Development and application of a multiple typing system for Clostridium difficile

A combination of bacteriocin, bacteriophage, and plasmid typing techniques was used to differentiate strains of Clostridium difficile. A typing set of 20 bacteriocin-producing strains was established after 400 isolates of C. difficile were screened for the ability to produce bacteriocin. These strains were used to type a collection of 114 isolates of C. difficile. Forty-six (40%) of the 114 isolates were typeable, and 31 typing patterns were distinguishable. Plasmid typing of the same 114 isolates of C. difficile showed that 67 (59%) of the isolates carried up to four plasmids ranging from 7 to 60 kb in size, although most strains contained only one or two plasmids. Twenty different plasmid typing patterns were observed among the isolates. A combination of bacteriocin and plasmid typing provided 77% typeability. Fifteen (13%) of the 114 strains were typeable with five bacteriophages isolated in our laboratory, but the increase in typeability of strains over that obtainable by plasmid and bacteriocin typing was only 1.8%. Isolates that were nontypeable by bacteriocins, plasmids, or phages could be divided into two groups on the basis of positive or negative cytotoxin production. This further division of strains would increase the typeability potential by 7%; i.e., the ability to differentiate strains would rise from 77 to 84%, or perhaps 86%, if phage typing were included. We conclude that more than one of the techniques reported in this paper must be used to achieve an acceptable level of typeability of this species.     

Clostridium difficile electrophoretic typing

Abstract Two typing schemes for Clostridium difficile based on slide agglutinations and polyacrylamide gel electrophoresis (PAGE) have been described. We compared the reference strains of each typing system with a simplified PAGE method using whole cells and Coomassie blue staining. The method was also applied to clinical isolates and immunoblots were performed with a monospecific serum directed against a major band of low molecular weight. The results indicated the great heterogeneity of Clostridium difficile strains complicated by antigenic subdivision for strains belonging to the same electrophoretic type.     

Further development of a bacteriocin typing system for Clostridium perfringens

The specificity of typing Clostridium perfringens with bacteriocins was improved by adding new bacteriocins and deleting others from the original typing set of ten. A total of 516 new isolates of Cl. perfringens were screened for bacteriocin production and, of these, 162 strains (31%) were found to be producers. The sensitivity patterns obtained by testing 40 bacteriocins against 200 isolates of Cl. perfringens were recorded and the data subjected to a computer analysis. A total of 18 bacteriocins capable of dividing the 200 isolates into 98 typing patterns was selected. The repro-ducibility of the new system was tested by performing three sequential typings of 60 strains of Cl. perfringens. No variation was found in 73% of the strains, while a further 16% of the strains demonstrated a change in sensitivity to only one bacteriocin. Common serological types of Cl. perfringens were divisible into subtypes based upon both their ability to produce bacteriocins and their sensitivity to bacteriocins, suggesting a useful role for bacteriocin typing in conjunction with an already well-established tool for typing Cl. perfringens.     

5个X-STR基因座荧光复合扩增体系的建立及法医学应用

为了发掘更多多态性高的X染色体短串联重复(X-STR)基因座, 以解决法医学实践中的特殊案例, 建立了一组荧光复合扩增体系, 同时检测DXS6803、DXS981、DXS6809、DXS6789和DXS7132 5个X-STR基因座, 并用ABI PRISM 3100作毛细管电泳和GeneMapper ID 3.1软件进行基因分型, 结果清晰, 灵敏度高, 重复性好。最低检出限为0.25 ng, 10~20 ng模板DNA能得到最佳结果, 在实际检案中能得到满意结果。实验表明, 本体系能为用X-STR基因座解决特殊的亲权鉴定案提供快速鉴定技术, 是常染色体STR、Y-STR等鉴定方法的良好补充, 在法医学实践中有较好的实用价值。     

Non-radioactive restriction fragment length polymorphism (RFLP) typing of Clostridium difficile

A typing method for Clostridium difficile based on restriction fragment length polymorphisms (RFLP) is described. The technique utilizes commercially available Escherichia coli ribosomal ribonucleic acid (rRNA) as probe material. Probe labelling, hybridization and detection was performed using the Enhanced Chemiluminescence (ECL) gene detection system. The probe labelling procedure was easy to perform, taking only 20 min. The complete typing method was comparatively simple, reproducible and readily adaptable to most bacterial genera.     

