Skip to main content

Advertisement

SpringerLink
Log in

Clostridium clostridioforme: a mixture of three clinically important species

  • Article
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

Clostridium clostridioforme shows much variability in phenotypic and antimicrobial susceptibility tests, suggesting it may be more than a single species even though all strains share unique morphology. This study was designed to determine if there are multiple species and, if so, to demonstrate the differences that exist between them. A total of 107 strains of C. clostridioforme were investigated by sequencing of the 16S rRNA gene, phenotypic studies, and antimicrobial susceptibility testing. In addition, clinical data from patients whose infections yielded an organism identified as C. clostridioforme was reviewed. Data from the above studies revealed three principal species in what has been called C. clostridioforme: Clostridium bolteae, C. clostridioforme, and Clostridium hathewayi. Each species may be distinguished by certain phenotypic tests. All three species were involved in infections, including bacteremia. C. clostridioforme appears to be associated with more serious or invasive human infections than the other two species in the group. Resistance to penicillin G is common and is due to β-lactamase production. Resistance to clindamycin and moxifloxacin is also seen. The three species differ in terms of virulence and antimicrobial resistance. “C. clostridioforme” actually represents three distinct species that are different in terms of 16S rRNA sequences, phenotypic characteristics, and antimicrobial susceptibility. It is important for microbiology laboratories to distinguish between these species and for clinicians to be aware of the differences between them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Burri R, Ankersmit O (1906) Bacterium clostridiiforme. In: Ankersmit P (ed) Untersuchunger uber tralbl. Bacteriol Parasitenkd Infektionskr Hyg Abt I Orig 40:100–118

    Google Scholar 

  2. Prévot AR, Turpin A, Kaiser P (1967) Les Bactėries Anaėrobies. Dunod, Paris

    Google Scholar 

  3. Buchanan RE, Gibbons NE (1974) Bergey’s manual of determinative Bacteriology, 8th edn. Williams & Wilkins, Baltimore

    Google Scholar 

  4. Kaneuchi C, Watanabe K, Terada A, Benno Y, Mitsuoka T (1976) Taxonomic study of Bacteroides clostridiiformis subsp. clostridiiformis (Burri and Ankersmit) Holdeman and Moore and of related organisms: proposal of Clostridium clostridiiformis (Burri and Ankersmit) comb. nov. and Clostridium symbiosum (Stevens) comb.nov. Int J Syst Bacteriol 26:195–204

    Google Scholar 

  5. Cato EP, George WL, Finegold SM (1986) Genus Clostridium Prazmowski 1880, 23AL. In: Holt JG, Sneath PHA (eds) Bergey’s manual of systematic bacteriology, vol. 2, 9th edn. Williams & Wilkins, Baltimore, pp 1141–1200

    Google Scholar 

  6. Finegold SM, Molitoris D, Song Y, et al (2002) Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis 35(Suppl 1):S6–S16

    Article  PubMed  Google Scholar 

  7. Song Y, Liu C, Finegold SM (2004) Quantitation of clostridia in feces of autistic children by real-time PCR. Appl Environ Microbiol 70:6459–6465

    Article  CAS  PubMed  Google Scholar 

  8. Song Y, Liu C, Molitoris DR, et al (2003) Clostridium bolteae sp. nov., isolated from human sources. Syst Applied Microbiol 26:84–89

    Article  CAS  Google Scholar 

  9. Jousimies-Somer HR, Summanen P, Citron D, Baron E, Wexler HM, Finegold SM (2002) Wadsworth-KTL anaerobic bacteriology manual, 6th edn. Star Publishing, Belmont, CA

    Google Scholar 

  10. Benson DA, Boguski MS, Lipman DJ, Ostell J (1997) GenBank. Nucleic Acids Res 25:1–6

    Article  CAS  PubMed  Google Scholar 

  11. National Committe for Clinical Laboratory Standards (2001) Methods for antimicrobial susceptibility testing of anaerobic bacteria. Approved standard M11-A5. NCCLS, Wayne, PA

    Google Scholar 

  12. Steer T, Collins MD, Gibson GR, Hippe H, Lawson PA (2001) Clostridium hathewayi sp.nov., from human faeces. Syst Appl Microbiol 24:353–357

    CAS  PubMed  Google Scholar 

  13. Elsayed S (2004) Human infection caused by Clostridium hathewayi. Emerg Infect Dis 10:1950–1952

    PubMed  Google Scholar 

  14. Woo PC, Lau SK, Woo GK, Fung AM, Yiu VP, Yuen KY (2004) Bacteremia due to Clostridium hathewayi in a patient with acute appendicitis. J Clin Microbiol 42:5947–5949

