Clostridium

Manual of Clinical Microbiology: Tenth Edition

Volumn 1-2, Issue , 2022, Pages 834-857

  Stevens, Dennis L ^a   Bryant, Amy E ^a   Berger, Anja ^b   von Eichel Streiber, Christoph ^c  

^a Boise VA Medical Center   (United States)

^b Dienststelle Oberschleibheim   (Germany)

^c UNIVERSITY MEDICAL CENTER MAINZ   (Germany)

Author keywords

C. difficile infection (CDI); C. perfringens; Clostridium; Infant Botulism

Indexed keywords

EID: 85188867696     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1128/9781555816728.ch50     Document Type: Chapter

References (207)

1. Abrahao, C., R. J. Carman, H. Hahn, and O. Liesenfeld. 2001. Similar frequency of detection of Clostridium perfringens enterotoxin and Clostridium difficile toxins in patients with antibiotic-associated diarrhea. Eur. J. Clin. Microbiol. Infect. Dis. 20:676-677.
2. Ackermann, G., R. Schaumann, B. Pless, M. C. Claros, E. J. Goldstein, and A. C. Rodloff. 2000. Comparative activity of moxifloxacin in vitro against obligately anaerobic bacteria. Eur. J. Clin. Microbiol. Infect. Dis. 19:228-232.
3. Ackermann, G., Y. J. Tang, S. S. Jang, J. Silva, A. C. Rodloff, and S. H. Cohen. 2001. Isolation of Clostridium innocuum from cases of recurrent diarrhea in patients with prior Clostridium difficile associated diarrhea. Diagn. Microbiol. Infect. Dis. 40:103-106.
4. Ackermann, G., Y. J. Tang, R. Kueper, P. Heisig, A. C. Rodloff, J. Silva, Jr., and S. H. Cohen. 2001. Resistance to moxifloxacin in toxigenic Clostridium difficile isolates is associated with mutations in gyrA. Antimicrob. Agents Chemother. 45:2348-2353.
5. Akbulut, D., K. A. Grant, and J. McLauchlin. 2005. Improvement in laboratory diagnosis of wound botulism and tetanus among injecting illicit-drug users by use of real-time PCR assays for neurotoxin gene fragments. J. Clin. Microbiol. 43:4342-4348.
6. Aldape, M. J., A. E. Bryant, Y. Ma, and D. L. Stevens. 2007. The leukemoid reaction in Clostridium sordellii infection: neuraminidase induction of promyelocytic cell proliferation. J. Infect. Dis. 195:1838-1845.
7. Aldape, M. J., A. E. Bryant, and D. L. Stevens. 2006. Clostridium sordellii infection: epidemiology, clinical findings, and current perspectives on diagnosis and treatment. Clin. Infect. Dis. 43:1436-1446.
8. Alexander, C. J., D. M. Citron, J. S. Brazier, and E. J. Goldstein. 1995. Identification and antimicrobial resistance patterns of clinical isolates of Clostridium clostridioforme, Clostridium innocuum, and Clostridium ramosum compared with those of clinical isolates of Clostridium perfringens. J. Clin. Microbiol. 33:3209-3215.
9. Alfa, M. J., D. Robson, M. Davi, K. Bernard, C. P. Van, and G. K. Harding. 2002. An outbreak of necrotizing enterocolitis associated with a novel clostridium species in a neonatal intensive care unit. Clin. Infect. Dis. 35:S101-S105.
10. Allen, S. D., C. L. Emery, and J. A. Siders. 2002. Anaerobic bacteriology, p. 50-81. In A. L. Truant (ed.), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC.
11. Allen, S. D., J. A. Siders, M. J. Riddell, J. A. Fill, and W. S. Wegener. 1995. Cellular fatty acid analysis in the differentiation of Clostridium in the clinical microbiology laboratory. Clin. Infect. Dis. 20(Suppl. 2):S198-S201.
12. Arnon, S. S. 2004. Infant botulism, p. 1758-1766. In R. D. Feigen, J. D. Cherry, G. Demmler, and S. Kaplan (ed.), Textbook of Pediatric Infectious Diseases. W. B. Saunders, Philadelphia, PA.
