The Detection of Clostridium welchii in the Differential Reinforced Clostridial Medium Technique

S ummary . The enumeration of sparse populations of clostridia by a total clostridia count technique in a fluid medium (DRCM) gives small estimates of the numbers of Clostridium welchii. This organism may be readily detected in mixed 'presumptive total' clostridia cultures by streaking on lactose-egg yolk-milk agar before pasteurizing these cultures. The results of screening poultry carcases and processing plants with this technique are presented and the incidence of Cl. welchii on 3 sites of poultry carcases (breast, vent and neck skin) are compared for 3 processing plants.     

The Differentiation of Various Strains of Clostridium botulinum and Transformation Experiments with Type E

The colonial forms and other characteristics of toxigenic and less toxigenic (hypotoxigenic) variants of Clostridium botulinum types A, B, C, D and E are described. In addition to differences in the appearance of the colonies the hypotoxigenic variants were able to produce larger numbers of spores. Transformation from one form to the other was found when they were grown in Robertson's meat broth to which sterile culture filtrates (boiled or unboiled) from the other form was added. A transformation from hypotoxigenic variants to toxigenic forms was also found when hypotoxigenic forms were grown in Robertson's medium to which the sterile culture filtrate (boiled or unboiled) of a strain of Cl. welchii had been added. The possibility of contamination of the cultures is emphasized.
A final appraisal of the situation must be reserved until experiments with single cell isolates have been performed.     

OBSERVATIONS ON THE ANAEROBES PRESENT IN A CITY WATER SUPPLY, WITH SPECIAL REFERENCE TO CLOSTRIDIUM WELCHII

SUMMARY: Black colonies 3 mm or more in diameter, which developed in Wilson & Blair's medium inoculated with samples of untreated water from a city water supply, were examined for their anaerobe content by isolation of pure cultures and by subculture in milk. It was shown that the development of such colonies almost always signifies the presence of clostridia, usually Cl. welchii , and that subculture of such a colony into milk gives reliable confirmation of the presence of clostridia in general and of Cl. welchii in particular.
Fifty strains of Cl. welchii isolated from the water supply were examined, but none was found to be of the heat-resistant food-poisoning variety described by Hobbs et al. (1953).     

Clostridium difficile in association with sporadic diarrhoea.

A total of 154 patients admitted to an infectious diseases unit were included in a year''s prospective survey of sporadic diarrhoeal disease. Stools from 19 of them yielded Clostridium difficile, generally on more than one occasion. Twelve of these patients were assessed as having a severe or moderately severe gastrointestinal illness: Cl difficile was the only pathogen isolated from 10 of them, and two had an associated salmonella infection. Seven had had a recent course of antibiotics, but five had not taken antibiotics. Faeces from seven patients with moderate or mild gastrointestinal illness yielded Cl difficile, and two of these patients also had an associated salmonella infection. Two patients in this group had no antibiotic history. From these findings, the occurrence of C difficile in faeces could not be described as antibiotic-associated. Faecal Cl difficile cytotoxin was detected in only six patients, and generally at low levels. In such patients a more relevant pathogenic index might take account of the numbers of Cl difficile present and of their toxigenic potential.     

The Incidence of Organisms of the Genus Clostridium in Vacuum Packed Fish in the United Kingdom

Of a total of 224 samples of commercial vacuum packed fish products examined for the presence of Clostridium spp., 151 gave positive cultures. The predominant species was Cl. welchii; Cl. botulinum was not isolated. Spore suspensions of 29 strains of Cl. welchii were tested for heat resistance; none survived treatment for 5 min at 100°.     

The stoicheiometry of electron transfer by bacterial and plant ferredoxins

1. The number of electrons carried by ferredoxins from spinach, the blue-green alga Anacystis nidulans, the anaerobic bacterium Clostridium welchii and the photosynthetic bacterium Chromatium was determined. 2. Ferredoxins were reduced by illuminated chloroplasts, and the stoicheiometry of the reoxidation in the dark of the ferredoxins by NADP and benzyl viologen was measured. 3. Spinach and A. nidulans ferredoxins were found to be one-electron carriers, and Cl. welchii and Chromatium ferredoxins were two-electron carriers.     