    Article  PubMed  Google Scholar 

  15. Linscott AJ, Flamholtz RB, Shukla D, Song Y, Liu C, Finegold SM (2005) Fatal septicemia due to Clostridium hathewayi and Campylobacter hominis. Anaerobe 11:97–98

    Article  Google Scholar 

  16. Zambon JJ, Reynolds HS, Genco RJ (1990) Studies of the subgingival microflora in patients with acquired immunodeficiency syndrome. J Periodontol 61:699–704

    CAS  PubMed  Google Scholar 

  17. Onderdonk AB, Zamarchi GR, Walsh JA, Mellor RD, Muñoz A, Kass EH (1986) Method for quantitative and qualitative evaluation of vaginal microflora during menstruation. Appl Environ Microbiol 51:333–339

    CAS  PubMed  Google Scholar 

  18. Fredricsson B, Hagström B, Moller AK, Nord C-E (1986) Bacterial vaginosis treated with metronidazole. Effects on the vaginal microbiology by a single dose versus a five-day regimen. Zentralbl Gynakol 108:799–804

    CAS  PubMed  Google Scholar 

  19. Hall G, Hedström SA, Heimdahl A, Nord CE (1993) Prophylactic administration of penicillins for endocarditis does not reduce the incidence of postextraction bacteremia. Clin Infect Dis 17:188–194

    CAS  PubMed  Google Scholar 

  20. Wang R-F, Cao W-W, Cerniglia CE (1996) PCR detection and quantitation of predominant anaerobic bacteria in human and animal faecal samples. Appl Environ Microbiol 62:1242–1247

    CAS  PubMed  Google Scholar 

  21. Haralambie E, Mahmoud HK, Linzenmeier G, Wendt F (1983) The “clostridial effect” of selective decontamination of the human gut with trimethoprim/sulphamethoxazole in neutropenic patients. Infection 11:201–204

    CAS  PubMed  Google Scholar 

  22. Goldstein EJ, Citron DM, Merriam CV, Warren Y, Tyrrell K (2000) Comparative in vitro activities of ABT-773 against aerobic and anaerobic pathogens isolated from skin and soft-tissue animal and human bite wound infections. Antimicrob Agents Chemother 44:2525–2529

    Article  CAS  PubMed  Google Scholar 

  23. Goldstein EJ, Citron DM, Merriam CV, Warren Y, Tyrrell K, Fernandez HT (2003) In vitro activities of dalbavancin and nine comparator agents against anaerobic gram-positive species and corynebacteria. Antimicrob Agents Chemother 47:1968–1971

    Article  CAS  PubMed  Google Scholar 

  24. Goldstein EJ, Citron DM, Merriam CV, Warren YA, Tyrrell KL, Fernandez HT (2003) In vitro activities of daptomycin, vancomycin, quinupristin-dalfopristin, linezolid, and five other antimicrobials against 307 gram-positive anaerobic and 31 Corynebacterium clinical isolates. Antimicrob Agents Chemother 47:337–341

    Article  CAS  PubMed  Google Scholar 

  25. Goldstein EJ, Citron DM, Warren Y, Tyrrell K, Merriam CV (1999) In vitro activity of gemifloxacin (SB 265805) against anaerobes. Antimicrob Agents Chemother 43:2231–2235

    CAS  PubMed  Google Scholar 

  26. Goldstein EJC, Citron DM, Merriam CV, Tyrrell K, Warren Y (1999) Activities of gemifloxacin (SB 265805, LB20304) compared to those of other oral antimicrobial agents against unusual anaerobes. Antimicrob Agents Chemother 43:2726–2730

    CAS  PubMed  Google Scholar 

  27. Mory F, Lozniewski A, David V, Carlier JP, Dubreuil L, Leclercq R (1998) Low-level vancomycin resistance in Clostridium innocuum. J Clin Microbiol 36:1767–1768

    CAS  PubMed  Google Scholar 

  28. Nord CE, Hedberg M (1990) Resistance to beta-lactam antibiotics in anaerobic bacteria. Rev Infect Dis 12(Suppl 2):S231–S234

    PubMed  Google Scholar 

  29. Appelbaum PC, Spangler SK, Pankuch GA, et al (1994) Characterization of a beta-lactamase from Clostridium clostridioforme. J Antimicrob Chemother 33:33–40

    CAS  PubMed  Google Scholar 

  30. Garbarini-Maywood C, Mulligan ME (1995) Ventriculoperitoneal shunt infection due to anaerobic and facultative bacteria: case report. Clin Infect Dis 20(Suppl 2):S240–S241

    PubMed  Google Scholar 

  31. Borrega-Garcia P, Jimenez-Mejias ME, Chinchon I, Cuello-Contreras JA (1994) [A retrorectal paravertebral abscess and meningitis due to Clostridium clostridioforme]. Med Clin (Barc) 102:279

