Clostridium - tetanus, gas gangrene, botulism, c. diff

Describe the symptoms of botulism.

Appear 12-36 hours after ingestion - double vison, fatigue, difficulty swallowing - progressive flaccid paralysis (can't move/no strength; opposite of rigid paralysis) - respiratory/cardiac failure = death

Is a C. tetani infection invasive? Do the exotoxins enter the body? Which is the killer?

C. tetani is NON-INVASIVE, but PRODUCES EXOTOXINS that cause systemic shutdown of the nervous system Exotoxin = tentanospasmin - killer that inhibits certain classes of neurotransmitters, results in constant activation of muscles

What is debridement? Why is it extra important for Clostridium infections?

Chemical or surgical removal of dead tissues that promotes wound healing and allows new tissue to grow.

What are the different types of Clostridium?

Clostridium tetani (tetanus), Clostridium perfingens (gas gangrene), Clostridium botulinum (botulism and Botox), and Clostridium difficile (C. dif).

In adult botulism, what causes the disease? Is it an infection? In infant botulism, what causes the disease? Is it an infection?

Exotoxin in infected food (ie. sausages) adults eat; spores in food (ie. honey) kids eat and causes infection in them. Toxin acts on our nerves, causing faced paralysis MOST POTENT TOXIN ON THE PLANET; most common in kids

What gives Clostridium perfringens (aka gas gangrene) its name? Is the infection invasive?

GG is an INVASIVE INFECTION that get's its name because gas production pushes out oxygen from nearby tissues.

How is botulism prevent? Why are we not freaked out about it?

Proper food handling = effective. As long as the spores are killed, we will be alright b/c TOXIN = HEAT SENSITIVE. Canned foods are heated are heated to kill spores. Acidic foods, high sugar content, or addition o nitrite preservatives prevent spore germination.

What are the symptoms and outcomes of tetanus?

Symptoms: muscles become rigid from constant spasms (starts with jaw muscles - lock jaw); muscle spasms can break bones; causes respiratory failure Outcomes: rigid paralysis

What does the tetanus vaccine give us immunity to? Are boosters required? What's the most important step in treating tetanus? Will recovery be rapid or slow? Why?

The vaccine gives us immunity to the TOXINS (it's a TOXOID VACCINE) and boosters will always be required.The most important treatment for tetanus is administration of the ANTITOXIN (antibodies against tetanospasmin) and debridement and disinfection of the dead tissue from the wound, and rest. Recovery is slow because the dead/damages neurons have to be replaced with new ones.

What about botulism toxin allows Botox injections to last for months?

nerve damage in injected regent is permanent until they can regrow which can take weeks to months

What is antibiotic-associated diarrhea?

non-invasive infection causing inflammation of intestine; major pathogen in hospitals caused by Clostridium difficile (C. Dif.).

How is antibiotic-associated diarrhea treated?

stop normal antibiotic treatment (which can be difficult) and start treatment of C. difficile antibiotics.

How does Clostridium tetani (tetanus) work?

tetanospasmin toxin affects the nervous system by binding permanently to neurons causing rigid paralysis.

Describe Clostridium perfringens (gas gangrene)

A aggressive, invasive infection attacks deep wounds with no oxygen and causes necrosis due to a lack of blood flow b/c to the lack of O2. This low O2 environment promotes material grows and gas production pushes O2 out from near by tissues. Hyperbolic chambers are used to increase oxygen supply. Toxins enter blood stream after 2-3 days: can = septic shock/death Prevention: proper wound cleaning Treatment: debridement, antibiotics, antitoxin

Describe clostridium

- gram positive - spore forming - obligate anaerobic

Why does antibiotic-associated diarrhea occur?

antibiotic treatment/other conditions reduces normal intestinal flora, making a less acidic environment, which is perfect for C. Dif to noninvasive colonize gut and produce and exotoxin.

Most important part of Botulism treatment?

administration of antitoxin (neutralizing antibodies)