Contamination of Pig Carcasses at Two Abattoirs by Escherichia coli with Special Reference to O-serotypes and Antibiotic Resistance

Evidence of the source of carcass contamination of pigs at slaughter was obtained by determining presumptive coliform counts on faeces and on carcass surfaces, and comparing the O-serotypes and antibiotic sensitivity patterns of Escherichia coli from both sites. All of the 16 pig carcasses from the slaughter line of a commercial abattoir were contaminated with presumptive coliform bacilli on most sites examined; the carcasses of six out of eight pigs slaughtered at the Meat Research Institute (MRI) abattoir were also contaminated, but only small numbers of coliforms could be detected on a few of the sites. The proportion of O-serotypes of E. coli present in faeces which were also detected on carcass surfaces, indicating faecal contamination, varied between 0 and 8.6% in MRI slaughtered pigs but reached 66.6% in one group of commercially slaughtered pigs. O-serotypes found on carcass surfaces but not in the faeces of the pigs, were used as an indication of environmental contamination and this was very evident in the commercially slaughtered pigs. A high proportion of E. coli O-serotypes in the gut were resistant to antibiotics and these were also often found on the carcass surface and, since the range of O-serotypes in the pig is similar to that reported in man, the pig must be considered to be a potential reservoir of antibiotic resistant E. coli for man.     

The incidence and level of Listeria monocytogenes contamination of food sources at primary production and initial processing

Listeria monocytogenes was isolated in low numbers from a variety of environmental samples associated with the primary production of food, including vegetation, faeces and meat. The organism was rarely detected on growing grass and vegetables prior to processing. The excretion of L. monocytogenes by farm animals was linked to their diet, with animals fed entirely on hay or manufactured diets not excreting detectable levels of Listeria (i.e. absence in 25 g). However, animals fed on silage, which is frequently contaminated with L. monocytogenes , commonly excreted the organism. Transport of live animals over long distances (> 100 km) significantly increased the level of excretion of Listeria , but the contamination of carcasses of sheep and cattle was not high. Pigs and poultry faeces were free of Listeria prior to slaughter and pig carcasses were not found to have Listeria present. Frozen and chilled chicken did show detectable levels reflecting the greater potential for contamination during poultry processing. Samples of minced beef were tested and 21 of 23 samples were positive for L. monocytogenes , demonstrating that processing significantly increases the level of contamination compared to whole carcasses. Multilocus enzyme electrophoresis of a representative selection of the isolates showed that there was a wide range of electrophoretic types present in the primary production environment, relatively few of which have been linked to cases of human listeriosis. However, these types do arise on farms and occasional contamination of food raw material by potentially virulent strains may be sufficient to allow adaptable strains to become established in the processing environment and thus be responsible for more widespread contamination of the food available to the consumer.     

Fecundity and egg output by Toxocara canis in the red fox, Vulpes vulpes

The role of the red fox Vulpes vulpes in the dissemination of eggs of Toxocara canis into the environment is considered with reference to female worm fecundity and egg output in the faeces of infected foxes collected from four localities in southern England. A significant positive correlation was found between female worm size and the number of eggs in the uterus but there was no significant relationship between T. canis worm numbers and egg output in fox faeces. Reliable estimates of worm burdens in foxes could not, therefore, be determined from faecal egg counts alone. The highest mean egg output of 2145.0 epg recorded from adult foxes indicated that fox cubs are not necessarily the main sources of environmental contamination with T. canis eggs. Saturated magnesium sulphate was found to be a more effective flotation solution than zinc sulphate and sodium chloride for recovering eggs from fox faecal samples.     