13. Arnon, S. S., R. Schechter, T. V. Inglesby, D. A. Henderson, J. G. Bartlett, M. S. Ascher, E. Eitzen, A. D. Fine, J. Hauer, M. Layton, S. Lillibridge, M. T. Osterholm, T. O'Toole, G. Parker, T. M. Perl, P. K. Russell, D. L. Swerdlow, and K. Tonat. 2001. Botulinum toxin as a biological weapon: medical and public health management. JAMA 285:1059-1070.
14. Arnon, S. S., R. Schechter, S. E. Maslanka, N. P. Jewell, and C. L. Hatheway. 2006. Human botulism immune globulin for the treatment of infant botulism. N. Engl. J. Med. 354:462-471.
15. Asha, N. J., D. Tompkins, and M. H. Wilcox. 2006. Comparative analysis of prevalence, risk factors, and molecular epidemiology of antibiotic-associated diarrhea due to Clostridium difficile, Clostridium perfringens, and Staphylococcus aureus. J. Clin. Microbiol. 44:2785-2791.
16. Assadian, O., A. Assadian, C. Senekowitsch, A. Makristathis, and G. Hagmuller. 2004. Gas gangrene due to Clostridium perfringens in two injecting drug users in Vienna, Austria. Wien. Klin. Wochenschr. 116:264-267.
17. Ballard, J., A. Bryant, D. Stevens, and R. K. Tweten. 1992. Purification and characterization of the lethal toxin (alphatoxin) of Clostridium septicum. Infect. Immun. 60:784-790.
18. Bangsberg, D. R., J. I. Rosen, T. Aragon, A. Campbell, L. Weir, and F. Perdreau-Remington. 2002. Clostridial myonecrosis cluster among injection drug users: a molecular epidemiology investigation. Arch. Intern. Med. 162:517-522.
19. Barash, J. R., T. W. Tang, and S. S. Arnon. 2005. First case of infant botulism caused by Clostridium baratii type F in California. J. Clin. Microbiol. 43:4280-4282.
20. Barbut, F., P. Mastrantonio, M. Delmee, J. Brazier, E. Kuijper, and I. Poxton. 2007. Prospective study of Clostridium difficile infections in Europe with phenotypic and genotypic characterisation of the isolates. Clin. Microbiol. Infect. 13:1048-1057.
21. Barsam, A., M. Kerins, and P. Jaye. 2005. Tetanus and intravenous drug use. Eur. J. Clin. Microbiol. Infect. Dis. 24:497-498.
22. Barth, H., K. Aktories, M. R. Popoff, and B. G. Stiles. 2004. Binary bacterial toxins: biochemistry, biology, and applications of common Clostridium and Bacillus proteins. Microbiol. Mol. Biol. Rev. 68:373-402.
23. Bartlett, J. G. 2002. Clinical practice. Antibiotic-associated diarrhea. N. Engl. J. Med. 346:334-339.
24. Bartlett, J. G., and D. N. Gerding. 2008. Clinical recognition and diagnosis of Clostridium difficile infection. Clin. Infect. Dis. 46(Suppl. 1):S12-S18.
25. Belmares, J., D. N. Gerding, J. P. Parada, S. Miskevics, F. Weaver, and S. Johnson. 2007. Outcome of metronidazole therapy for Clostridium difficile disease and correlation with a scoring system. J. Infect. 55:495-501.
26. Bleck, T. P. 1991. Tetanus: pathophysiology, management, and prophylaxis. Dis. Mon. 37:545-603.
27. Bloedt, K., M. Riecker, S. Poppert, and N. Wellinghausen. 2009. Evaluation of new selective culture media and a rapid fluorescence in situ hybridization assay for identification of Clostridium difficile from stool samples. J. Med. Microbiol. 58:874-877.
28. Borriello, S. P., F. E. Barclay, A. R. Welch, M. F. Stringer, G. N. Watson, R. K. Williams, D. V. Seal, and K. Sullens. 1985. Epidemiology of diarrhoea caused by enterotoxigenic Clostridium perfringens. J. Med. Microbiol. 20:363-372.
29. Bos, J., L. Smithee, B. McClane, R. F. Distefano, F. Uzal, J. G. Songer, S. Mallonee, and J. M. Crutcher. 2005. Fatal necrotizing colitis following a foodborne outbreak of enterotoxigenic Clostridium perfringens type A infection. Clin. Infect. Dis. 40:e78-e83.
30. Bouvet, P. J., and M. R. Popoff. 2008. Genetic relatedness of Clostridium difficile isolates from various origins determined by triple-locus sequence analysis based on toxin regulatory genes tcdC, tcdR, and cdtR. J. Clin. Microbiol. 46:3703-3713.
