The Enterotoxic Clostridia

  • Bruce A. McClane
  • Francisco A. Uzal
  • Mariano E. Fernandez Miyakawa
  • David Lyerly
  • Tracy Wilkins

Introduction to the Enterotoxic Clostridia

The anaerobic, nutrient-rich conditions of the mammalian gastrointestinal (GI) tract provide a relatively attractive niche for many clostridia. Several of those clostridial species also produce toxins with potent activity on the GI tract, enabling them to cause human and/or veterinary enteric diseases (Table 1).

Table 1.

Major clostridial species causing human and/or veterinary enteric disease.


Associated diseases

Toxins involved

C. colinum

Enterotoxemiaa (chickens); ulcerative colitis of psittacines


C. difficile

Antibiotic-associated diarrhea and pseudomembranous colitis of humans; veterinary diarrheas (dogs) and necrotizing enteritis (foals)

Toxin A; toxin B; and CDTb (ι toxin)

C. perfringens

C. perfringens type A food poisoning of humans; necrotizing enteritis of humans (PigBel); antibiotic-associated and sporadic diarrhea of humans; animal enterotoxemias

C. perfringensenterotoxin (CPE), α toxin, β toxin, β2 toxin, ɛ toxin, and...


Clostridium Difficile Clostridium Perfringens Necrotic Enteritis Clostridium Perfringens Enterotoxin Nontoxigenic Strain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Literature Cited