Prototheca zopfii: Natural,transient, occurrence in pigs and rats

Domestic swine faeces and fresh faeces from trapped barnyard rats were heavily contaminated with Prototheca zopfii, a cause of dairy cow mastitis. When the pigs and rats were maintained on Prototheca-free diets, the transient intestinal population of P. zopfii decreased precipitously and disappeared. When combined with the information that other farm animals excrete P. zopfii, it was concluded that contaminated animal feed may be the source of large numbers of P. zopfii in the farm environment. We found P. zopfii in wet spoiled feed. Rats are logical vectors for contamination of feed.     

Bacterial contamination of the small intestine is an important cause of occult malabsorption in the elderly.

A study was conducted to examine the contribution that occult malabsorption makes to malnutrition among elderly patients admitted to an acute geriatric ward. Malnutrition was defined by anthropometric, haematological, and biochemical measurements. Out of 490 patients, 55--many of whom had presented with non-gastrointestinal symptoms--were found to be malnourished. In 31 poor diet alone was probably the cause, but in the remaining 24 patients previously unrecognised malabsorption was detected. Of these patients, 17 were found to have bacterial contamination of the small bowel (nine with duodenojejunal diverticula, four after gastric surgery, and four diagnosed as contamination with "no sump"). In 10 patients contamination was confirmed by culture of intestinal juice: Escherichia coli was predominant in nine cases, and anaerobic organisms in one. Small bowel bacterial overgrowth without a "blind loop" or obvious underlying cause has not previously been fully proved in the elderly. Coeliac disease was detected in two patients, and chronic pancreatitis in two. Occult malabsorption is an important cause of malnutrition in the elderly. Such malnutrition not infrequently occurs in geriatric patients presenting to hospital with non-specific symptoms of physical deterioration.     

Intestinal parasites in the Camiri, Gutierrez and Boyuibe areas, Santa Cruz Department, Bolivia

A parasitological study was carried out on 381 apparently healthy subjects from Camiri, Boyuibe, Gutierrez. Intestinal parasites and non-pathogenic protozoa were present in 78.7% of the population sampled; multiple infections were observed in 67.7% of the parasitized individuals. The protozoon most commonly found was Entamoeba coli (in 40.7% of specimens), followed by Giardia intestinalis (30.7%), Iodamoeba bütschlii (10%), Chilomastix mesnili (8.7%). Other protozoon parasites also present were Enteromonas hominis (3.4%), Retortamonas intestinalis (2.4%), Cryptosporidium (2.1%), Endolimax nana (2.1%), Balantidium coli (1.8%) and Pentatrichomonas hominis (0.8%). The helminths observed were hookworms (28.6%), Trichuris trichiura (19.7%), Ascaris lumbricoides (9.7%), Hymenolepis nana (8.7%), Trichostrongylus (5.5%), Strongyloides stercoralis (1.8%), Taenia (5 cases) and Enterobius (6 cases). Prevalence for nematodes is probably underestimated in the 3-9 years age group because of a mebendazole treatment given 5 weeks before the survey, under a Program of P D C of the Ministry of Health. The sample from Camiri was found to be the most parasitized (84.1%). An extraordinarily high infection rate was found in two urban institutions, as well as in Itanambicua, a rural community close to Camiri. No significant differences were observed in parasitic prevalence between rural and urban environments. Exposure to contamination with human and animal faeces, overcrowding and poor sanitation habits are some of the factors responsible for the parasitic situation evidenced.     