Adaptation of Clostridium difficile toxin A for use as a protein translocation system

A cellular delivery system is a useful biotechnology tool, with many possible applications. Two derivatives of Clostridium difficile toxin A (TcdA) have been constructed (GFP-TcdA and Luc-TcdA), by fusing reporter genes to functional domains of TcdA, and evaluated for their ability to translocate their cargo into mammalian cells. The cysteine protease and receptor binding domains of TcdA have been examined and found to be functional when expressed in the chimeric construct. Whereas GFP failed to internalize in the context of the TcdA fusion, significant cellular luciferase activity was detected in vero cell lysates after treatment with Luc-TcdA. Treatment with bafilomycin A1, which inhibits endosomal acidification, traps the luciferase activity within endosomes. To further understand these results, clarified lysates were subjected to molecular weight sieving, demonstrating that active luciferase was released from Luc-TcdA after translocation and internal processing.     

Phospholipid profiles of Clostridium difficile.

Phospholipid molecular species present in 32 isolates of Clostridium difficile were examined by fast atom bombardment-mass spectrometry in negative-ion mode. This revealed major anions consistent with the expected presence of the following phosphatidylglycerol (PG) analogs: PG(31:2), PG(32:1), PG(33:2), PG(33:1), PG(34:2), and PG(34:1). The major phospholipid molecular species are distinct from those of other bacterial groups examined.     

Comparison of ribotyping, pulsed-field gel electrophoresis and random amplified polymorphic DNA for typing Clostridium difficile strains

Abstract Clostridium difficile is a Gram-positive sporulating anaerobic bacillus which causes pseudomembranous colitis. Nosocomial acquisition of this bacteria has proved frequent, and epidemiological markers are needed to recognize and control common-source outbreaks. We therefore compared the results of pulsed-field gel electrophoresis (PFGE) after restriction with Sma I or Nru I, random-amplified polymorphic DNA (RAPD) using 3 10-mer oligonucleotides, and ribotyping to differentiate between 30 unrelated strains of C. difficile belonging to 8 serotypes. The strains were separated into 26 different types by PFGE, 25 by RAPD, but into only 18 types by ribotyping. Median percentages of similarity between strains ranged from 27 in the PFGE assay to 90 in the ribotyping assay, but there was good agreement between the 3 methods for the clustering of strains. PFGE was more time-consuming than RAPD but its patterns were easier to analyze.     

Antibiotics and Clostridium difficile

Clostridium difficile is now established as a major nosocomial pathogen. C. difficile infection is seen almost exclusively as a complication of antibiotic therapy, and is particularly associated with clindamycin and third-generation cephalosporins. Depletion of the indigenous gut microflora by antibiotic therapy has long been established as a major factor in the disease. However, the direct influence of antimicrobials upon virulence mechanisms such as toxin production and adhesion in the bowel, and the exact mechanisms by which the organism causes disease remain to be elucidated.     

Clostridium difficile infection in adult hamsters.

Diarrhea was encountered in a group of adult female golden Syrian hamsters (Mesocricetus auratus) used for titrating the scrapie agent. Ninety percent of the cases occurred in animals over 210 days old even though animals of all age groups lived in the colony concurrently. The cause of diarrhea was investigated in both uninoculated animals and those receiving greater than a limiting dilution of scrapie infectivity, i.e., animals that were not expected to contract the experimental scrapie disease. Three forms of diarrhea were observed. The most commonly encountered was profuse and watery. A chronic form presented with semiformed, thin fecal material smearing the retroperitoneal region. Hemorrhagic diarrhea was observed rarely. Mortality was high among animals with acute watery or hemorrhagic diarrhea. Animals with semiformed soft stools were dehydrated, had a roughened hair-coat, and hunched back. Cardinal lesions were necrosis, inflammation, and mucosal hyperplasia of the cecum and colon and cholangiohepatitis with amyloid deposition. Diffuse renal amyloidosis was present in chronic cases. Toxigenic, cytotoxin B-positive Clostridium difficile was isolated from a majority of affected animals. Cytotoxin B was also present in cecal homogenates of diarrheic animals with C. difficile. The pathological and microbiologic findings indicated a typhlitis and colitis in adult hamsters that was associated with C. difficile infection.     

