keto timonen riikka lindström miia korkeala hannu 2021 09 08 comparative genome analysis and spore heat resistance assay reveal a new component to population structure and genome epidemiology within clostridium perfringens enterotoxin carrying isolates frontiers in microbiology 12 717176 doi 10 3389 fmicb 2021 717176 issn 1664 302x pmc 8456093 pmid 34566921 miyamoto kazuaki li jihong mcclane bruce a 2012 enterotoxigenic clostridium perfringens detection and identification microbes and environments 27 4 343 349 doi 10 1264 jsme2 me12002 issn 1342 6311 pmc 4103540 pmid 22504431 s2cid 7743606 gulliver emily l adams vicki marcelino vanessa rossetto gould jodee rutten emily l powell david r young remy b d adamo gemma l hemphill jamia solari sean m revitt mills sarah a munn samantha jirapanjawat thanavit greening chris boer jennifer c 2023 extensive genome analysis identifies novel plasmid families in clostridium perfringens microbial genomics 9 4 000995 doi 10 1099 mgen 0 000995 issn 2057 5858 pmc 10210947 pmid 37079454 adams vicki han xiaoyan lyras dena rood julian i september 2018 antibiotic resistance plasmids and mobile genetic elements of clostridium perfringens plasmid 99 32 39 doi 10 1016 j plasmid 2018 07 002 pmid 30055188 s2cid 51866356 kiu raymond caim shabhonam alexander sarah pachori purnima hall lindsay j 2017 12 12 probing genomic aspects of the multi host pathogen clostridium perfringens reveals significant pangenome diversity and a diverse array of virulence factors frontiers in microbiology 8 2485 doi 10 3389 fmicb 2017 02485 issn 1664 302x pmc 5733095 pmid 29312194 1 2 liu hualan mccord kristin d howarth jonathon popham david l jensen roderick v melville stephen b july 2014 hypermotility in clostridium perfringens strain sm101 is due to spontaneous mutations in genes linked to cell division journal of bacteriology 196 13 2405 2412 doi 10 1128 jb 01614 14 issn 0021 9193 pmc 4054169 pmid 24748614 1 2 3 valeriani renzo g beard lamonta l moller abraham ohtani kaori vidal jorge e 2020 12 01 gas gangrene associated gliding motility is regulated by the clostridium perfringens cpal virsr system anaer...