  1. Adak, G. K., S. M. Long, and S. J. O’Brien. 2002 Trends in indigenous foodborne disease and deaths, England and Wales: 1992 to 2000 Gut 51 832–841PubMedGoogle Scholar
  2. Alfa, M. J., A. Kabani, D. Lyerly, S. Moncrief, L. M. Neville, A. Al-Barrak, G. K. H. Harding, B. Dyck, K. Olekson, and J. M. Embil. 2000 Characterization of a toxin A-negative, toxin B-positive strain of Clostridium difficile responsible for a nosocomial outbreak of Clostridium difficile-associated diarrhea J. Clin. Microbiol. 38 2706–2714PubMedGoogle Scholar
  3. Alonso, R., C. Munoz, T. Pelaez, E. Cercenado, M. Rodriguez-Creixems, and E. Bouza. 1997 Rapid detection of toxigenic Clostridium difficile strains by a nested PCR of the toxin B gene Clin. Microbiol. Infect. 3 145–147PubMedGoogle Scholar
  4. Al-Sheikhly, F., and R. B. Truscott. 1977 The interaction of Clostridium perfringens and its toxins in the production of necrotic enteritis of chickens Avian Dis. 21 256–263PubMedGoogle Scholar
  5. Al-Sheikhly, F., and A. Al-Saieg. 1980 Role of coccidian in the occurrence of necrotic enteritis of chickens Avian Dis. 24 333Google Scholar
  6. Anonymous. 1993 British Pharmacopoeia (Veterinary) HMSO London, UK 118Google Scholar
  7. Arbuckle, J. B. R. 1972 The attachment of Clostridium welchii (Clostridium perfringens) type C to intestinal villi of pigs J. Pathol. 106 65–72PubMedGoogle Scholar
  8. Ardehali, M., M. Moosawi, and R. Pilehchian. 1994 Isolation of Toxigenic Strains of Clostridium perfringens from the soil of farms in Iran Arch. Inst. RAZI 44 45Google Scholar
  9. Aspinall, S. T., and D. N. Hutchinson. 1992 New selective medium for isolating Clostridium difficile from faeces J. Clin. Pathol. 45 812–814PubMedGoogle Scholar
  10. Awad, M. M., A. E. Bryant, D. L. Stevens, and J. I. Rood. 1995 Virulence studies on chromosomal α toxin and β toxin mutants constructed by θ allelic exchange provide genetic evidence for the essential role of α toxin in Clostridium perfringens-mediated gas gangrene Molec. Microbiol. 15 191–202Google Scholar
  11. Baba, S. G., E., A. L. Fuller, J. M. Gilbert, Thayer, and L. R. McDougald. 1992 Effects of Eimeria brunetti infection and dietary zinc on experimental induction of necrotic enteritis in broiler chickens Avian Dis. 36 59–62PubMedGoogle Scholar
  12. Baldassarri, L., G. Donelli, M. Cerquetti, and P. Mastrantonio. 1991 Capsule-like structures in Clostridium difficile strains Microbiologica 14 295–300PubMedGoogle Scholar
  13. Banno, Y., T. Kobayashi, K. Watanable, K. Ueno, and Y. Nozawa. 1981 Two toxins (D-1 and D-2) and Clostridium difficile causing antibiotic associated colitis: purification and some biological characterization Biochem. Int. 2 629–635Google Scholar
  14. Banu, S., K. Ohtani, H. Yaguchi, T. Swe, S. Cole, H. Hayashi, and T. Shimizu. 2000 Identification of novel VirR/VirS-regulated genes in Clostridium perfringens Molec. Microbiol. 35 854–864Google Scholar
  15. Barbut, F., and J. C. Petit. 2001 Epidemiology of Clostridium difficile-associated infections Clin. Microbiol. Infect. 7 405–410PubMedGoogle Scholar
  16. Barbut, F., V. Lalande, B. Burghoffer, H. V. Thien, E. Grimprel, and J. C. Petit. 2002 Prevalence and genetic characterization of toxin A variant strains of Clostridium difficile among adults and children with diarrhea in France J. Clin. Microbiol. 40 2079–2083PubMedGoogle Scholar
  17. Barker, I. K., A. A. Van Dreumel, and N. Palmer. 1993 The alimentary system In: K. F. Jubb, P. C. Kennedy, and N. Palmer (Eds.) Pathology of Domestic Animals Academic Press San Diego, CA 1–318Google Scholar
  18. Barron, N. S. 1942 Enterotoxaemia in goats Vet. Rec. 54 82Google Scholar
  19. Barroso, L. A., S. Z. Wang, C. J. Phelps, J. L. Johnson, and T. D. Wilkins. 1990 Nucleotide sequence of the Clostridium difficile toxin B gene Nucleic Acids Res. 18 4004PubMedGoogle Scholar
  20. Bartlett, J. G., and S. L. Gorbach. 1977 Pseudomembranous enterocolitis (antibiotic-related colitis) Adv. Intern. Med. 22 455–476PubMedGoogle Scholar
  21. Bartlett, J. G., T. W. Change, M. Gurwith, S. I. Gorbach, and A. B. Onderdonk. 1978 Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia N. Engl. J. Med. 298(10) 531–534Google Scholar
  22. Bartlett, J. G. 1995 Antibiotic-associated diarrhea In: M. J. Blaser, P. D. Smith, J. I. Ravdin, H. B. Greenberg, and R. L. Guerrant (Eds.) Infections of the Gastrointestinal Tract Raven Press New York, NY 893–904Google Scholar
  23. Bartley, S. L., and V. R. Dowell Jr. 1991 Comparison of media for the isolation of Clostridium difficile from fecal specimens Lab. Med. 22 335–338Google Scholar
  24. Baskerville, M., M. Wood, and J. H. Seamer. 1980 Clostridium perfringens type E enterotoxaemia in rabbits Vet. Rec. 107 18–19PubMedGoogle Scholar
  25. Ba-Thein, W., M. Lyristis, K. Ohtani, I. T. Nisbet, H. Hayashi, J. I. Rood, and T. Shimizu. 1996 The virR/virS locus regulates the transcription of genes encoding extracellular toxin production in Clostridium perfringens J. Bacteriol. 178 2514–252PubMedGoogle Scholar
  26. Baxendell, S. A. 1988 The Diagnosis of the Diseases of Goats University of Sydney Post-graduate Foundation in Veterinary Science Sydney, Australia 89Google Scholar
  27. Bean, N. H., J. S. Goulding, C. Lao, and F. J. Angulo. 1996 Surveillance for foodborne-disease outbreaks-United States, 1988–1982 Morbid. Mortal. Weekly Rep. 45 1–54Google Scholar
  28. Belanger, S. D., M. Boissinot, N. Clairoux, F. J. Picard, and M. G. Bergeron. 2002 Rapid detection of Clostridium difficile in feces by real-time PCR J. Clin. Microbiol. 41 730–734Google Scholar
  29. Bennett, G. H. 1961 Diagnosis of enterotoxaemia: the effect of chloroform added as a preservative to intestinal contents of test animals Vet. Rec. 73 168–169Google Scholar
  30. Betancor, A. B., M. R. Fermepin, L. D. Betancor, and R. A. De Torres. 1999 Detection of the etx gene (epsilon toxin-inducer) in plasmids of high molecular weight in Clostridium perfringens type D FEMS Immun. Med. Microbiol. 24 373–377Google Scholar
  31. Billington, S. J., E. U. Wieckowski, M. R. Sarker, D. Bueschel, J. G. Songer, and B. A. McClane. 1998 Clostridium perfringens type E animal enteritis isolates with highly conserved, silent enterotoxin sequences Infect. Immun. 66 4531–4536PubMedGoogle Scholar
  32. Blackwell, T. E., D. G. Butler, and J. A. Bell. 1983 Enterotoxaemia in the goat: the humoral response and local tissue reaction following vaccination with two different bacterin-toxoids Can. J. Comp. Path. Med. 47 127–132Google Scholar
  33. Blackwell, T. E., D. G. Butler, J. F. Prescott, and B. P. Wilcock. 1991 Differences in signs and lesions in sheep and goats with enterotoxaemia induced by intraduodenal infusion of Clostridium perfringens type D Am. J. Vet. Res. 52 1147–1152PubMedGoogle Scholar
  34. Blackwell, T. E., and D. G. Butler. 1992 Clinical signs, treatment and postmortem lesions in dairy goats with enterotoxaemia: 13 cases (1979–1982) J. Am. Vet. Med. Assoc. 200 214–217PubMedGoogle Scholar
  35. Blood, D. C., O. M. Radostits, and J. A. Henderson. 1983 Veterinary Medicine: A Textbook of the Diseases of Cattle, Sheep, Goats and Horses Bailliere Tindall London, UK 553Google Scholar
  36. Bolton, R. P., and M. A. Culshaw. 1986 Faecal metronidazole concentrations during oral and intravenous therapy for antibiotic colitis due to Clostridium difficile Gut 27 1169–1172PubMedGoogle Scholar
  37. Borriello, S. P., A. R. Welch, H. E. Larson, F. Barclay, M. F. Stringer, and B. A. Bartholomew. 1984 Enterotoxigenic Clostridium perfringens: A possible cause of antibiotic-associated diarrhea Lancet 1 305–307PubMedGoogle Scholar
  38. Borriello, S. P. 1985a Newly described clostridial diseases of the gastrointestinal tract: Clostridium perfringens enterotoxin-associated diarrhea and neutropenic enterocolitis due to Clostridium septicum In: S. P. Borriello (Ed.) Clostridia in Gastrointestinal Disease CRC Press Boca Raton, FL 223–228Google Scholar
  39. Borriello, S. P., and F. E. Barclay. 1985b Protection of hamsters against Clostridium difficile ileocaecitis by prior colonization with nonpathogenic strains J. Med. Microbiol. 19 339–350PubMedGoogle Scholar
  40. Borriello, S. P., F. E. Barclay, A. R. Welch, M. F. Stringer, G. N. Watson, R. K. T. Williams, D. V. Seal, and K. Sullens. 1985c Epidemiology of diarrhea caused by enterotoxigenic Clostridium perfringens J. Med. Microbiol. 20 363–372PubMedGoogle Scholar
  41. Borriello, S. P., H. A. Davies, and F. E. Barclay. 1988 Detection of fimbriae amongst strains of Clostridium difficile FEMS Microbiol. Lett. 49 65–67Google Scholar
  42. Borriello, S. P. 1995 Clostridial diseases of the gut Clin. Infect. Dis 20 (Suppl. 2) S242–S250PubMedGoogle Scholar
  43. Braun, M., C. Herholz, R. Straub, B. Choisat, J. Frey, J. Nicolet, and P. Kuhnert. 2000 Detection of the ADP-ribosyltransferase toxin gene (cdtA) and its activity in Clostridium difficile isolates from equidae FEMS Microbiol. Lett. 184 29–33PubMedGoogle Scholar
  44. Brynestad, S., B. Synstad, and P. E. Granum. 1997 The Clostridium perfringens enterotoxin gene is on a transposable element in type A human food poisoning strains Microbiology 143 2109–2115PubMedGoogle Scholar
  45. Brynestad, S., and P. E. Granum. 1999 Evidence that Tn5565, which includes the enterotoxin gene in Clostridium perfringens, can have a circular form which may be a transposition intermediate FEMS Microbiol. Lett. 170 281–286PubMedGoogle Scholar
  46. Brynestad, S., M. R. Sarker, B. A. McClane, P. E. Granum, and J. I. Rood. 2001 The enterotoxin (CPE) plasmid from Clostridium perfringens is conjugative Infect. Immun. 69 3483–3487PubMedGoogle Scholar
  47. Bueschel, D. M., B. H. Jost, S. J. Billington, H. Trinh, and J. G. Songer. 2003 Prevalence of cpb2, encoding beta2 toxin, in Clostridium perfringens field isolates: correlation of genotype with phenotype Vet. Microbiol. 94 121–129PubMedGoogle Scholar
  48. Bullen, J. J. 1952 Enterotoxaemia of sheep: Clostridium welchii type D in the alimentary tract of normal animals J. Path. Bact. 62 201–206Google Scholar
  49. Bullen, J. J., and I. I. Batty. 1957 Enterotoxaemia of sheep Vet. Rec. 69 1268–1276Google Scholar