31. Bradshaw, M., S. S. Dineen, N. D. Maks, and E. A. Johnson. 2004. Regulation of neurotoxin complex expression in Clostridium botulinum strains 62A, Hall A-hyper, and NCTC 2916. Anaerobe 10:321-333.
32. Braun, V., T. Hundsberger, P. Leukel, M. Sauerborn, and C. von Eichel-Streiber. 1996. Definition of the single integration site of the pathogenicity locus in Clostridium difficile. Gene 181:29-38.
33. Brazier, J. S., M. Gal, V. Hall, and T. Morris. 2004. Outbreak of Clostridium histolyticum infections in injecting drug users in England and Scotland. Euro Surveill. 9:15-16.
34. Brett, M. M., G. Hallas, and O. Mpamugo. 2004. Wound botulism in the UK and Ireland. J. Med. Microbiol. 53:555-561.
35. Brook, I. 1995. Clostridial infection in children. J. Med. Microbiol. 42:78-82.
36. Bruggemann, H., and G. Gottschalk. 2004. Insights in metabolism and toxin production from the complete genome sequence of Clostridium tetani. Anaerobe 10:53-68.
37. Bryant, A. E., R. Bergstrom, G. A. Zimmerman, J. L. Salyer, H. R. Hill, R. K. Tweten, H. Sato, and D. L. Stevens. 1993. Clostridium perfringens invasiveness is enhanced by effects of theta toxin upon PMNL structure and function: the roles of leukocytotoxicity and expression of CD11/CD18 adherence glycoprotein. FEMS Immunol. Med. Microbiol. 7:321-336.
38. Bryant, A. E., R. Y. Z. Chen, Y. Nagata, Y. Wang, C. H. Lee, S. Finegold, P. H. Guth, and D. L. Stevens. 2000. Clostridial gas gangrene I: cellular and molecular mechanisms of microvascular dysfunction induced by exotoxins of C. per- fringens. J. Infect. Dis. 182:799-807.
39. Bryant, A. E., R. Y. Z. Chen, Y. Nagata, Y. Wang, C. H. Lee, S. Finegold, P. H. Guth, and D. L. Stevens. 2000. Clostridial gas gangrene II: phospholipase C-induced activation of platelet gpIIb/IIIa mediates vascular occlusion and myonecrosis in C. perfringens gas gangrene. J. Infect. Dis. 182:808-815.
40. Bryant, A. E., and D. L. Stevens. 1997. The pathogenesis of gas gangrene, p. 185-196. In J. I. Rood, R. Titball, B. McClane, and G. Songer (ed.), The Clostridia: Molecular Biology and Pathogenesis. Academic Press Limited, San Diego, CA.
41. Brynestad, S., M. R. Sarker, B. A. McClane, P. E. Granum, and J. I. Rood. 2001. Enterotoxin plasmid from Clostridium perfringens is conjugative. Infect. Immun. 69:3483-3487.
42. Carlier, J. P., M. Bedora-Faure, G. K'ouas, C. Alauzet, and F. Mory. 2009. Proposal to unify Clostridium orbiscindens Winter et al. 1991 and Eubacterium plautii (Seguin 1928) Hofstad and Aasjord 1982 with description of Flavonifractor plautii gen. nov., comb. nov. and reassignment of Bacteroides capillosus to Pseudoflavonifractor capillosus gen. nov., comb. nov. Int. J. Syst. Evol. Microbiol. 60:585-590.
43. Cavallaro, J. J., L. S. Wiggs, and J. M. Miller. 1997. Evaluation of the BBL Crystal Anaerobe identification system. J. Clin. Microbiol. 35:3186-3191.
44. Centers for Disease Control and Prevention. 1998. Botulism in the United States 1899-1996. Handbook for Epidemiologists, Clinicians, and Laboratory Workers. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Atlanta, GA.
45. Centers for Disease Control and Prevention. 2000. Update: Clostridium novyi and unexplained illness among injecting- drug users-Scotland, Ireland, and England, April-June 2000. MMWR Morb. Mortal. Wkly. Rep. 49:543-545.
46. Centers for Disease Control and Prevention. 2001. Soft tissue infections among injection drug users-San Francisco, California, 1996-2000. MMWR Morb. Mortal. Wkly. Rep. 50:381-384.
