Abstract
Pseudomembranous colitis, a severe diarrheal disease, has been linked to the administration of antibiotics and to two toxins produced by Clostridium difficile. Eighty-two strains of C. difficile isolated from humans and hamsters were assayed for the presence of plasmid DNA. Agarose gel electrophoresis of Sarkosyl-lysed cells indicated that 18% of the strains contained from one to four plasmids. The plasmid DNA in these strains ranged in molecular weight from 2.7 X 10(6) to 60 X 10(6). Strains with and without plasmids were examined for the cytopathogenic effect of the toxins on MRC-5 cells. No correlation was observed between plasmid content and cytopathogenic effect. The results of in vitro antibiotic susceptibility testing with plasmid-containing strains revealed that 33% of the strains tested exhibited growth with four or more of the antimicrobial agents used.
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Selected References
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- Bartlett J. G., Chang T., Taylor N. S., Onderdonk A. B. Colitis induced by Clostridium difficile. Rev Infect Dis. 1979 Mar-Apr;1(2):370–378. doi: 10.1093/clinids/1.2.370. [DOI] [PubMed] [Google Scholar]
- Bartlett J. G., Taylor N. S., Chang T., Dzink J. Clinical and laboratory observations in Clostridium difficile colitis. Am J Clin Nutr. 1980 Nov;33(11 Suppl):2521–2526. doi: 10.1093/ajcn/33.11.2521. [DOI] [PubMed] [Google Scholar]
- Benner E. J., Tellman W. H. Pseudomembraneous colitis as a sequel to oral lincomycin therapy. Am J Gastroenterol. 1970 Jul;54(1):55–58. [PubMed] [Google Scholar]
- Blaschek H. P., Solberg M. Isolation of a plasmid responsible for caseinase activity in Clostridium perfringens ATCC 3626B. J Bacteriol. 1981 Jul;147(1):262–266. doi: 10.1128/jb.147.1.262-266.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burdon D. W., Brown J. D., Youngs D. J., Arabi Y., Shinagawa N., Alexander-Williams J., Keighley M. R., George R. H. Antibiotic susceptibility of Clostridium difficile. J Antimicrob Chemother. 1979 May;5(3):307–310. doi: 10.1093/jac/5.3.307. [DOI] [PubMed] [Google Scholar]
- 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]
- Eklund M. W., Poysky F. T., Meyers J. A., Pelroy G. A. Interspecies conversion of Clostridium botulinum type C to Clostridium novyi type A by bacteriophage. Science. 1974 Nov 1;186(4162):456–458. doi: 10.1126/science.186.4162.456. [DOI] [PubMed] [Google Scholar]
- Fee H. J., Ament M. E., Holmes E. C. Pseudomembranous colitis associated with cephazolin therapy. Am J Surg. 1977 Feb;133(2):247–248. doi: 10.1016/0002-9610(77)90092-7. [DOI] [PubMed] [Google Scholar]
- Florin I., Thelestam M. Intoxication of cultured human lung fibroblasts with Clostridium difficile toxin. Infect Immun. 1981 Jul;33(1):67–74. doi: 10.1128/iai.33.1.67-74.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gyles C., So M., Falkow S. The enterotoxin plasmids of Escherichia coli. J Infect Dis. 1974 Jul;130(1):40–49. doi: 10.1093/infdis/130.1.40. [DOI] [PubMed] [Google Scholar]
- Holst E., Helin I., Mårdh P. A. Recovery of Clostridium difficile from children. Scand J Infect Dis. 1981;13(1):41–45. doi: 10.1080/00365548.1981.11690365. [DOI] [PubMed] [Google Scholar]
- Humphreys G. O., Willshaw G. A., Anderson E. S. A simple method for the preparation of large quantities of pure plasmid DNA. Biochim Biophys Acta. 1975 Apr 2;383(4):457–463. doi: 10.1016/0005-2787(75)90318-4. [DOI] [PubMed] [Google Scholar]
- Kado C. I., Liu S. T. Rapid procedure for detection and isolation of large and small plasmids. J Bacteriol. 1981 Mar;145(3):1365–1373. doi: 10.1128/jb.145.3.1365-1373.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Laird W. J., Aaronson W., Silver R. P., Habig W. H., Hardegree M. C. Plasmid-associated toxigenicity in Clostridium tetani. J Infect Dis. 1980 Oct;142(4):623–623. doi: 10.1093/infdis/142.4.623. [DOI] [PubMed] [Google Scholar]
- 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]
- Lyerly D. M., Lockwood D. E., Richardson S. H., Wilkins T. D. Biological activities of toxins A and B of Clostridium difficile. Infect Immun. 1982 Mar;35(3):1147–1150. doi: 10.1128/iai.35.3.1147-1150.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Macrina F. L., Kopecko D. J., Jones K. R., Ayers D. J., McCowen S. M. A multiple plasmid-containing Escherichia coli strain: convenient source of size reference plasmid molecules. Plasmid. 1978 Jun;1(3):417–420. doi: 10.1016/0147-619x(78)90056-2. [DOI] [PubMed] [Google Scholar]
- Medline A., Shin D. H., Medline N. M. Pseudomembranous colitis associated with antibiotics. Hum Pathol. 1976 Nov;7(6):693–703. doi: 10.1016/s0046-8177(76)80080-9. [DOI] [PubMed] [Google Scholar]
- Rolfe R. D., Finegold S. M. Purification and characterization of Clostridium difficile toxin. Infect Immun. 1979 Jul;25(1):191–201. doi: 10.1128/iai.25.1.191-201.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sack R. B. Enterotoxigenic Escherichia coli: identification and characterization. J Infect Dis. 1980 Aug;142(2):279–286. doi: 10.1093/infdis/142.2.279. [DOI] [PubMed] [Google Scholar]
- Shuttleworth R., Taylor M., Jones D. M. Antimicrobial susceptibilities of Clostridium difficile. J Clin Pathol. 1980 Oct;33(10):1002–1005. doi: 10.1136/jcp.33.10.1002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith C. J., Markowitz S. M., Macrina F. L. Transferable tetracycline resistance in Clostridium difficile. Antimicrob Agents Chemother. 1981 Jun;19(6):997–1003. doi: 10.1128/aac.19.6.997. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sullivan N. M., Pellett S., Wilkins T. D. Purification and characterization of toxins A and B of Clostridium difficile. Infect Immun. 1982 Mar;35(3):1032–1040. doi: 10.1128/iai.35.3.1032-1040.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Taylor N. S., Bartlett J. G. Partial purification and characterization of a cytotoxin from Clostridium difficile. Rev Infect Dis. 1979 Mar-Apr;1(2):379–385. doi: 10.1093/clinids/1.2.379. [DOI] [PubMed] [Google Scholar]
- Tedesco F. J. Clindamycin-associated colitis. Review of the clinical spectrum of 47 cases. Am J Dig Dis. 1976 Jan;21(1):26–32. doi: 10.1007/BF01074135. [DOI] [PubMed] [Google Scholar]
- Toshniwal R., Fekety R., Silva J., Jr Etiology of tetracycline-associated pseudomembranous colitis in hamsters. Antimicrob Agents Chemother. 1979 Aug;16(2):167–170. doi: 10.1128/aac.16.2.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Totten M. A., Gregg J. A., Fremont-Smith P., Legg M. Clinical and pathological spectrum of antibiotic-associated colitis. Am J Gastroenterol. 1978 Mar;69(3 Pt 1):311–319. [PubMed] [Google Scholar]