  50. Bullen, J. J. 1963 The influence of the diet on the pathogenesis of enterotoxaemia of sheep Bull. Int. Off. Epizoot. 59 1453–1461Google Scholar
  51. Buxton, D., and K. T. Morgan. 1976 Studies of the lesions produced in the brain of colostrum deprived lambs by Clostridium welchii (Clostridium perfringens) type D toxin J. Comp. Pathol. 86 435–447PubMedGoogle Scholar
  52. Buxton, D. 1978a Further studies on the mode of action of Clostridium welchii type D epsilon toxin J. Med. Microbiol. 11 293–298PubMedGoogle Scholar
  53. Buxton, D., K. A. Linklater, and D. A. Dyson. 1978b Pulpy kidney disease and its diagnosis by histological examination Vet. Rec. 102 241PubMedGoogle Scholar
  54. Buxton, D., N. S. Macleod, and T. B. Nicolson. 1981 Focal symmetrical encephalomalacia in young cattle Vet. Rec. 108 459PubMedGoogle Scholar
  55. Canard, B., B. Saint-Joanis, and S. T. Cole. 1992 Genomic diversity and organization of virulence genes in the pathogenic anaerobe Clostridium perfringens Molec. Microbiol. 6 1421–1429Google Scholar
  56. Carman, R. J., and J. C. M. Lewis. 1983 Recurrent diarrhea in a dog associated with Clostridium perfringens type A Vet. Rec. 112 342–343PubMedGoogle Scholar
  57. Carman, R. J. 1997a Clostridium perfringens in spontaneous and antibiotic-associated diarrhoea of man and other animals Rev. Med. Microbiol. 8 (Suppl. 1) S43–S45Google Scholar
  58. Carman, R. J., S. Perelle, and M. R. Popoff. 1997b Binary toxins from Clostridium spiroforme and Clostridium perfringens In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 359–368Google Scholar
  59. Carrillo, B. J., M. I. Pasini, J. J. Pereira, J. M. Miquet, F. Olaechea, and M. Suarez. 1982 Enterotoxaemia en ovinos causada por Clostridium perfringens tipo D Rev. Invest. Agrop. 17 55–63Google Scholar
  60. Carter, G. R. 1984 Diagnostic Pin Veterinary Microbiology Charles C. Thomas Springfield, ILGoogle Scholar
  61. Cerquetti, M., A. Pantosti, P. Stefanelli, and P. Mastrantonio. 1992 Purification and characterization of an immunodominant 36 kDa antigen present on the cell surface of Clostridium difficile Microb. Pathog. 13 271–279PubMedGoogle Scholar
  62. Chakrabarti, G., X. Zhou, and B. A. McClane. 2003 Death pathways activated in CaCo-2 cells by Clostridium perfringens enterotoxin Infect. Immun. 71 4260–4270PubMedGoogle Scholar
  63. Cheung, J. K., and J. I. Rood. 2000 The VirR response regulator from Clostridium perfringens binds independently to two imperfect direct repeats located upstream of the pfoA promoter J. Bacteriol. 182 57–66PubMedGoogle Scholar
  64. Cho, S. K., J. Y. Kim, and J. M. Park. 1991 Studies on Clostridium perfringens infection of piglets Res. Rep. Rural Dev. Adm. Vet. 33 25–31Google Scholar
  65. Clabots, C. R., S. J. Gerding, M. M. Olson, L. R. Peterson, and D. N. Gerding. 1989 Detection of asymptomatic Clostridium difficile carriage by an alcohol shock procedure J. Clin. Microbiol. 27 2386–2387PubMedGoogle Scholar
  66. Cole, S. T., and B. T. Canard. 1997 Structure, Organization, and Evolution of the Genome of Clostridium perfringens In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 49–64Google Scholar
  67. Collie, R. E., and B. A. McClane. 1998a Evidence that the enterotoxin gene can be episomal in Clostridium perfringens isolates associated with nonfoodborne human gastrointestinal diseases J. Clin. Microbiol. 36 30–36PubMedGoogle Scholar
  68. Collie, R. E., J. F. Kokai-Kun, and B. A. McClane. 1998b Phenotypic characterization of enterotoxigenic Clostridium perfringens isolates from non-foodborne human gastrointestinal diseases Anaerobe 4 69–79PubMedGoogle Scholar
  69. Collins, J. E., M. E. Bergeland, D. Bouley, A. L. Ducommun, D. H. Francis, and P. Yeske. 1989 Diarrhea associated with Clostridium perfringens type A enterotoxin in neonatal pigs J. Vet. Diag. Invest. 1 351–353Google Scholar
  70. Corfield, A. P., S. A. Wagner, J. R. Clamp, M. S. Kriaris, and L. C. Hoskins. 1992 Mucin degradation in the human colon: production of sialidase, sialate O-acetylesterase, N-acetyl-neuraminate lyase, arylesterase, and glycosulfatase activities by strains of fecal bacteria Infect. Immun. 60 3971–3978PubMedGoogle Scholar
  71. Cornillot, E., B. Saint-Joanis, G. Daube, S. Katayama, S., P. E. Granum, B. Carnard, and S. T. Cole. 1995 The enterotoxin gene (cpe) of Clostridium perfringens can be chromosomal or plasmid-borne Molec. Microbiol. 15 639–647Google Scholar
  72. Czeczulin, J. R., P. C. Hanna, and B. A. McClane. 1993 Cloning, nucleotide sequencing, and expression of the Clostridium perfringens enterotoxin gene in Escherichia coli Infect. Immun. 61 3429–3439PubMedGoogle Scholar
  73. Czeczulin, J. R., R. E. Collie, and B. A. McClane. 1996 Regulated expression of Clostridium perfringens enterotoxin in naturally cpe-negative type A, B, and C isolates of C. perfringens Infect. Immun. 64 3301–3309PubMedGoogle Scholar
  74. Dart, A. J. 1988 Enterotoxaemia in a foal due to Clostridium perfringens type A Austral. Vet. J. 65 330–331PubMedGoogle Scholar
  75. Davies, H. A., and S. P. Borriello. 1990 Detection of capsule in strains of Clostridium difficile of varying virulence and toxigenicity Microb. Pathog. 9 141–146PubMedGoogle Scholar
  76. Denison, A. C., D. C. VanMetre, R. J. Callan, P. Dinsmore, G. L. Mason, and R. P. Ellis. 2002 Hemorrhagic bowel syndrome in dairy cattle: 22 cases (1997–2000) J. Am. Vet. Med. Assoc. 221 686–689Google Scholar
  77. Dickie, C. W., D. L. Klinkerman, and E. F. Petrie. 1978 Enterotoxaemia in two foals J. Am. Vet. Med. Assoc. 173 306–307PubMedGoogle Scholar
  78. Dillon, S. T., E. J. Rubin, M. Yakubovich, C. Pothoulakis, J. T. LaMont, L. A. Feig, and R. J. Gilbert. 1995 Involvement of Ras-Related Rho proteins in the mechanism of action of Clostridium difficile toxin A and toxin B Infect. Immun. 63 1421–1426PubMedGoogle Scholar
  79. Dove, C. H., S. Z. Wang, S. B. Price, C. J. Phelps, D. M. Lyerly, T. D. Wilkins, and J. L. Johnson. 1990 Molecular characterization of the Clostridium difficile toxin A gene Infect. Immun. 58 480–488PubMedGoogle Scholar
  80. Drolet, R., R. Higgins, and A. Cecyre. 1990 Necrohemorrhagic enterocolitis caused by Clostridium perfringens type C in a foal Can. Vet. J. 31 449–450PubMedGoogle Scholar
  81. Duncan, C. L., E. A. Rokos, C. M. Christenson, and J. I. Rood. 1978 Multiple plasmids in different toxigenic types of Clostridium perfringens: possible control of beta toxin production In: D. Schlessinger (Ed.) Microbiology 1978 ASM Press Washington, DC 246–248Google Scholar
  82. Dupuy, B., G. Daube, M. R. Popoff, and S. T. Cole. 1997 Clostridium perfringens urease genes are plasmid-borne Infect. Immun. 65 2313–2320PubMedGoogle Scholar
  83. Dupuy, B., and A. L. Sonenshein. 1998 Regulated transcription of Clostridium difficile toxin genes Molec. Microbiol. 27 107–120Google Scholar
  84. Elliot, D. C. 1986 Tapeworm (Moniezia expansa) and its effects on sheep production: The evidence reviewed NZ Vet. J. 34 61–65Google Scholar
  85. El-Seedy, F. R. 1990 Studies on necrotic enteritis in chickens Vet. Med. J. Giza 38 407–417Google Scholar
  86. Estrada Correa, A. E., and D. J. Taylor. 1989 Porcine Clostridium perfringens type A spores, enterotoxin, and antibody to enterotoxin Vet. Rec. 124 606–610PubMedGoogle Scholar
  87. Fekety, R., J. Silva, C. Kauffman, B. Buggy, and H. G. Deery. 1989 Treatment of antibiotic-associated Clostridium difficile colitis with oral vancomycin; comparison of two dosage regimens Am. J. Med. 86 15–19PubMedGoogle Scholar
  88. Fekety, R. 1997 Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis Am. J. Gastroenterol. 92 739–750PubMedGoogle Scholar
  89. Fernandez Miyakawa, M. E., and F. A. Uzal. 2002 The early effects of Clostridium perfringens type D epsilon toxin in ligated intestinal loops of goats and sheep Vet. Res. Commun. 27 231–241Google Scholar
  90. Ficken, M. D., and D. P. Wages. 1997 Necrotic enteritis Diseases of Poultry Iowa State Press Ames, IA 261–264Google Scholar
  91. Field, H. I., and E. A. Gibson. 1955 Studies on piglet mortality. 2: Clostridium welchii infection Vet. Rec. 67 31–34Google Scholar
  92. Finnie, J. W., Blumberg, P. C., and J. Manavis. 1999 Neuronal damage in rat brains by Clostridium perfringens type D epsilon toxin J. Comp. Pathol. 120 415–420PubMedGoogle Scholar
  93. Fitzgerald, G. R., T. Barker, M. W. Welter, and C. J. Welter. 1988 Diarrhea in young pigs: Comparing the incidence of the five most common infectious agents Vet. Med. 83 80–86Google Scholar
  94. Fowler, M. E. 1998 Medicine and Surgery of South American Camelids, Llama, Alpaca, Vicuña, Guanaco Iowa State University Press Ames, IA 166–169Google Scholar
  95. Fujita, K., J. Katahira, Y. Horiguchi, N. Sonoda, M. Furuse, and S. Tskuita. 2000 Clostridium perfringens enterotoxin binds to the second extracellular loop of claudin-3, a tight junction membrane protein FEBS Lett. 476 258–261PubMedGoogle Scholar
  96. Fukata, T., Y. Hadate, E. Baba, T. Uemura, and A. Arakawa. 1988 Influence of Clostridium perfringens and its toxin in germ-free chickens Res. Vet. Sci. 44 68–70PubMedGoogle Scholar
  97. Fukata, T., Y. Hadate, E. Baba, and A. Arakawa. 1991 Influence of bacteria on Clostridium perfringens infections in young chickens Avian Dis. 35 224–247PubMedGoogle Scholar
  98. Garmory, H. S., N. Chanter, N. P. French, D. Busechel, J. G. Songer, and R. W. Titball. 2000 Occurrence of Clostridium perfringens β2-toxin amongst animals determined using genotyping and subtyping PCR assays Epidemiol. Infect. 124 61–67PubMedGoogle Scholar
  99. Garnier, T., and S. T. Cole. 1988a Complete nucleotide sequence and genetic organization of the bacteriocinogenic plasmid, pIP404, from Clostridium perfringens Plasmid 19 134–150PubMedGoogle Scholar
  100. Garnier, T., and S. T. Cole. 1988b Studies of UV-inducible promoters from Clostridium perfringens in vivo and in vitro Molec. Microbiol. 2 607–614Google Scholar
  101. George, W. L., V. L. Sutter, D. Citron, and S. M. Finegold. 1979 Selective and differential medium for isolation of Clostridium difficile J. Clin. Micriobiol. 9 214–219Google Scholar
  102. Gerding, D., and J. S. Brazier. 1993 Optimal methods for identifying Clostridium difficile infections Clin. Infect. Dis. 16 S439–S442PubMedGoogle Scholar