    CAS  Google Scholar 

  32. Spitzer RD, Ratzan KR (1991) Chronic osteomyelitis due to Clostridium clostridiiforme. South Med J 84:671–672

    CAS  PubMed  Google Scholar 

  33. Marrie TJ, Costerton JW (1985) Mode of growth of bacterial pathogens in chronic polymicrobial human osteomyelitis. J Clin Microbiol 22:924–933

    CAS  PubMed  Google Scholar 

  34. Wong S-N, Lau Y-L, Lo RNS, Yuen K-Y (1992) Clostridium clostridiiforme infection in a postoperative cardiac patient. Pediatr Infect Dis J 11:52–54

    CAS  PubMed  Google Scholar 

  35. Peraino VA, Cross SA, Goldstein EJC (1993) Incidence and clinical significance of anaerobic bacteremia in a community hospital. Clin Infect Dis 16(Suppl 4):S288–S291

    PubMed  Google Scholar 

  36. Lombardi DP, Engleberg NC (1992) Anaerobic bacteremia: incidence, patient characteristics, and clinical significance. Am J Med 92:53–60

    Article  CAS  PubMed  Google Scholar 

  37. Cockerill FRI, Hughes JG, Vetter EA, et al (1997) Analysis of 281,797 consecutive blood cultures performed over an eight-year period: trends in microorganisms isolated and the value of anaerobic culture of blood. Clin Infect Dis 24:403–418

    Google Scholar 

  38. Brook I (1988) Recovery of anaerobic bacteria from clinical specimens in 12 years at two military hospitals. J Clin Microbiol 26:1181–1188

    CAS  PubMed  Google Scholar 

  39. Ing AF, McLean AP, Meakins JL (1981) Multiple-organism bacteremia in the surgical intensive care unit: a sign of intraperitoneal sepsis. Surgery 90:779–786

    CAS  PubMed  Google Scholar 

  40. Schallehn G, Wolff MH (1988) Morphological changes in human embryonic lung fibroblasts caused by cytotoxins of various Clostridium species. Zentralbl Bakteriol Mikrobiol 267:367–378

    CAS  Google Scholar 

  41. Allen SD, Emery CL, Lyerly DM (2003) Clostridium. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH (eds) Manual of clinical microbiology. ASM Press, Washington, DC, pp 835–856

    Google Scholar 

Download references

Acknowledgements

We wish to thank S. Kelkar for the statistical analysis and J.R. Osmolski for technical assistance

Author information

Authors and Affiliations

  1. Infectious Diseases Section (111 F), VA Medical Center West Los Angeles, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA

    S. M. Finegold

  2. Department of Medicine, UCLA School of Medicine, Los Angeles, CA, USA

    S. M. Finegold

  3. Department of Microbiology, Immunology, and Molecular Genetics, UCLA School of Medicine, Los Angeles, CA, USA

    S. M. Finegold

  4. Research Service, VA Medical Center West Los Angeles, Los Angeles, CA, USA

    Y. Song, C. Liu & P. Summanen

  5. Division of Infectious Diseases, Department of Medicine, Loyola University Medical Center Chicago, 2160 S. First Avenue, Bldg. 54-149, Maywood, IL, 60153, USA

    D. W. Hecht

  6. Department of Microbiology and Immunology, Loyola University Medical Center, Chicago, IL, USA

    D. W. Hecht

  7. Infectious Disease Section, Hines VA Hospital, Chicago, IL, USA

    D. W. Hecht

  8. Anaerobe Reference Laboratory, Department of Microbiology, National Public Health Institute (KTL), Mannerheiminte 166, 00300, Helsinki, Finland

    E. Könönen

  9. Department of Pathology and Laboratory Medicine, Division of Clinical Microbiology, Indiana University Medical Center, Indiana University Hospital, Room 4430, 550 N. University Blvd., Indianapolis, IN, 46202-5283, USA

    S. D. Allen

  10. Clinical Microbiology Laboratory, Roudebush VA Hospital, Indianapolis, IN, USA

    S. D. Allen

  11. Clarian Health Partners (Methodist-IU-Riley Hospitals), Indianapolis, IN, USA

    S. D. Allen

Authors
  1. S. M. Finegold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. W. Hecht
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Summanen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Könönen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. D. Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. M. Finegold.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Finegold, S.M., Song, Y., Liu, C. et al. Clostridium clostridioforme: a mixture of three clinically important species. Eur J Clin Microbiol Infect Dis 24, 319–324 (2005). https://doi.org/10.1007/s10096-005-1334-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-005-1334-6

Keywords

Search

Navigation