Chronic osteomyelitis due to Clostridium difficile.

Osteomyelitis caused by anaerobic bacteria is rarely reported, and a case of chronic osteomyelitis of the femur may be the first in which Clostridium difficile was the causative agent. The organism was isolated over several months and, although initially sensitive to penicillin, it developed resistance during this time. The organism''s repeated isolation may have been due to the presence of resistant spores. Although the patient had no gastrointestinal symptoms the source of the organism was probably the patient''s own gastrointestinal tract. Infection from the environment cannot, however, be excluded. Treatment was finally successful with metronidazole.     

益生菌制剂在防治艰难梭菌相关性腹泻上的应用及前景

益生菌制剂(probiotics)通过各种机制调节肠道微生态环境,在维持肠道微生态平衡及防治艰难梭菌相关性腹泻(Clostridium difficile associated diarrhea,CDAD)上有着巨大的潜力。目前各国均有相关产品推出,但其防治CDAD的效果参差不齐。本文就益生菌制剂防治CDAD作一知识性回顾,并对益生菌制剂防治CDAD的前景进行展望。     

Preparation of antibacterial and antitoxic Clostridium difficile sera.

Preparation of Clostridium difficile antibacterial and antitoxic sera is presented. Fifty one strains (72%) were typeable within Delmee scheme. Twenty strains (28%) belonged to new Polish serogroups designated 18, 27, 70, 71, 72, 88, 89 and NICH. Supernatants of all toxigenic Clostridium difficile strains were neutralized by gamma-globulin fraction of goat Clostridium difficile antitoxin in neutralization assay when it was performed on McCoy cell line. Only 8 toxigenic strains (21%) were positive in counterimmunoelectrophoresis.     

艰难梭菌特异性鸡卵黄抗体的研制及初步应用

目的制备艰难梭菌菌体特异性鸡卵黄抗体,探讨其对艰难梭菌感染小鼠的治疗作用。方法建立艰难梭菌相关腹泻(CDAD)小鼠模型,将30只CDAD小鼠随机分为5组,每组6只,以11.86mg/mL、1.186mg/mL、0.1186mg/mL艰难梭菌菌体特异性IgY灌胃,设立空白对照组及阴性对照组,1d/次,0.5mL/只,连续3d。末次治疗24h后处死小鼠,取盲肠组织中段制作病理切片;其余盲肠组织进行DAO、D-乳酸和TNF-α含量测定;测定回肠组织含水率。结果阴性对照组和空白对照组小鼠盲肠黏膜脱落伴大量炎细胞浸润;高IgY组小鼠盲肠黏膜完整,未见炎性细胞浸润;中IgY组小鼠盲肠黏膜少量炎细胞浸润;低IgY组小鼠盲肠黏膜上皮细胞脱落,少量炎细胞浸润。高IgY组小鼠盲肠DAO含量均显著高于空白对照组和阴性对照组(P0.01);中IgY组小鼠DAO含量高于阴性对照组(P0.05);中、高IgY组小鼠TNF-α含量均低于低IgY组、空白对照组和阴性对照组(P0.05)。结论艰难梭菌菌体特异性IgY对艰难梭菌感染小鼠具有治疗作用。     

Development of a new shuttle plasmid system for Escherichia coli and Clostridium perfringens.

We constructed a 7.9-kilobase-pair recombinant shuttle plasmid, designated pHR106, by combining desired segments of three plasmids: an Escherichia coli plasmid (pSL100) which provides a multiple cloning site, a Clostridium perfringens plasmid (pJU122) which provides a clostridial origin of replication, and an E. coli plasmid (pJIR62) which provides an E. coli origin of replication, an ampicillin resistance gene, and a chloramphenicol resistance gene of clostridial origin. The shuttle plasmid transformed E. coli HB101 with a frequency of 1 transformant per 10(4) viable cells and C. perfringens L-phase strain L-13 with a frequency of approximately 1 transformant per 10(6) viable cells. Because of the set of unique cloning sites and the chloramphenicol resistance marker, this shuttle plasmid should be particularly useful for studies of gene regulation and for enzyme production with C. perfringens.