  103. Gibert, M., C. Jolivet-Reynaud, and M. R. Popoff. 1997 Beta2 toxin, a novel toxin produced by Clostridium perfringens Gene 203 65–73PubMedGoogle Scholar
  104. Gibert, M., L. Petit, S. Raffestin, A. Okabe, and M. R. Popoff. 2000 Clostridium perfringens iota toxin requires activation of both binding and enzymatic components for cytopathic activity Infect. Immun. 68 3848–3853PubMedGoogle Scholar
  105. Gkiourtzidis, K., J. Frey, E. Bourtzi-Hatzopoulou, N. Iliadis, and K. Sarris. 2001 PCR detection and prevalence of alpha, beta, beta 2, epsilon, iota and enterotoxin genes in Clostridium perfringens isolated from lambs with clostridial dysentery Vet. Microbiol. 82 39–43PubMedGoogle Scholar
  106. Gottschalk, G. 1979 Bacterial Metabolism Springer-Verlag New York, NYGoogle Scholar
  107. Granum, P. E., J. R. Whitaker, and R. Skjelkvale. 1981 Trypsin activation of enterotoxin from Clostridium perfringens type A Biochim. Biophys. Acta 668 325–332PubMedGoogle Scholar
  108. Granum, P. E., and M. Richardson. 1991 Chymotrypsin treatment increases the activity of Clostridium perfringens enterotoxin Toxicon 29 445–453Google Scholar
  109. Greenfield, C., J. R. Aguilar Ramirez, R. E. Pounder, T. Williams, M. Danvers, S. R Marper, and P. Noone. 1983 Clostridium difficile and inflammatory bowel disease Gut 24 713–717PubMedGoogle Scholar
  110. Griner, L. A., and F. K. Bracken. 1953 Clostridium perfringens (type C) in acute hemorrhagic enteritis of calves J. Am. Vet. Med. Assoc 122 99–102PubMedGoogle Scholar
  111. Guilbault, C., A. C. Labbe, L. Poirier, L. Busque, C. Beliveau, and M. Laverdiere. 2002 Development and evaluation of a PCR method for detection of the Clostridium difficile toxin B gene in stool specimens J. Clin. Microbiol. 40 2288–2290PubMedGoogle Scholar
  112. Gulke, I., G. Pfeifer, J. Liese, M. Fritz, F. Hofmann, K. Aktories, and H. Barth. 2001 Characterization of the enzymatic component of the ADP-ribosyltransferase toxin CDTa from Clostridium difficile Infect. Immun. 69 6004–6011PubMedGoogle Scholar
  113. Gumerlock, P. H., Y. J. Tang, J. B. Weiss, and J. Silva Jr. 1993 Specific detection of toxigenic strains of Clostridium difficile in stool specimens J. Clin. Microbiol. 31 507–511PubMedGoogle Scholar
  114. Guss, S. B. 1977 Management and Diseases of Dairy Goats Dairy Goat Journal Publishing Corporation Tucson, AZ 106–109Google Scholar
  115. Hafiz, S., and C. L. Oakley. 1975 Clostridium difficile: Isolation and characteristics J. Med. Microbiol. 9 129–137Google Scholar
  116. Hall, J. C., and E. O’Toole. 1935 Intestinal flora in new-born infants with a description of a new pathogenic anaerobe. Bacillus difficilis Am. J. Dis. Child. 49 390–402Google Scholar
  117. Hammond, G. A., D. M. Lyerly, and J. L. Johnson. 1996 Transcriptional analysis of the toxigenic element of Clostridium difficile Microb. Pathog. 22 143–154Google Scholar
  118. Hanna, P. C., A. P. Wnek, and B. A. McClane. 1989 Molecular cloning of the 3’ half of the Clostridium perfringens enterotoxin gene and demonstration that this region encodes receptor-binding activity J. Bacteriol. 171 6815–6820PubMedGoogle Scholar
  119. Hanna, P. C., T. A. Mietzner, G. K. Schoolnik, and B. A. McClane. 1991 Localization of the receptor-binding region of Clostridium perfringens enterotoxin utilizing cloned toxin fragments and synthetic peptides: The 30 C-terminal amino acids define a functional binding region J. Biol. Chem. 266 11037–11043PubMedGoogle Scholar
  120. Hanna, P. C., E. U. Wieckowski, T. A. Mietzner, and B. A. McClane. 1992 Mapping functional regions of Clostridium perfringens type A enterotoxin Infect. Immun. 60 2110–2114PubMedGoogle Scholar
  121. Hardy, S. P., M. Denmead, N. Parekh, and P. E. Granum. 1999 Cationic currents induced by Clostridium perfringens type A enterotoxin in human intestinal Caco-2 cells J. Med. Microbiol. 48 235–243PubMedGoogle Scholar
  122. Hart, B., and P. T. Hooper. 1967 Enterotoxaemia of calves due to Clostridium welchii type E Austral. Vet. J. 43 360–363PubMedGoogle Scholar
  123. Hartley, W. J. 1956 A focal symmetrical encephalomalacia of lambs NZ Vet. J. 4 129–135Google Scholar
  124. Helmboldt, C. F., and E. S. Bryant. 1971 The pathology of necrotic enteritis in domestic fowl Avian Dis. 15 775–780PubMedGoogle Scholar
  125. Herholz, C., R. Miserez, J. Nicolet, J. Frey, M. Popoff, M. Gibert, H. Gerber, and R. Straub. 1999 Prevalence of beta 2 toxigenic Clostridium perfringens in horses with intestinal disorders J. Clin. Microbiol. 37 358–361PubMedGoogle Scholar
  126. Hjerpe, C. A. 1990 Clostridial disease vaccines Vet. Clin. North Am. Food Anim. Pract. 6 222–234Google Scholar
  127. Hofmann, F., C. Busch, U. Prepens, K. Aktories, and I. Just. 1997 Localization of the glucosyltransferase activity of Clostridium difficile toxin B to the N-terminal part of the holotoxin J. Biol. Chem. 272 11074–11078PubMedGoogle Scholar
  128. Hornitzky, M. A. Z., and J. Glastonbury. 1993 Enterotoxaemia in sheep, goats and cattle In: L. A. Corner and T. J. Bagust (Eds.) Australian Standard Diagnostic Techniques for Animal Diseases Standing Committee on Agricultural and Resource Management, CSIRO Melbourne, Australia 5Google Scholar
  129. Howard-Martin, M., R. J. Morton, C. W. Qualls Jr., and C. G. MacAllister. 1986 Clostridium perfringens enterotoxaemia in a newborn foal J. Am. Vet. Med. Assoc. 189 564–565PubMedGoogle Scholar
  130. Hundsberger, T., V. Braun, M. Weidmann, P. Leukel, M. Sauerborn, and C. von Eichel-Streiber. 1997 Transcription analysis of the genes tcdA-E of the pathogenicity locus of Clostridium difficile Eur. J. Biochem. 244 735–742PubMedGoogle Scholar
  131. Hunter, S. E. C., I. N. Clarke, D. C. Kelley, and R. W. Titball. 1992 Cloning and nucleotide sequencing of the Clostridium perfringens epsilon-toxin gene and its expression in Escherichia coli Infect. Immun. 60 102–110PubMedGoogle Scholar
  132. Hunter, S. E. C., J. E. Brown, P. C. Oynston, J. Sakurai, and R. W. Titball. 1993 Molecular genetic analysis of beta-toxin of Clostridium perfringens reveals sequence homology with alpha-toxin, gamma-toxin, and leukocidin of Staphylococcus aureus Infect. Immun. 61 3958–3965PubMedGoogle Scholar
  133. Itodo A. E., A. A. Adesiyun, J. O. Adekeye, and J. U. Umoh. 1986 Toxin-types of Clostridium perfringens strains isolated from sheep, cattle and paddock soils in Nigeria Vet. Microbiol. 12 93–96PubMedGoogle Scholar
  134. Jansen, B. C. 1960 The experimental reproduction of pulpy kidney disease J. SA Vet. Med. Assoc. 31 205–208Google Scholar
  135. Johnson, L. L., L. V. McFarland, P. Dearing, V. Raisys, and F. D. Schoenknecht. 1989 Identification of Clostridium difficile in stool specimens by culture-enhanced gas-liquid chromatography J. Clin. Microbiol. 27 2218–2221PubMedGoogle Scholar
  136. Johnson, J. L., C. J. Phelps, L. A. Barroso, M. D. Roberts, D. M. Lyerly, and T. D. Wilkins. 1990 Cloning and expression of the toxin B gene of Clostridium difficile Curr. Microbiol. 20 397–401Google Scholar
  137. Johnson, M. W., G. R. Fitzgerald, M. W. Welter, and C. J. Welter. 1992 The six most common pathogens responsible for diarrhea in newborn pigs Vet. Med. 87 382–386Google Scholar
  138. Johnson, S., and D. N. Gerding. 1997 Enterotoxemic infections In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 117–140Google Scholar
  139. Johnson, S., S. A. Kent, K. J. O’Leary, M. M. Merrigan, S. P. Sambol., L. R. Peterson, and D. N. Gerding. 2001 Fatal pseudomembranous colitis associated with a variant Clostridium difficile strain not detected by toxin A immunoassay Ann. Intern. Med. 135 434–438PubMedGoogle Scholar
  140. Jolivet-Reynaud, C., M. R. Popoff, M. A. Vinit, P. Ravisse, H. Moreau, and J. E. Alouf. 1986 Enteropathogenicity of Clostridium perfringens beta toxin and other clostridial toxins Zbl. Bakteriol. S15 145–151Google Scholar
  141. Just, I., G. Fritz, K. Aktories, M. Giry, M. R. Popoff, P. Boquet, S. Hegenbarth, and C. von Eichel-Streiber. 1994 Clostridium difficile toxin B acts on the GTP-binding protein Rho J. Biol. Chem. 269 10706–10712PubMedGoogle Scholar
  142. Just, I., J. Selzer, C. von Eichel-Streiber, and K. Aktories. 1995a The low molecular mass GTP-binding protein Rho is affected by toxin A from Clostridium difficile J. Clin. Invest. 95 1026–1031PubMedGoogle Scholar
  143. Just, I., J. Selzer, M. Wilm, C. von Eichel-Streiber, M. Mann, and K. Aktories. 1995b Glucosylation of Rho proteins by Clostridium difficile toxin B Nature 375 500–503PubMedGoogle Scholar
  144. Just, I., M. Wilm, J. Selzer, G. Rex, C. von Eichel-Streiber, M. Mann, and K. Aktories. 1995c The enterotoxin from Clostridium difficile (ToxA) monoglucosylates the Rho proteins J. Biol. Chem. 270 13932–13939PubMedGoogle Scholar
  145. Kader, H. A., D. A. Piccoli, A. F. Jawad, K. L. McGowan, and E. S. Maller. 1998 Single toxin detection is inadequate to diagnose Clostridium difficile diarrhea in pediatric patients Gastroenterology 115 1329–1334PubMedGoogle Scholar
  146. Kaldhusdal, M., and M. Hofshagen. 1992 Barley inclusion and avoparcin supplementation in broiler diets. 2: Clinical, pathological, and bacteriological findings in a mild form of necrotic enteritis Poul. Sci. 71 1145–1153Google Scholar
  147. Kamiya, S., K. Yamakawa, H. Ogura, and S. Nakamura. 1989 Recovery of spores of Clostridium difficile altered by heat or alkali J. Med. Microbiol. 28 217–221PubMedGoogle Scholar
  148. Kanoe, M., S. Inoue, T. Abe, T. Anzai, M. Kamada, H. Imagawa, and T. Kanemaru. 1990 Isolation of Clostridium perfringens from foals Microbios 64 153–158PubMedGoogle Scholar
  149. Karasawa, T., T. Nojiri, Y. Hayashi, T. Maegawa, K. Yamakawa, X. M. Wang, and S. Nakamura. 1999 aboratory diagnosis of toxigenic Clostridium difficile by polymerase chain reaction: presence of toxin genes and their stable expression in toxigenic isolates from Japanese individuals J. Gastroenterol. 34 41–45PubMedGoogle Scholar
  150. Katahira, J., N. Inoue, Y. Horiguchi, M. Matsuda, and N. Sugimoto. 1997a Molecular cloning and functional characterization of the receptor for Clostridium perfringens enterotoxin J. Cell Biol. 136 1239–1247PubMedGoogle Scholar