47. Centers for Disease Control and Prevention. 2009. Biosafety in Microbiological and Biomedical Laboratories, 5th ed. Centers for Disease Control and Prevention, Atlanta, GA. http://www.cdc.gov/biosafety/publications/bmbl5/index.htm.
48. Chalmers, G., H. L. Bruce, D. B. Hunter, V. R. Parreira, R. R. Kulkarni, Y. F. Jiang, J. F. Prescott, and P. Boerlin. 2008. Multilocus sequence typing analysis of Clostridium perfringens isolates from necrotic enteritis outbreaks in broiler chicken populations. J. Clin. Microbiol. 46:3957-3964.
49. Chalmers, G., S. W. Martin, J. F. Prescott, and P. Boerlin. 2008. Typing of Clostridium perfringens by multiple-locus variable number of tandem repeats analysis. Vet. Microbiol. 128:126-135.
50. Chaudhry, R., B. Dhawan, D. Kumar, R. Bhatia, J. C. Gandhi, R. K. Patel, and B. C. Purohit. 1998. Outbreak of suspected Clostridium butyricum botulism in India. Emerg. Infect. Dis. 4:506-507.
51. Chen, Y. M., H. C. Lee, C. M. Chang, Y. C. Chuang, and W. C. Ko. 2001. Clostridium bacteremia: emphasis on the poor prognosis in cirrhotic patients. J. Microbiol. Immunol. Infect. 34:113-118.
52. Cherington, M. 2004. Botulism: update and review. Semin. Neurol. 24:155-163.
53. Chertow, D. S., E. T. Tan, S. E. Maslanka, J. Schulte, E. A. Bresnitz, R. S. Weisman, J. Bernstein, S. M. Marcus, S. Kumar, J. Malecki, J. Sobel, and C. R. Braden. 2006. Botulism in 4 adults following cosmetic injections with an unlicensed, highly concentrated botulinum preparation. JAMA 296:2476-2479.
54. Citron, D. M., and P. C. Appelbaum. 1993. How far should a clinical laboratory go in identifying anaerobic isolates, and who should pay? Clin. Infect. Dis. 16(Suppl. 4):S435-S438.
55. Clinical and Laboratory Standards Institute. 2004. Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria. Approved method M11-A6. Clinical and Laboratory Standards Institute, Wayne, PA.
56. Cohen, A. L., J. Bhatnagar, S. Reagan, S. B. Zane, M. A. D'Angeli, M. Fischer, G. Killgore, T. S. Kwan-Gett, D. B. Blossom, W. J. Shieh, J. Guarner, J. Jernigan, J. S. Duchin, S. R. Zaki, and L. C. McDonald. 2007. Toxic shock associated with Clostridium sordellii and Clostridium perfringens after medical and spontaneous abortion. Obstet. Gynecol. 110:1027-1033.
57. Coleman, N., G. Speirs, J. Khan, V. Broadbent, D. G. Wight, and R. E. Warren. 1993. Neutropenic enterocolitis associated with Clostridium tertium. J. Clin. Pathol. 46:180-183.
58. Collins, M. D., P. A. Lawson, A. Willems, J. J. Cordoba, J. Fernandez-Garayzabal, P. Garcia, J. Cai, H. Hippe, and J. A. Farrow. 1994. The phylogeny of the genus Clostridium: proposal of five new genera and eleven new species combinations. Int. J. Syst. Bacteriol. 44:812-826.
59. Cresci, A., C. Orpianesi, R. F. La, F. Pannelli, G. Saltalamacchia, G. Scaloni, F. Trotta, and V. Mastrandrea. 1988. Characterization of some Clostridium species by gasliquid chromatography using numerical analysis. Microbiologica 11:179-199.
60. De Medici, D., F. Anniballi, G. M. Wyatt, M. Lindstrom, U. Messelhausser, C. F. Aldus, E. Delibato, H. Korkeala, M. W. Peck, and L. Fenicia. 2009. Multiplex PCR to detect botulinum neurotoxin-producing clostridia in clinical, food, and environmental samples. Appl. Environ. Microbiol. 75:6457-6461.
61. Doern, G. V., R. T. Coughlin, and L. Wu. 1992. Laboratory diagnosis of Clostridium difficile-associated gastrointestinal disease: comparison of a monoclonal antibody enzyme immunoassay for toxins A and B with a monoclonal antibody enzyme immunoassay for toxin A only and two cytotoxicity assays. J. Clin. Microbiol. 30:2042-2046.
62. Domingo, R. M., J. S. Haller, and M. Gruenthal. 2008. Infant botulism: two recent cases and literature review. J. Child Neurol. 23:1336-1346.