Molecular epidemiological survey of Listeria monocytogenes in broilers and poultry products

AIMS: To investigate the prevalence of Listeria monocytogenes in poultry products, and to elucidate whether poultry products may be linked to listeriosis cases. A further goal was to identify contamination routes for L. monocytogenes to broiler carcasses. METHODS AND RESULTS: Poultry products (385 samples) were screened for L. monocytogenes. The recovered isolates and 19 patient isolates were characterized by multilocus enzyme electrophoresis and restriction enzyme analysis. The poultry isolates showed great genetic diversity, but no identical subclones were identified from poultry sources and patients. One slaughterhouse was examined in detail during a 16-month period. The contamination rates increased along the processing line, and one subclone was found during the whole period. Only low prevalence of the bacteria was revealed from broiler faeces. CONCLUSIONS: The prevalence of L. monocytogenes in poultry products was high, but no listeriosis cases was linked to poultry products. Broilers seem to be contaminated during the slaughter process, and specific strains may persist in the processing environment. Broiler faeces does not seem to be an important source of L. monocytogenes in poultry products. SIGNIFICANCE AND IMPACT OF THE STUDY: Preventive measures to avoid contamination of poultry products by L. monocytogenes must be taken in the processing plants.     

A medium for the isolation, enumeration and rapid presumptive identification of injured Clostridium perfringens and Bacillus cereus

A blood-free egg yolk medium (BCP) containing pyruvate, inositol, mannitol and a bromocresol purple indicator in a nutrient agar base has been developed to initiate the growth of Clostridium perfringens . It is comparable to blood agar for the growth of normal, chilled stored vegetative cells and heat-injured spores of Cl. perfringens and Bacillus cereus . It has the advantage over blood agar in exhibiting presumptive evidence of Cl. perfringens (production of lecithinase and inositol fermentation) after an overnight incubation at 43°C-45°C. Pyruvate, catalase and other hydrogen peroxide degraders were found to remove toxins rapidly formed in media exposed to air and light. Free radical scavengers of superoxide, hydroxyl ions and singlet oxygen were ineffective. Without scavengers the formation of 10–20 μg/ml hydrogen peroxide in the exposed medium was indicated and found lethal to injured Cl. perfringens .
The BCP medium has been used successfully for the rapid identification and enumeration of Cl. perfringens in foods and faeces from food poisoning outbreaks and cases of suspected infectious diarrhoea. Greater recovery of severely injured vegetative Cl. perfringens could be obtained by pre-incubation at 37°C of inoculated media for 2–4 h followed by overnight incubation at 43°C-45°C. Tryptose-sulphite-cyclo-serine and Shahidi-Ferguson-perfringens agar base were found to inhibit the growth of several strains of injured vegetative Cl. perfringens . This was not completely overcome by the addition of pyruvate. The inclusion of mannitol also allows the medium to be used for the presumptive identification of B. cereus . Growth and lecithinase activity are profuse on BCP. Heat-injured spores are recovered equally well on BCP and blood agar. A scheme for the identification of some other clos-tridia on BCP is presented.     

A Quantitative Comparison of the Faecal Microflora of Baboons Fed a Natural Diet or a Synthetic Diet Complete or Deficient in Pyridoxine or Riboflavin

S ummary . Quantitative methods were used to study the microflora of faeces produced by a group of baboons receiving fresh fruit and vegetables (natural diet), and 3 groups fed a synthetic diet deficient in either pyridoxine or riboflavin, or which contained both vitamins (pair fed). There was no significant difference between the microbial counts of any of the groups of organisms studied in the pyridoxine or riboflavin deficient and pair fed baboons. Compared with baboons on natural diet, faecal counts from baboons fed the synthetic diet showed highly significant increases in Clostridium welchii and in lactose-fermenting enterobacteria, together with a considerable decrease in the number of lactobacilli. Small increases in the numbers of micrococci, staphylococci and faecal streptococci were noted, whilst the numbers of yeasts were reduced slightly. Whilst the change from the natural to the synthetic diet caused a great alteration in the flora, the synthetic diet flora appeared to be extremely stable and generally unaffected by drastic modifications of the synthetic diet. However, marked alteration did occur on re-feeding with the natural diet. Data on the faecal microflora of baboons are compared briefly with published data for man and other animals, and the effects of dietary changes on the composition of the faecal flora are discussed.     