  151. Katahira, J., H. Sugiyama, N. Inoue, Y. Horiguchi, M. Matsuda, and N. Sugimoto. 1997b Clostridium perfringens enterotoxin utilizes two structurally related membrane proteins as functional receptors in vivo J. Biol. Chem. 272 26652–26658PubMedGoogle Scholar
  152. Kato, N., C. Y. Ou, H. Kato, S. L. Bartley, C. C. Luo, G. E. Killgore, and K. Ueno. 1993 Detection of toxigenic Clostridium difficile in stool specimens by the polymerase chain reaction J. Infect. Dis. 167 455–458PubMedGoogle Scholar
  153. Kato, H., N. Kato, K. Watanabe, N. Iwai, H. Nakamura, T. Yamamoto, K. Suzuki, S. M. Kim, Y. Chong, and E. B. Wasito. 1998 Identification of toxin A-negative, toxin B-positive Clostridium difficile by PCR J. Clin. Microbiol. 36 2178–2182PubMedGoogle Scholar
  154. Kato, H., N. Kato, S. Katow, T. Naegawa, S. Nakamura, and D. M. Lyerly. 1999 Deletions in the repeating sequences of the toxin A gene of toxin A-negative, toxin B-positive Clostridium difficile strains FEMS Microbiol. Lett. 175 197–203PubMedGoogle Scholar
  155. Keighley, M. R. B., D. Youngs, M. Johnson, R. N Allan, and D. W. Burdon. 1982 Clostridium difficile toxin in acute diarrhoea complicating inflammatory bowel disease Gut 23 410–414PubMedGoogle Scholar
  156. Kennedy, K. K., S. J. Norris, W. H. Beckenhauer, and R. C. White. 1977 Vaccination of cattle and sheep with combined Clostridium perfringens type C and type D toxoid Am. J. Vet. Res. 38 1515–1518PubMedGoogle Scholar
  157. King, N. B. 1980 Pregnancy toxaemia and enterotoxaemia In: Proceedings, Refresher Course for Veterinarians, Post-graduate Committee in Veterinary Science University of Sydney Sydney, Australia 52 209–212Google Scholar
  158. Kokai-Kun, J. F., and B. A. McClane. 1996 Evidence that region(s) of the Clostridium perfringens enterotoxin molecule remain exposed on the external surface of the mammalian plasma membrane when the toxin is sequestered in small or large complex Infect. Immun. 64 1020–1025PubMedGoogle Scholar
  159. Kokai-Kun, J. F., and B. A. McClane. 1997a Deletion analysis of the Clostridium perfringens enterotoxin Infect. Immun. 65 1014–1022PubMedGoogle Scholar
  160. Kokai-Kun, J. F., and B. A. McClane. 1997b The Clostridium perfringens enterotoxin In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 325–358Google Scholar
  161. Kokai-Kun, J. F., K. Benton, E. U. Wieckowski, and B. A. McClane. 1999 Identification of a Clostridium perfringens enterotoxin region required for large complex formation and cytotoxicity by random mutagenesis Infect. Immun. 67 6534–6541Google Scholar
  162. Kruth, S. A., J. F. Prescott, M. K. Welch, and M. H. Brodsky. 1989 Nosocomial diarrhea associated with enterotoxigenic Clostridium perfringens infection in dogs J. Am. Vet. Med. Assoc. 195 331–334PubMedGoogle Scholar
  163. Kuhl, S. J., Y. J. Tang, L. Navarro, P. H. Gumerlock, and J. Silva Jr. 1993 Diagnosis and monitoring of Clostridium difficile infections with the polymerase chain reaction Clin. Infect. Dis. 16 (Suppl. 4) S234–S238PubMedGoogle Scholar
  164. Kuijper, E. J., J. de Weerdt, H. Kato, N. Kato, A. P. van Dam, E. R. van der Vorm, J. Weel, C. van Rheenen, and J. Dankert. 2001 Nosocomial outbreak of Clostridium difficile-associated diarrhoea due to a clindamycin-resistant enterotoxin A-negative strain Eur. J. Clin. Microbiol. Infect. Dis 20 528–534PubMedGoogle Scholar
  165. Labbe, R. G., and C. L. Duncan. 1977 Evidence for stable messenger ribonucleic acid during sporulation and enterotoxin synthesis by Clostridium perfringens type A J. Bacteriol. 129 843–849PubMedGoogle Scholar
  166. Larson, H. E., J. V. Parry, A. B. Price, D. R. Davies, J. Dolby, and D. A. Tyrrell. 1977 Undescribed toxin in pseudomembranous colitis BMJ 1 1246–1248PubMedGoogle Scholar
  167. Lawrence, G. W. 1997 The pathogenesis of enteritis necroticans In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 198–207Google Scholar
  168. Leary, S. E. C., and R. W. Titball. 1997 The Clostridium perfringens β-toxin In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 243–250Google Scholar
  169. Lee, S. D., D. K. Turgeon, C. W. Ko, T. R. Fritsche, and C. M. Surawicz. 2003 Clinical correlation of toxin and common antigen enzyme immunoassay testing in patients with Clostridium difficile disease Am. J. Gastroenterol. 98 1569–1572PubMedGoogle Scholar
  170. Levett, P. N. 1984 Effect of antibiotic concentration in a selective medium on the isolation of Clostridium difficile from faecal specimens J. Clin. Pathol. 38 233–234Google Scholar
  171. Levett, P. N. 1987 Production of p-cresol by Clostridium difficile on different basal media Lett. Appl. Microbiol. 5 71–73Google Scholar
  172. Lewis, C. J., B. E. Preece, and B. A. Synge. 1995 Increased incidence of clostridial disease Vet. Rec. 36 23 and 595Google Scholar
  173. Lewis, C. 1998 Aspects of clostridial disease in sheep In Practice 9 494–500Google Scholar
  174. Lewis, C. J. 2000 Clostridial diseases In: W. B. Martin and I. D. Aitken (Eds.) Diseases of Sheep Blackwell Science Oxford, UK 131–142Google Scholar
  175. Libby, J. M., and T. D. Wilkins. 1982 Production of antitoxins to two toxins of Clostridium difficile and immunological comparison of the toxins by cross-neutralization studies Infect. Immun. 35 374–376PubMedGoogle Scholar
  176. Limaye, A. P., D. K. Turgeon, B. T. Cookson, and T. R. Fritsche. 2002 Pseudomembranous colitis caused by a toxin A-B+ strain of Clostridium difficile J. Clin. Microbiol. 38 1696–1697Google Scholar
  177. Liu, T. S., M. W. Musch, K. Sugi, M. M. Walsh-Reitz, M. J. Robeleski, B. A. Hendrickson, C. Pothoulakis, J. T. Lamont, and E. B. Chang. 2003 Protective role of HSP72 against Clostridium difficile toxin A-induced intestinal epithelial cell dysfunction Am. J. Physiol. Cell. Physiol. 284 C1073–C1082PubMedGoogle Scholar
  178. Long, H., C. D. Crean, W. H. Lee, O. W. Cummings, and T. G. Gabig. 2001 Expression of Clostridium perfringens enterotoxin receptors claudin-3 and claudin-4 in prostate cancer epithelium Cancer Res. 61 7878–7881PubMedGoogle Scholar
  179. Long, J. R., and R. B. Truscott. 1976 Necrotic enteritis in broiler chickens. III. Reproduction of the disease Can. J. Comp. Med. 40 53–59PubMedGoogle Scholar
  180. Lyerly, D. M., K. E. Saum, D. MacDonald, and T. D. Wilkins. 1985 Effect of toxins A and B given intragastrically to animals Infect. Immun. 47 349–352PubMedGoogle Scholar
  181. Lyerly, D. M., M. D. Roberts, C. J. Phelps, and T. D. Wilkins. 1986 Properties of toxins A and B of Clostridium difficile FEMS Microbiol. Lett. 33 31–35Google Scholar
  182. Lyerly, D. M., J. L. Johnson, and T. D. Wilkins. 1989 Characterization of the binding portion of Clostridium difficile toxin A Microecol. Ther. 19 233–237Google Scholar
  183. Lyerly, D. M., L. A. Barroso, and T. D. Wilkins. 1991 Identification of the latex test-reactive protein of Clostridium difficile as glutamate dehydrogenas J. Clin. Microbiol. 29 2639–2642PubMedGoogle Scholar
  184. Lyerly, D. M., L. A. Barroso, T. D. Wilkins, C. Depitre, and G. Corthier. 1992 Characterization of a toxin A-negative, toxin B-positive strain of Clostridium difficile Infect. Immun. 60(11) 4633–4639Google Scholar
  185. Lyerly, D. M., L. M. Neville, D. T. Evans, J. Fill, S. Allen, W. Greene, R. Sautter, P. Hnatuck, D. J. Torpey, and R. Schwalbe. 1998 Multicenter evaluation of the Clostridium difficile TOX A/B TEST J. Clin. Microbiol. 36 184–190PubMedGoogle Scholar
  186. Lyristis, M., A. E. Bryant, J. Sloan, M. M. Awad, I. T. Nisbet, D. L. Stevens, and J. I. Rood. 1994 Identification and molecular analysis of a locus that regulates extracellular toxin production in Clostridium perfringens Molec. Microbiol. 12 761–777Google Scholar
  187. Macarie, I., C. Cure, and A. Pop. 1980 Histopathology of natural Clostridium perfringens type A infection in mink Lucr. Stiint. Inst. Agron. “Nicolae Balcescu” Med. Vet. 23 23–27Google Scholar
  188. Mackinnon, J. D. 1989 Enterotoxaemia caused by Clostridium perfringens type C Pig Vet. J. 22 119–125Google Scholar
  189. MacLaren, R., T. H. Morton, and D. A. Kuhl. 1997 Effective management of Clostridium difficile colitis Hosp. Pharm. 32 1126–1132Google Scholar
  190. Mani, N., D. Lyras, L. Barroso, P. Howarth, T. Wilkins, J. I. Rood, A. L. Sonenshein, and B. Dupuy. 2002 Environmental response and autoregulation of Clostridium difficile txeR, a sigma factor for toxin gene expression J. Bacteriol. 184 5971–5978PubMedGoogle Scholar
  191. Manteca, C., G. Daube, T. Jauniaux, A. Linden, V. Pirson, J. Detilleux, A. Ginter, and P. Coppe. 2002 A role for the Clostridium perfringens beta2 toxin in bovine enterotoxaemia? Vet. Microbiol. 86 191–202PubMedGoogle Scholar
  192. Marler, L. M., J. A. Siders, L. C. Wolters, Y. Pettigrew, G. L. Skitt, and S. D. Allen. 1992 Comparison of five cultural procedures for isolation of Clostridium difficile from stools J. Clin. Microbiol. 30 514–516PubMedGoogle Scholar
  193. Marvaud, J. C., M. Gibert, K. Inoue, Y. Fujinaga, K. Oguma, and M. R. Popoff. 1998a botR/A is a positive regulator of botulinum neurotoxin and associated non-toxin protein genes in Clostridium botulinum A Molec. Microbiol. 29 1009–1018Google Scholar
  194. Marvaud, J. C., U. Eisel, T. Binz, H. Niemann, and M. R. Popoff. 1998b TetR is a positive regulator for the tetanus toxin gene in Clostridium tetani and is homologous to BotR Infect. Immun. 66 5698–5702PubMedGoogle Scholar
  195. Masuda, K., M. Itoh, and T. Kawata. 1989 Characterization and reassembly of a regular array in the cell wall of Clostridium difficile GAI 4131 Microbiol. Immunol. 33 287–298PubMedGoogle Scholar
  196. McClane, B. A., and J. L. McDonel. 1981 Protective effects of osmotic stabilizers on morphological and permeability alterations induced in Vero cells by Clostridium perfringens enterotoxin Biochim. Biophys. Acta 641 401–409PubMedGoogle Scholar
  197. McClane, B. A., and A. P. Wnek. 1990 Studies of Clostridium perfringens enterotoxin action at different temperatures demonstrate a correlation between complex formation and cytotoxicity Infect. Immun. 58 3109–3115PubMedGoogle Scholar
  198. McClane, B. A. 1992 Clostridium perfringens enterotoxin: structure, action and detection J. Food Safety 12 237–252Google Scholar
