Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1990 Jul;34(7):1348–1353. doi: 10.1128/aac.34.7.1348

Quantitative study of antibiotic-induced susceptibility to Clostridium difficile enterocecitis in hamsters.

H E Larson 1, S P Borriello 1
PMCID: PMC175979  PMID: 2386366

Abstract

Commonly used antibiotics were compared for their ability to induce Clostridium difficile enterocecitis and death in hamsters. Susceptibility to infection with C. difficile was measured by calculating 50% lethal doses (in CFU) for hamsters for various intervals after antibiotic treatment. Infection occurred after very small doses of C. difficile were given to hamsters treated with clindamycin, ampicillin, flucloxacillin, and cefuroxime; there was little difference between the antibiotics in the degree of susceptibility that they induced. A large difference in the duration of susceptibility was observed, however, with susceptibility being temporary following ampicillin, flucloxacillin, and cefuroxime administration but long-lived following clindamycin administration. A larger dose of ampicillin, multiple doses of ampicillin, and a combination of antibiotics had comparatively small effects on the duration of susceptibility. C. difficile growth and toxin production in in vitro suspensions of cecal contents were found to correlate closely with in vivo hamster infectivity. A persisting loss of colonization resistance following antibiotic treatment may be a type of postantibiotic effect. Although these results cannot be applied directly to humans, they suggest lines of further investigation into how antibiotics may differ in producing risks of C. difficile infection and pseudomembranous colitis in patients.

Full text

PDF
1348

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aronsson B., Möllby R., Nord C. E. Clostridium difficile and antibiotic associated diarrhoea in Sweden. Scand J Infect Dis Suppl. 1982;35:53–58. [PubMed] [Google Scholar]
  2. Bartlett J. G., Chang T. W., Moon N., Onderdonk A. B. Antibiotic-induced lethal enterocolitis in hamsters: studies with eleven agents and evidence to support the pathogenic role of toxin-producing Clostridia. Am J Vet Res. 1978 Sep;39(9):1525–1530. [PubMed] [Google Scholar]
  3. Block B. S., Mercer L. J., Ismail M. A., Moawad A. H. Clostridium difficile-associated diarrhea follows perioperative prophylaxis with cefoxitin. Am J Obstet Gynecol. 1985 Dec 15;153(8):835–838. doi: 10.1016/0002-9378(85)90685-4. [DOI] [PubMed] [Google Scholar]
  4. Borriello S. P., Barclay F. E. An in-vitro model of colonisation resistance to Clostridium difficile infection. J Med Microbiol. 1986 Jun;21(4):299–309. doi: 10.1099/00222615-21-4-299. [DOI] [PubMed] [Google Scholar]
  5. Bowden T. A., Jr, Mansberger A. R., Jr, Lykins L. E. Pseudomembraneous enterocolitis: mechanism for restoring floral homeostasis. Am Surg. 1981 Apr;47(4):178–183. [PubMed] [Google Scholar]
  6. Craig W. A., Vogelman B. The postantibiotic effect. Ann Intern Med. 1987 Jun;106(6):900–902. doi: 10.7326/0003-4819-106-6-900. [DOI] [PubMed] [Google Scholar]
  7. Dzink J., Bartlett J. G. In vitro susceptibility of Clostridium difficile isolates from patients with antibiotic-associated diarrhea or colitis. Antimicrob Agents Chemother. 1980 Apr;17(4):695–698. doi: 10.1128/aac.17.4.695. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fekety R., Silva J., Toshniwal R., Allo M., Armstrong J., Browne R., Ebright J., Rifkin G. Antibiotic-associated colitis: effects of antibiotics on Clostridium difficile and the disease in hamsters. Rev Infect Dis. 1979 Mar-Apr;1(2):386–397. doi: 10.1093/clinids/1.2.386. [DOI] [PubMed] [Google Scholar]
  9. Gorbach S. L., Bartlett J. G. Pseudomembranous enterocolitis: a review of its diverse forms. J Infect Dis. 1977 Mar;135 (Suppl):S89–S94. doi: 10.1093/infdis/135.supplement.s89. [DOI] [PubMed] [Google Scholar]
  10. Heimdahl A., Nord C. E. Effect of erythromycin and clindamycin on the indigenous human anaerobic flora and new colonization of the gastrointestinal tract. Eur J Clin Microbiol. 1982 Feb;1(1):38–48. doi: 10.1007/BF02014139. [DOI] [PubMed] [Google Scholar]
  11. Kager L., Liljeqvist L., Malmborg A. S., Nord C. E. Effect of clindamycin prophylaxis on the colonic microflora in patients undergoing colorectal surgery. Antimicrob Agents Chemother. 1981 Dec;20(6):736–740. doi: 10.1128/aac.20.6.736. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kaiser A. B. Antimicrobial prophylaxis in surgery. N Engl J Med. 1986 Oct 30;315(18):1129–1138. doi: 10.1056/NEJM198610303151805. [DOI] [PubMed] [Google Scholar]
  13. Klainer A. S. Clindamycin. Med Clin North Am. 1987 Nov;71(6):1169–1175. doi: 10.1016/s0025-7125(16)30804-5. [DOI] [PubMed] [Google Scholar]
  14. Larson H. E., Price A. B., Borriello S. P. Epidemiology of experimental enterocecitis due to Clostridium difficile. J Infect Dis. 1980 Sep;142(3):408–413. doi: 10.1093/infdis/142.3.408. [DOI] [PubMed] [Google Scholar]
  15. Larson H. E., Price A. B., Honour P., Borriello S. P. Clostridium difficile and the aetiology of pseudomembranous colitis. Lancet. 1978 May 20;1(8073):1063–1066. doi: 10.1016/s0140-6736(78)90912-1. [DOI] [PubMed] [Google Scholar]
  16. Pierce P. F., Jr, Wilson R., Silva J., Jr, Garagusi V. F., Rifkin G. D., Fekety R., Nunez-Montiel O., Dowell V. R., Jr, Hughes J. M. Antibiotic-associated pseudomembranous colitis: an epidemiologic investigation of a cluster of cases. J Infect Dis. 1982 Feb;145(2):269–274. doi: 10.1093/infdis/145.2.269. [DOI] [PubMed] [Google Scholar]
  17. Roberts A. P., Eastwood J. B., Gower P. E., Fenton C. M., Curtis J. R. Serum and plasma concentrations of clindamycin following a single intramuscular injection of clindamycin phosphate in maintenance haemodialysis patients and normal subjects. Eur J Clin Pharmacol. 1978 Dec 18;14(6):435–439. doi: 10.1007/BF00716386. [DOI] [PubMed] [Google Scholar]
  18. Rolfe R. D., Finegold S. M. Intestinal beta-lactamase activity in ampicillin-induced, Clostridium difficile-associated ileocecitis. J Infect Dis. 1983 Feb;147(2):227–235. doi: 10.1093/infdis/147.2.227. [DOI] [PubMed] [Google Scholar]
  19. Schwan A., Sjölin S., Trottestam U., Aronsson B. Relapsing Clostridium difficile enterocolitis cured by rectal infusion of normal faeces. Scand J Infect Dis. 1984;16(2):211–215. doi: 10.3109/00365548409087145. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES