Clostridium difficile infection historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.

Overview

Clostridium difficile was first isolated in 1935 during an experiment from fecal extracts of healthy neonates. The association between C. difficile and antibiotic-associated pseudomembranous colitis was first made in 1978. In 2003, a resistant, hypervirulent strain of C. difficile (NAP/BI/027 strain) with increased synthesis of toxins A and B was first identified.

Historical Perspective

  • In 1935, Hall and O'Toole were the first to isolate Clostridium difficile from fecal extracts of healthy neonates. Following isolation, the bacterium was originally named Bacillus difficilis because the isolation process during the original experiment was difficult.[1]
  • The association between C. difficile and antibiotic-associated pseudomembranous colitis was first made in 1978.[1][2]
  • Cell-cytotoxicity assay was first developed by Te-Wen Chang, who demonstrated that Clostridium sordellii antitoxin is produced among patients with pseudomembranous colitis and is able to neutralize the cytotoxic effects of an unidentified toxin (later to be identified as C. difficile toxin B).[3][4]

References

  1. 1.0 1.1 Hall IC, O’Toole E (1935). "Intestinal flora in new-born infants". Am J Dis Child. 49: 390–402.
  2. Bartlett JG, Moon N, Chang TW, Taylor N, Onderdonk AB (1978). "Role of Clostridium difficile in antibiotic-associated pseudomembranous colitis". Gastroenterology. 75 (5): 778–82. PMID 700321.
  3. Chang T-W, Bartlett JG, Gorbach SL, Onderdonk AB (1978). ". Clindamycin induced enterocolitis in hamsters as a model of pseudomembranous colitis in patients". Infect Immun. 20: 526–9.
  4. Bartlett JG, Onderdonk AB, Cisneros RL, Kasper DL (1977). ". Clindamycinassociated colitis due to a toxin-producing species of Clostridium in hamsters". . J Infect Dis. 136: 701–5.
  5. Bartlett JG (2006). "Narrative review: the new epidemic of Clostridium difficile-associated enteric disease". Ann Intern Med. 145 (10): 758–64. PMID 17116920.
  6. Warny M, Pepin J, Fang A, Killgore G, Thompson A, Brazier J; et al. (2005). "Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe". Lancet. 366 (9491): 1079–84. doi:10.1016/S0140-6736(05)67420-X. PMID 16182895.
  7. Pépin J, Saheb N, Coulombe MA, Alary ME, Corriveau MP, Authier S; et al. (2005). "Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec". Clin Infect Dis. 41 (9): 1254–60. doi:10.1086/496986. PMID 16206099.