  199. McClane, B. A. 2000 Clostridium perfringens enterotoxin and intestinal tight junctions Trends Microbiol. 8 145–146PubMedGoogle Scholar
  200. McClane, B. A. 2001a Clostridium perfringens In: M. P. Doyle, L. R. Beuchat, and T. J. Montville (Eds.) Food Microbiology: Fundamentals and Frontiers, 2nd ed ASM Press Washington, DC 351–372Google Scholar
  201. McClane, B. A. 2001b The complex interactions between Clostridium perfringens enterotoxin and epithelial tight junctions Toxicon 39 1781–1791PubMedGoogle Scholar
  202. McDonel, J. L. 1986 Toxins of Clostridium perfringens types A, B, C, D, and E In: F. Dorner and H. Drews (Eds.) Pharmacology of Bacterial Toxins Pergamon Press Oxford, UK 477–517Google Scholar
  203. McFarland, L. V., C. M. Surawicz, and W. E. Stamm. 1990 Nosocomial acquisition of Clostridium difficile infection N. Engl. J. Med. 320 204–210Google Scholar
  204. McFarland, L. V., C. M. Surawicz, R. N. Greenberg, K. E. Bowen, S. A. Melcher, and M. E. Mulligan. 1998 Possible role of cross-transmission between neonates and mothers with recurrent Clostridium difficile infections Am. J. Infect. Contr. 27 301–303Google Scholar
  205. McGowan, G., J. E. Moulton, and S. E. Rood. 1958 Lamb losses associated with Clostridium perfringens type A J. Am. Vet. Med. Assoc. 133 219–221PubMedGoogle Scholar
  206. Mead, P. S., L. Slutsker, V. Dietz, L. F. McCaig, J. S. Bresee, C. Shapiro, P. M. Griffen, and R. V. Tauxe. 1999 Food-related illness and death in the United States Emerg. Infect. Dis. 5 607–625PubMedGoogle Scholar
  207. Meer, R. R., and J. G. Songer. 1997 Multiplex PCR method for genotyping Clostridium perfringens Am. J. Vet. Res. 58 702–705PubMedGoogle Scholar
  208. Mehlig, M., M. Moos, V. Braun, B. Kalt, D. E. Mahony, and C. von Eichel-Streiber. 2001 Variant toxin B and a functional toxin A produced by Clostridium difficile C34 FEMS Microbiol. Lett. 198 171–176PubMedGoogle Scholar
  209. Melville, S. B., R. Labbe, and A. L. Sonenshein. 1994 Expression from the Clostridium perfringens cpe promoter in C. perfringens and Bacillus subtilus Infect. Immun. 62 5550–5558PubMedGoogle Scholar
  210. Melville, S. B., R. E. Collie, and B. A. McClane. 1997 Regulation of enterotoxin production in Clostridium perfringens In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 471–487Google Scholar
  211. Merchen, N. R. 1988 Digestion, absorption and excretion in ruminants In: D. C. Church (Ed.) The Ruminant Animal Waveland Press Prospect Heights, IL 172–201Google Scholar
  212. Michl, P., M. Buchholz, M. Rolke, S. Kunsch, M. Lohr, B. McClane, S. Tsukita, G. Leder, G. Adler, and T. M. Gress. 2001 Claudin-4: A new target for pancreatic cancer treatment using Clostridium perfringens enterotoxin Gastroenterology 121 678–684PubMedGoogle Scholar
  213. Mietzner, T. A., J. F. Kokai-Kun, P. C. Hanna, and B. A. McClane. 1992 A conjugated synthetic peptide corresponding to the C-terminal region of Clostridium perfringens type A enterotoxin elicits an enterotoxin-neutralizing antibody response in mice Infect. Immun. 60 3947–3951PubMedGoogle Scholar
  214. Mitchell, G., and K. Linklater. 1983 Differential diagnosis of scouring in lambs In Practice 5 4–12PubMedGoogle Scholar
  215. Mitchell, W. J. 2001 Biology and physiology In: H. Bahl and P. Dürre (Eds.) Clostridia: Biotechnology and Medical Applications Wiley-VCH Weinheim, Germany 49–104Google Scholar
  216. Miyamoto, K., G. Chakrabarti, Y. Morino, and B. A. McClane. 2002 Organization of the plasmid cpe locus of Clostridium perfringens type A isolates Infect. Immun. 70 4261–4272PubMedGoogle Scholar
  217. Miyata, S., O. Matsushita, J. Minami, S. Katayama, S. Shimamoto, and A. Okabe. 2001 Cleavage of a C-terminal peptide is essential for hepatmerization of Clostridium perfringens-toxin in the synaptosomal membrane J. Biol. Chem. 276 13778–13783PubMedGoogle Scholar
  218. Miyata, S., J. Minami, E. Tamia, O. Matsushita, S. Shimamoto, and A. Okabe. 2002 Clostridium perfringens epsilon-toxin forms a hepatmeric pore within the detergent-insoluble microdomains of Madin-Darby canine kidney cells and rat synaptosomes J. Biol. Chem. 277 39463–39468PubMedGoogle Scholar
  219. Moncrief, J. S., L. A. Barroso, and T. D. Wilkins. 1997 Positive regulation of Clostridium difficile toxins Infect. Immun. 65 1105–1108PubMedGoogle Scholar
  220. Moncrief, J. S., D. M. Lyerly, and T. D. Wilkins. 2000a Molecular biology of large clostridial toxins In: K. Aktories and I. Just (Eds.) Handbook of Experimental Pharmacology Springer-Verlag Berlin, Germany 145 and 333–359Google Scholar
  221. Moncrief, J. S., L. Zheng, L. M. Neville, and D. M. Lyerly. 2000b Genetic characterization of toxin A-negative, toxin B-positive Clostridium difficile isolates by PCR J. Clin. Microbiol. 38 3072–3075PubMedGoogle Scholar
  222. Mulligan, M. E. 1988 General epidemiology, potential reservoirs, and typing procedures In: R. D. Rolfe and S. M. Finegold (Eds.) Clostridium difficile: Its Role in Intestinal Disease Academic Press New York, NY 229–256Google Scholar
  223. Munday, B. L., R. W. Mason, and W. J. Hartley. 1976 Encephalopathies in cattle in Tasmania Austral. Vet. J. 52 92–96PubMedGoogle Scholar
  224. Nabuurs, M. J. A., J. Haagsma, E. J. van der Molen, and P. J. van der Heijden. 1983 Diarrhea in one to three week-old piglets associated with Clostridium perfringens type A Ann. Rech. Vet. 14 408–411PubMedGoogle Scholar
  225. Nagahama, M., S. Hayashi, S. Morimitsu, and J. Sakurai. 2003 Biological activities and pore formation of Clostridium perfringens beta toxin in HL 60 cells J. Biol. Chem. 278 36934–36941PubMedGoogle Scholar
  226. Nairn, M. E., and V. W. Bamford. 1967 Necrotic enteritis of broiler chickens in western Australia Austral. Vet. J. 43 49–54PubMedGoogle Scholar
  227. Niilo, L. 1965 Bovine enterotoxaemia. III. Factors affecting the stability of the toxins of Clostridium perfringens types A, C, and D Can. Vet. J. 6 38–42PubMedGoogle Scholar
  228. Niilo, L. 1978 Enterotoxigenic Clostridium perfringens type A isolated from intestinal contents of cattle, sheep and chickens Can. J. Comp. Med. 42 357–63PubMedGoogle Scholar
  229. Niilo, L. 1980 Clostridium perfringens in animal disease: a review of current knowledge Can. Vet. J. 21 141–148PubMedGoogle Scholar
  230. Niilo, L. 1986 Experimental production of hemorrhagic enterotoxaemia by Clostridium perfringens type C in maturing lambs Can. J. Vet. Res. 50 32–35PubMedGoogle Scholar
  231. Niilo, L. 1988 Clostridium perfringens type C enterotoxaemia Can. Vet.. J. 29 658–664PubMedGoogle Scholar
  232. Nolling, J., G. Breton, M. V. Omelchenko, K. S. Makarova, Q. Zeng, R. Gibson, H. M. Lee, J. Dubois, D. Qiu, J. Hitt, Y. I. Wolf, R. L. Tatusov, F. Sabathe, L. Doucette-Stamm, P. Soucaille, M. J. Daly, G. N. Bennett, E. V. Koonin, and D. R. Smith. 2001 Genome sequence and comparative analysis of the solvent-producing bacterium Clostridium acetobutyliticum J. Bacteriol. 183 4823–4838PubMedGoogle Scholar
  233. Odendaal, M. W., J. J. Visser, N. Bergh, and J. S. Botha. 1989 The effect of passive immunization on active immunity against Clostridium perfringens type D in lambs Ondertepoort J. Vet. Res. 56 251–255Google Scholar
  234. Ohnuna, K. H., H. Saino, M. Taguchi, A. Ohno, and T. Matsuda. 1992 Necrotic enteritis due to Clostridium perfringens type C in newborn piglets J. Jpn. Vet. Med. Assoc. 45 738–741Google Scholar
  235. Ohtani, K., H. I. Kawsar, K. Okumura, H. Hayashi, and T. Shimizu. 2003 The VirR/VirS regulatory cascade affects transcription of plasmid-encoded putative virulence genes in Clostridium perfringens FEMS Microbiol. Lett. 222 137–141PubMedGoogle Scholar
  236. Onderka, D. K., C. C. Langevin, and J. A. Hanson. 1990 Fibrosing cholehepatitis in broiler chickens induced by bile duct ligations or inoculation of Clostridium perfringens Can. J. Vet. Res. 54 285–290PubMedGoogle Scholar
  237. Oxer, D. T. 1956 Enterotoxaemia in goats Austral. Vet. J. 32 62–66Google Scholar
  238. Pace, L. W., J. M. Kreeger, M. A. Miller, S. E. Turnquist, J. R. Fischer, G. C. Johnson, J. R. Turk, L. L. Pittman, W. H. Fales, C. W. Maddox, A. A. Rottinghaus, and H. S. Gosser. 1992 Necropsy findings from Vietnamese potbellied pigs, 33 cases J. Vet. Diagn. Invest. 4 351–352PubMedGoogle Scholar
  239. Pantosti, A., M. Cerquetti, F. Viti, G. Ortisi, and P. Mastrantonio. 1989 Immunoblot analysis of serum immunoglobulin G response to surface proteins of Clostridium difficile in patients with antibiotic-associated diarrhoea J. Clin. Microbiol. 27 2594–2597PubMedGoogle Scholar
  240. Payne, D., and P. Oyston. 1997 The Clostridium perfringens toxin In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 439–450Google Scholar
  241. Pearson, E. G., O. R. Hedstrom, R. Sonn, and J. Wedam. 1986 Hemorrhagic enteritis caused by Clostridium perfringens type C in a foal J. Am. Vet. Med. Assoc. 188 1309–1310PubMedGoogle Scholar
  242. Percy, D. H., and S. W. Barthold. 2001 The rabbit Pathology of Laboratory Rodents and Rabbits, 2nd ed Iowa State University Press Ames, IA 315Google Scholar
  243. Perelle, S., M. Gibert, P. Bourlioux, G. Corthier, and M. R. Popoff. 1997 Production of a complete binary toxin (actin-specific ADP-ribosyltransferase) by Clostridium difficile CD196 Infect. Immun. 65 1402–1407PubMedGoogle Scholar
  244. Petit, L., M. Gibert, and M. R. Popoff. 1999 Clostridium perfringens: toxinotype and genotype Trends Microbiol. 7 104–10PubMedGoogle Scholar
  245. Petit, L., M. Gibert, A. Gourch, M. Bens, A. Vendewalle, and M. R. Popoff. 2003 Clostridium perfringens epsilon toxin rapidly decreases membrane barrier permeability of polarized MDCK cells Cell Microbiol. 5 155–164PubMedGoogle Scholar
  246. Pituch, H., N. van den Braak, W. van Leeuwen, A. van Belkum, G. Martirosian, P. Obuch-Woszczatynski, M. Luczak, and F. Meisel-Mikolajczyk. 2001 Clonal dissemination of a toxin-A-negative/toxin-B-positive Clostridium difficile strain from patients with antibiotic-associated diarrhea in Poland Clin. Microbiol. Infect. 7 442–446PubMedGoogle Scholar
  247. Popoff, M. R. 1984 Bacteriological examination in enterotoxaemia of sheep and lamb Vet. Rec. 114 324PubMedGoogle Scholar