Strategies for the avoidance of faeces by grazing sheep

Experiments were conducted to investigate which environmental cues were used by sheep when discriminating against patches of pasture contaminated with faeces. The influence of the spatial distribution of contaminated patches and the parasite infection status of sheep on avoidance of contaminated patches and ingestion of parasite larvae was also investigated. In experiment 1, sheep infected with the parasite Ostertagia circumcincta were given the opportunity to graze in uncontaminated or aggregated contaminated patches. Patch contamination comprised of either faeces from sheep infected with O. circumcincta larvae, faeces from uninfected sheep, or O. circumcincta larvae only. Infected sheep discriminated against faeces from parasite-infected animals and faeces from uninfected animals equally. Sheep did not discriminate against patches contaminated with parasite larvae only. In experiment 2, sheep infected with O. circumcincta and uninfected sheep grazed experimental plots with differing spatial patterns of faecal-contaminated patches, allowing animals the opportunity to forage in contaminated or uncontaminated patches of herbage. Plots were also grazed by infected and uninfected animals that were fistulated at the oesophagus to enable the collection of ingested herbage. Sheep spent a greater proportion of their time foraging in uncontaminated patches than in contaminated patches. Where patches were highly aggregated, infected animals spent a greater proportion of total grazing time in uncontaminated patches than did uninfected animals, and grazed uncontaminated patches for longer on each sampling occasion. On grazing plots where all patches were contaminated, the difference between the numbers of larvae isolated from pasture herbage and ingested herbage was greatest for infected animals. In this situation, infected animals avoided parasites most. On grazing plots consisting of both contaminated and uncontaminated patches, the difference between the numbers of larvae isolated from pasture herbage and ingested herbage was greatest for uninfected animals. In this situation, uninfected animals were most effective at parasite avoidance as they consumed fewer parasite larvae relative to what was available on pasture.     

Biotyping and resistotyping for epidemiological tracing of the fecal origin of Klebsiella pneumoniae in urinary infections

Twenty-four (82.7%) out of 29 patients suffering from hospital acquired urinary infections by Klebsiella pneumoniae had the same species in their faeces. Biotyping of 24 urinary and 219 fecal strains of K. pneumoniae resulted in 50 different biotypes - an average of four biotypes per fecal sample. Ten patients (34.4%) had the same biotype in urine and faeces without any correlation with previous vesical catheterization (p greater than 0.05). Using resistotyping to four chemical compounds selected among 34 tested substances (brilliant green, malachite green, potassium tellurite and mercuric chloride) 16 different resistotypes were found. Fourteen patients (58.3%) presented the same resistotype in urine and faeces but only in five patients was there correlation with simultaneous biotyping identity. Simultaneous occurrence of identical biotypes or resistotypes in faeces and urine occurred in only 54.2% of cases. However, there was a significant association between resistance ot mercuric and tellurite ions in fecal and urinary strains isolated from the same patient (p less than 0.001).     

Cutaneous microcirculation in systemic sclerosis and response to intra-arterial reserpine.

The cutaneous microcirculation in the hand was measured in 23 patients with systemic sclerosis, 19 with Raynaud''s phenomenon and four without Raynaud''s phenomenon, and 20 controls. The patients with Raynaud''s phenomenon had a reduced basal blood flow and an exaggerated further reduction on local cold stimulation, though both were normal in patients without Raynaud''s phenomenon. Reflex-induced vascular changes by cold stimulation of the contralateral hand showed no differences between the three groups. The blood flows were similar in the affected skin of the anterior chest wall in four patients with systemic sclerosis and peripheral Raynaud''s phenomenon and matched controls. In the seven most severely affected patients 1 mg of intra-arterial reserpine produced a prompt improvement in the cutaneous microcirculation which usually lasted one to three weeks but occasionally much longer. By judicious use of repeated injection guided by measurements of the microcirculation it was possible to heal indolent ulcers of the fingers. The results indicate that vascular changes are common in systemic sclerosis but are not fundamental in the pathogenesis of the disease. More probably there is a general soft tissue abnormality that usually but not necessarily affects the vessels.