  248. Popoff, M. R., and A. Jestin. 1985 Enteropathogenicity of purified Clostridium perfringens enterotoxin in the pig Am. J. Vet. Res. 46 2147–2148PubMedGoogle Scholar
  249. Pothoulakis, H., R. Sullivan, D. A. Melnick, G. Tridafilapoulos, A. S. Gadenne, T. Meshulam, and J. T. LaMont. 1988 Clostridium difficile toxin A stimulates intracellular calcium release and chemotactic response in human granulocytes J. Clin. Invest. 81 1741–1745PubMedGoogle Scholar
  250. Poxton, I. R., and T. D. I. Cartmill. 1982 Immunochemistry of the cell-surface carbohydrate antigens of Clostridium difficile J. Gen. Microbiol. 128 1365–1370PubMedGoogle Scholar
  251. Prescott, J. F. 1979 The prevention of experimentally induced necrotic enteritis in chicken by avoparcin Avian Dis. 4 1073Google Scholar
  252. Price, S. B., C. J. Phelps, T. D. Wilkins, and J. L. Johnson. 1987 Cloning of the carbohydrate-binding portion of the toxin A gene of Clostridium difficile Curr. Microbiol. 16 55–60Google Scholar
  253. Ratz, F., E. Szabo, and E. Szentmiklossy. 1989 Observations on the pathomorphology of necrotic enteritis in chickens Magy. Allatorv. Lapja 44 133–140Google Scholar
  254. Rehg, J. E., and S. P. Pakes. 1982 Implication of Clostridium difficile and Clostridium perfringens iota toxins in experimental lincomycin-associated colitis of rabbits Lab. Anim. Sci. 32 253–257PubMedGoogle Scholar
  255. Reinke, C. M. 1998 ASHP therapeutic position statement on the preferential use of metronidazole for the treatment of Clostridium difficile-associated disease Am. J. Health. Syst. Pharm. 55 1407–1411Google Scholar
  256. Rifkin, G. D., F. R. Fekety, J. Silva, and R. B. Sack. 1977 Antibiotic-induced colitis implication of a toxin neutralized by Clostridium sordellii antitoxin Lancet 2 1103–1106PubMedGoogle Scholar
  257. Ripley, P. H., and A. F. Gush. 1983 Immunization schedule for the prevention of infectious necrotic enteritis caused by Clostridium perfringens type C in piglets Vet. Rec. 112 201–202PubMedGoogle Scholar
  258. Rood, J. I. 1998 Virulence genes of Clostridium perfringens Ann. Rev. Microbiol. 52 333–360Google Scholar
  259. Rupnik, M., V. Braun, F. Soehn, M. Janc, M. Hofstetter, R. Laufenberg-Feldmann, and C. von Eichel-Streiber. 1997 Characterization of polymorphisms in the toxin A and B genes of Clostridium difficile FEMS Microbiol. Lett. 148 197–202PubMedGoogle Scholar
  260. Rupnik, M., V. Avesani, M. Janc, C. von Eichel-Streiber, and M. Delmee. 1998 A novel toxinotyping scheme and correlation of toxinotypes with serogroups of Clostridium difficile isolates J. Clin. Microbiol. 36 2240–2247PubMedGoogle Scholar
  261. Rupnik, M. 2002 Binary toxin producing Clostridium difficile Anaerobe 8 164–165 (abstract)Google Scholar
  262. Rupnik, M., N. Kato, M. Grabnar, and H. Kato. 2003 New types of toxin A-negative, toxin B-positive strains among Clostridium difficile isolates from Asia J. Clin. Microbiol. 41 1118–1125PubMedGoogle Scholar
  263. Russell, W. C. 1970 Type A enterotoxaemia in captive wild goats J. Am. Vet. Med. Assoc. 157 643–646PubMedGoogle Scholar
  264. Sakurai, J., M. Nagahama, J. Hisatsune, N. Katunuma, and H. Tsuge. 2003 Clostridium perfringens ι toxin, ADP-ribosyltransferase: Structure and mechanism of action Adv. Enz. Regul. 43 361–377Google Scholar
  265. Sarker, M. R., R. J. Carman, and B. A. McClane. 1999 Inactivation of the gene (cpe) encoding Clostridium perfringens enterotoxin eliminates the ability of two cpe-positive C. perfringens type A human gastrointestinal disease isolates to affect rabbit ileal loops Molec. Microbiol. 33 946–958Google Scholar
  266. Sarker, M. R., R. P., Shivers, S. G. Sparks, V. K. Juneja, and B. A. McClane. 2000 Comparative experiments to examine the effects of heating on vegetative cells and spores of Clostridium perfringens isolates carrying plasmid versus chromosomal enterotoxin genes Appl. Env. Microbiol. 66 3234–3240Google Scholar
  267. Savidge, T. C., W. H. Pan, P. Newman, M. O’Brien, P. M. Anton, and C. Pothoulakis. 2003 Clostridium difficile toxin B is an inflammatory enterotoxin in human intestine Gastroenterology 125 413–420PubMedGoogle Scholar
  268. Seifert, H. S. H., H. Bohnel, S. Heitefuss, J. Rengel, R. Schaper, U. Sukop, and U. Wernery. 1992 Isolation of C. perfringens type A from enterotoxaemia in camels and production of a locality-specific vaccine In: W. R. Allen, A. J. Higgins, I. G. Mayhew, D. H. Snow, and J. F. Wade (Eds.) Proceedings of the 1st International Camel Conference R&W Publications Newmarket, UK 65–69Google Scholar
  269. Shane, S. M., J. E. Gyimah, K. S. Harrington, and T. G. Snider. 1985 Etiology and pathogenesis of necrotic enteritis Vet. Res. Commun. 9 269–287PubMedGoogle Scholar
  270. Shanks, P. L. 1949 Enterotoxaemia in goats Vet. Rec. 61 262–264Google Scholar
  271. Sherman, S., E. Klein, and B. A. McClane. 1994 Clostridium perfringens type A enterotoxin induces concurrent development of tissue damage and fluid accumulation in the rabbit ileum J. Diarrh. Dis. Res. 12 200–207Google Scholar
  272. Shimizu, T., W. Ba-Thein, M. Tamaki, and H. Hayashi. 1994 The virR gene, a member of a class of two-component response regulators, regulates the production of perfringolysin O, collagenase, and hemagglutinin in Clostridium perfringens J. Bacteriol. 176 1616–1623PubMedGoogle Scholar
  273. Shimizu, T., K. Ohtani, H. Hirakawa, K. Ohshima, A. Yamashita, T. Shiba, N. Ogasawara, M. Hattori, S. Kuhara, and H. Hayashi. 2002 Complete genome sequence of Clostridium perfringens, an anaerobic flesh-eater Proc. Natl. Acad. Sci. USA 99 996–1001PubMedGoogle Scholar
  274. Singh, U., C. M. Van Itallie, L. L. Mitic, J. M. Anderson, and B. A. McClane. 2000 CaCo-2 cells treated with Clostridium perfringens enterotoxin form multiple large complex species, one of which contains the tight junction protein occludin J. Biol. Chem. 275 18407–18417PubMedGoogle Scholar
  275. Singh, U., L. L. Mitic, E. U. Wieckowski, J. M. Anderson, and B. A. McClane. 2001 Comparative biochemical and immunochemical studies reveal differences in the effects of Clostridium perfringens enterotoxin on polarized CaCo-2 cells versus Vero cells J. Biol. Chem. 276 33402–33412PubMedGoogle Scholar
  276. Sinha, H. B., and P. B. Kuppuswamy. 1969 Heat resistant variants of Clostridium welchii in the alimentary tract of healthy goats Indian J. Anim. Health 8 89–93Google Scholar
  277. Sinha, M. N. 1970 The incidence of clostridial species in the alimentary tract of apparently healthy goats Kajian Veterinarian (Singapore) 2 171–175Google Scholar
  278. Sivsammye, G., and H. V. Sims. 1990 Presumptive identification of Clostridium difficile by detection of p-cresol in prepared peptone yeast glucose broth supplemented with p-hydroxyphenylacetic acid J. Clin. Microbiol. 28 1851–1853PubMedGoogle Scholar
  279. Skjelkvale, R., and T. Uemura. 1977 Experimental diarrhea in human volunteers following oral administration of Clostridium perfringens enterotoxin J. Appl. Bacteriol. 46 281–286Google Scholar
  280. Smith, M. C., and D. M. Sherman. 1994 Goat Medicine Lea and Febiger Pennsylvania, PA 620Google Scholar
  281. Song, K. P., and C. Faust. 1998 Molecular analysis of the promoter region of the Clostridium difficile toxin B gene that is functional in Escherichia coli J. Med. Microbiol. 47 309–316PubMedGoogle Scholar
  282. Songer, J. G. 1996 Clostridial enteric diseases of domestic animals Clin. Microbiol. Rev. 9 216–234PubMedGoogle Scholar
  283. Songer, J. G. 1998 Clostridial diseases of small ruminants Vet. Res. 29 219–232PubMedGoogle Scholar
  284. Sparks, S. G., R. J. Carman, M. R. Sarker, and B. A. McClane. 2001 Genotyping of enterotoxigenic Clostridium perfringens isolates associated with gastrointestinal disease in North America J. Clin Microbiol. 39 883–888PubMedGoogle Scholar
  285. Stackebrandt, E. 1997 Phylogenetic relationships In: J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (Eds.) The Clostridia: Molecular Biology and Pathogenesis Academic Press London, UK 3–20Google Scholar
  286. Stackebrandt, E., I. Kramer, J. Swiderski, and H. Hippe. 1999 Phylogenetic basis for taxonomic dissection of the genus Clostridium FEMS Immun. Med. Microbiol. 24 253–258Google Scholar
  287. Staempfli, H. R., H. Townsed, and J. F. Prescott. 1991 Prognostic features and clinical presentation of acute idiopathic enterocolitis in horses Can. Vet. J. 32 11–17Google Scholar
  288. Steinsthorsdottir, V., V. Fridriksdottir, E. Gunnarsson, and O. S. Andresson. 1995 Expression and purification of Clostridium perfringens beta-toxin glutathionine S-transferase fusion proteins FEMS Microbiol. Lett. 130 273–278Google Scholar
  289. Sterne, M., and I. Batty. 1975 Criteria for diagnosis of clostridial infections Pathogenic Clostridia Butterworths London, UK 94–145Google Scholar
  290. Strelau, E., B. Wagner, M. Wagner, and W. Karsch. 1989 Demonstration of capsules on Clostridium difficile Zbl. Bakteriol. Hyg. 270 456–461Google Scholar
  291. Stringer, M. F. 1985 Clostridium perfringens type A food poisoning In: S. P. Borriello (Ed.) Clostridia in Gastrointestinal Disease CRC Press Boca Raton, FL 118–143Google Scholar
  292. Stubbs, S., M. Rupnik, M. Gilbert, J. Brazier, B. Duerden, and M. R. Popoff. 2000 Production of an actin-specific ADP-ribosyltransferase (binary toxin) by strains of Clostridium difficile FEMS Microbiol. Lett. 186 307–312PubMedGoogle Scholar
  293. Tanaka, D., J. Isobe, S. Hosorogi, K. Kimata, M. Shimizu, K. Katori, Y. Gyobu, Y. Nagai, T. Yamagishi, T. Karasawa, and S. Nakamura. 2003 An outbreak of food-borne gastroenteritis caused by Clostridium perfringens carrying the cpe gene on a plasmid Jpn. J. Infect. Dis. 56 137–139PubMedGoogle Scholar
  294. Taylor, N. S., G. M. Thorne, and J. G. Bartlett. 1980 Separation of an enterotoxin from the cytotoxin of Clostridium difficile Clin. Res. 28 285Google Scholar
  295. Tedesco, F. J., R. W. Barton, and D. H. Alpers. 1974 Clindamycin-associated colitis Ann. Intern. Med. 81 429–433PubMedGoogle Scholar
  296. Thomas, P. I., N. E. Downey, and R. S. Dreadon. 1956 Mortality in lambs due to enterotoxaemia associated with heavy infestations of Moniezia expansa NZ Vet. J. 4 161–165Google Scholar
  297. Timoney, J. F., J. H. Gillespie, F. W. Scott, and J. E. Barlough. 1988 The genus Clostridium Timoney, J. F., J. H. Gillespie, F. W. Scott, and J. E. Barlough In: Hagan and Bruner’s Microbiology and Infectious Diseases of Domestic Animals Comstock Publishing Ithaca, NY 198–220Google Scholar
  298. Torres, J. F. 1991 Purification and characterization of toxin B from a strain of Clostridium difficile that does not produce toxin A J. Med. Microbiol. 35 40–44PubMedGoogle Scholar
  299. Triadafilopoulos, G., C. Pothoulakis, M. J. O’Brien, and J. T. LaMont. 1987 Differential effects of Clostridium difficile toxins A and B on rabbit ileum Gastroenterology 93 273–279PubMedGoogle Scholar
  300. Triadafilopoulos, G., C. Pothoulakis, R. Weiss, C. Giampaolo, and J. T. LaMont. 1989 Comparative study of Clostridium difficile toxin A and cholera toxin in rabbit ileum Gastroenterology 97 1186–1192PubMedGoogle Scholar
  301. Tschirdewahn, B., S. Notermans, K. Wernars, and F. Untermann. 1991 The presence of enterotoxigenic Clostridium perfringens strains in faeces of various animals Int. J. Microbiol. 14 175–178Google Scholar
  302. Tucker, K. D., P. E. Carrig, and T. D. Wilkins. 1990 Toxin A of Clostridium difficile is a potent cytotoxin J. Clin. Microbiol. 28 869–871PubMedGoogle Scholar
  303. Tucker, K. D., and T. D. Wilkins. 1991 Toxin A of Clostridium difficile binds to the human carbohydrate antigens I, X, and Y Infect. Immun. 59 73–78PubMedGoogle Scholar
  304. Tunnicliff, E. A. 1933 A strain of Clostridium welchii producing fatal dysentery in lambs J. Infect. Dis. 52 407–412Google Scholar
  305. Tvede, M., P. O. Schiotz, and P. A. Krasilnikoff. 1990 Incidence of Clostridium difficile in hospitalized children Acta Paediatr. Scand. 79 292–299PubMedGoogle Scholar
  306. Udovicic, I., M. Martinjak, S. Kosorok, and Z. Kelneric. 1990 Vaccination of pregnant sows with a Clostridium perfringens type C and D bacterin-toxoid vaccine to prevent necrotic enteritis in piglets Prax. Vet. Zagreb 38 25–31Google Scholar
  307. Uzal, F. A., M. I. Pasini, F. V. Olaechea, C. A. Robles, and A. Elizondo. 1994 An outbreak of enterotoxaemia caused by Clostridium perfringens type D in goats in Patagonia Vet. Rec. 135 279–280PubMedGoogle Scholar
  308. Uzal, F. A., and W. R. Kelly. 1996 Enterotoxaemia in goats Vet. Res. Comm. 20 481–492Google Scholar
  309. Uzal, F. A., and W. R. Kelly. 1997a The effects of intravenous administration of Clostridium perfringens type D epsilon toxin on young goats and lambs J. Comp. Pathol. 116 63–71PubMedGoogle Scholar
  310. Uzal, F. A., J. W. R. Glastonbury, W. R. Kelly, and R. Thomas. 1997b Caprine enterotoxaemia associated with cerebral microangiopathy Vet. Rec. 141 224–226PubMedGoogle Scholar
  311. Uzal, F. A., and W. R. Kelly. 1998a Protection of goats against experimental enterotoxaemia by vaccination with Clostridium perfringens type D epsilon toxoid Vet. Rec. 142 722–725PubMedGoogle Scholar
  312. Uzal, F. A., D. A. V. Bodero, W. R. Kelly, and K. H. Nielsen. 1998b Variability of serum antibody responses to a commercial Clostridium perfringens epsilon toxoid vaccine in goat kids Vet. Rec. 143 472–474PubMedGoogle Scholar
  313. Uzal, F. A., and R. B. Marcellino. 2002a Clostridium perfringens in clinically healthy sheep of Patagonia, Argentina R. Goldman In: Abstracts of the Anaerobe Olympiad Anaerobe The 6th Biennial Congress of the Anaerobe Society of the Americas Park City, UT 8 168Google Scholar
  314. Uzal, F. A., W. R. Kelly, W. E. Morris, and R. Assis. 2002b Effects of intravenous injection of Clostridium perfringens type D epsilon toxin in calves J. Comp. Pathol. 126 71–75PubMedGoogle Scholar
  315. Uzal, F. A., W. R. Kelly, R. Thomas, M. Hornitzky, and F. Galea. 2003 Comparison of four techniques for the detection of Clostridium perfringens type D epsilon toxin in intestinal contents and other body fluids of sheep and goats J. Vet. Diagn. Invest. 15 94–99PubMedGoogle Scholar
  316. Uzal, F. A. 2004a Diagnosis of Clostridium perfringens intestinal infections in sheep and goats Anaerobe 2 135–143Google Scholar
  317. Uzal, F. A., W. R. Kelly, W. E. Morris, J. Bermudez, and M. Biason. 2004b The pathology of experimental Clostridium perfringens type D enterotoxaemia in sheep J. Vet. Diagn. Invest. 16 403–411PubMedGoogle Scholar
  318. Van Baelen, D. and Devriese L. A. 1987 Presence of Clostridium perfringens enterotoxin in intestinal samples from farm animals with diarrhoea of unknown origin Zentralbl. Veterinarmed. B. 34 713–6PubMedGoogle Scholar
  319. Van-Damme-Jongsten, M., J. Rodhouse, R. J. Gilbert, and S. Notermans. 1990 Synthetic DNA probes for detection of enterotoxigenic Clostridium perfringens isolated from outbreaks of food poisoning J. Clin. Microbiol. 28 131–133PubMedGoogle Scholar
  320. Van Tonder, E. M. 1975 Notes on some disease problems in Angora goats in South Africa Vet. Med. Rev. 1/2 109–138Google Scholar
  321. Von Eichel-Streiber, C., D. Suckau, M. Wachter, and U. Hadding. 1988 Cloning and characterization of overlapping DNA fragments of the toxin-A gene of Clostridium difficile J. Gen. Microbiol. 135 55–64Google Scholar
  322. Von Eichel-Streiber, C., and M. Sauerborn. 1990 Clostridium difficile toxin A carries a C-terminal repetitive structure homologous to the carbohydrate binding region of streptococcal glycosyltransferases Gene 96 107–113Google Scholar
  323. Von Eichel-Streiber, C., R. Laufenberg-Feldman, S. Sartingen, J. Schilze, and M. Sauerborn. 1992a Comparative sequence analysis of the Clostridium difficile toxins A and B Molec. Gen. Genet. 233 260–268Google Scholar
  324. Von Eichel-Streiber, C., M. Sauerborn, and H. K. Kuramitsu. 1992b Evidence for a modular structure of the homologous repetitive C-terminal carbohydrate-binding sites of Clostridium difficile toxins and Streptococcus mutans glucosyltransferases J. Bacteriol. 174 6707–6710Google Scholar
  325. Von Eichel-Streiber, C. 1995 Molecular biology of the Clostridium difficile toxins In: M. Sebald (Ed.) Genetics and Molecular Biology of the Anaerobic Bacteria Springer-Verlag New York, NY 264–289Google Scholar
  326. Von Eichel-Streiber, C., P. Boquet, and M. Sauerborn. 1996 Large clostridial cytotoxins—a family of glucosyltransferases modifying small GTP-binding proteins Trends Microbiol. 4 375–382Google Scholar
  327. Von Eichel-Streiber, C., I. Zec-Pirnat, M. Grabnar, and M. Rupnik. 1999 A nonsense mutation abrogates production of a functional enterotoxin A in Clostridium difficile toxinotype VIII strains of serogroups F and X FEMS Microbiol. Lett. 178 163–168Google Scholar
  328. Vustina, U. D. 1988 Infectious diseases of muskrat (Ondatra zibethica) Krolikovod. 1 23–24Google Scholar
  329. Wagenknecht-Wiesner, A., M. Weidmann, V. Braun, P. Leukel, M. Moos, and C. von Eichel-Streiber. 1997 Delineation of the catalytic domain of the Clostridium difficile toxin B-10463 to an enzymatically active N-terminal 467 amino acid fragment FEMS Microbiol. Lett. 152 109–116PubMedGoogle Scholar
  330. Warny, M., A. Fatimi, E. F. Bostwick, D. C. Laine, F. Lebel, J. T. LaMont, C. Pothoulakis, and C. P. Kelly. 1999 Bovine immunoglobulin concentration-Clostridium difficile retains C. difficile toxin neutralizing activity after passage through the human stomach and small intestine Gut 44(2) 212–217Google Scholar
  331. Wen, Q., K. Miyamoto, and B. A. McClane. 2003 Development of a duplex PCR genotyping assay for distinguishing Clostridium perfringens type A isolates carrying chromosomal enterotoxin (cpe) genes from those carrying plasmid-borne enterotoxin (cpe) genes J. Clin. Microbiol. 41 1494–1498PubMedGoogle Scholar
  332. Wieckowski, E. U., A. P. Wnek, and B. A. McClane. 1994 Evidence that an 50kDa mammalian plasma membrane protein with receptor-like properties mediates the amphiphilicity of specifically-bound Clostridium perfringens enterotoxin J. Biol. Chem. 269 10838–10848PubMedGoogle Scholar
  333. Wieckowski, E., J. F. Kokai-Kun, and B. A. McClane. 1998 Characterization of membrane-associated Clostridium perfringens enterotoxin following Pronase treatment Infect. Immun. 66 5897–5905PubMedGoogle Scholar
  334. Wierup, M., and J. A. DiPietro. 1981 Bacteriological examination of equine fecal flora as a diagnostic tool for equine intestinal clostridiosis by Clostridium perfringens Am. J. Vet. Res. 42 2167–2169PubMedGoogle Scholar
  335. Wilcox, M. H. 1998 Treatment of Clostridium difficile infection J. Antimicrob. Chemother. 41 41–46PubMedGoogle Scholar
  336. Wilkins, T. D., and K. D. Tucker. 1989 Clostridium difficile toxin A (enterotoxin) uses Galα1-3Galβ1-4GlcNAc as a functional receptor Microecol. Ther. 19 225–227Google Scholar
  337. Wilkins, T. D., and D. M. Lyerly. 2003 Clostridium difficile testing: after 20 years, still challenging J. Clin. Microbiol. 41 531–534PubMedGoogle Scholar
  338. Wilson, K. H. 1983 Efficiency of various bile salt preparations for stimulation of Clostridium difficile spore germination J. Clin. Microbiol. 18 1017–1019PubMedGoogle Scholar
  339. Wolfhagen, M., A. C. Fluit, R. Torensma, M. Poppelier, and J. Verhoef. 1994 Rapid detection of toxigenic Clostridium difficile in fecal samples by magnetic immuno PCR assay J. Clin. Microbiol. 32 1629–1633PubMedGoogle Scholar
  340. Worrall, E. E., L. Natalia, P. Ronohardjo, P. Tarmudji, and S. Partoutomo. 1987 Enterotoxaemia in water buffaloes caused by Clostridium perfringens type A Penyakit-Hewan 19 17–19Google Scholar
  341. Zhao, Y., and S. B. Melville. 1998 Identification and characterization of sporulation-dependent promoters upstream of the enterotoxin gene (cpe) of Clostridium perfringens J. Bacteriol. 180 136–142PubMedGoogle Scholar
  342. Zimmer, M., S. Scherer, and M. J. Loessner. 2002 Genomic analyses of Clostridium perfringens bacteriophage phi3624, which integrates into guaA and possibly affects sporulation J. Bacteriol. 184 4359–4368PubMedGoogle Scholar

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© Springer-Verlag 2006

Authors and Affiliations

  • Bruce A. McClane
  • Francisco A. Uzal
  • Mariano E. Fernandez Miyakawa
  • David Lyerly
  • Tracy Wilkins

There are no affiliations available

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