63. Dong, M., W. H. Tepp, E. A. Johnson, and E. R. Chapman. 2004. Using fluorescent sensors to detect botulinum neurotoxin activity in vitro and in living cells. Proc. Natl. Acad. Sci. USA 101:14701-14706.
64. Downes, F. P., and K. Ito. 2001. Compendium of Methods for the Microbiological Examination of Foods. American Public Health Association, Washington, DC.
65. Eklund, M. W., F. T. Poysky, and W. H. Habig. 1989. Bacteriophages and plasmids in Clostridium botulinum and Clostridium tetani and their relationship to production of toxins, p. 25-51. In L. L. Simpson (ed.), Botulinum Toxin and Tetanus Toxin. Academic Press, San Diego, CA.
66. Elsayed, S., and K. Zhang. 2004. Bacteremia caused by Clostridium symbiosum. J. Clin. Microbiol. 42:4390-4392.
67. Elsayed, S., and K. Zhang. 2005. Bacteremia caused by Clostridium intestinale. J. Clin. Microbiol. 43:2018-2020.
68. Everley, R. A., T. M. Mott, D. M. Toney, and T. R. Croley. 2009. Characterization of Clostridium species utilizing liquid chromatography/mass spectrometry of intact proteins. J. Microbiol. Methods 77:152-158.
69. Federal Register. Title 29, Code of Federal Regulations, part 1910, subpart I. Personal Protective Equipment.
70. Fedorko, D. P., H. D. Engler, E. M. O'Shaughnessy, E. C. Williams, C. J. Reichelderfer, and W. I. Smith, Jr. 1999. Evaluation of two rapid assays for detection of Clostridium difficile toxin A in stool specimens. J. Clin. Microbiol. 37:3044-3047.
71. Fenicia, L., F. Anniballi, S. Pulitano, O. Genovese, G. Polidori, and P. Aureli. 2004. A severe case of infant botulism caused by Clostridium botulinum type A with concomitant intestinal viral infections. Eur. J. Pediatr. 163:501-502.
72. Fenicia, L., D. L. Da, F. Anniballi, G. Franciosa, S. Zanconato, and P. Aureli. 2002. A case of infant botulism due to neurotoxigenic Clostridium butyricum type E associated with Clostridium difficile colitis. Eur. J. Clin. Microbiol. Infect. Dis. 21:736-738.
73. Finegold, S. M., D. Molitoris, and M. L. Vaisanen. 2009. Study of the in vitro activities of rifaximin and comparator agents against 536 anaerobic intestinal bacteria from the perspective of potential utility in pathology involving bowel flora. Antimicrob. Agents Chemother. 53:281-286.
74. Finegold, S. M., Y. Song, C. Liu, D. W. Hecht, P. Summanen, E. Kononen, and S. D. Allen. 2005. Clostridium clostridioforme: a mixture of three clinically important species. Eur. J. Clin. Microbiol. Infect. Dis. 24:319-324.
75. Fisher, D. J., K. Miyamoto, B. Harrison, S. Akimoto, M. R. Sarker, and B. A. McClane. 2005. Association of beta2 toxin production with Clostridium perfringens type A human gastrointestinal disease isolates carrying a plasmid enterotoxin gene. Mol. Microbiol. 56:747-762.
76. Forward, L. J., D. S. Tompkins, and M. M. Brett. 2003. Detection of Clostridium difficile cytotoxin and Clostridium per- fringens enterotoxin in cases of diarrhoea in the community. J. Med. Microbiol. 52:753-757.
77. Fox, C. K., C. A. Keet, and J. B. Strober. 2005. Recent advances in infant botulism. Pediatr. Neurol. 32:149-154.
78. Franciosa, G., P. Aureli, and R. Schechter. 2003. Clostridium botulinum, p. 61-89. In M. D. Bier and J. W. Miliotis (ed.), International Handbook of Foodborne Pathogens. Marcel Dekker, Inc., New York, NY.
79. Francisco, A. M., and S. S. Arnon. 2007. Clinical mimics of infant botulism. Pediatrics 119:826-828.
80. Gerding, D. N., C. A. Muto, and R. C. Owens, Jr. 2008. Treatment of Clostridium difficile infection. Clin. Infect. Dis. 46(Suppl. 1):S32-S42.
81. Ghanem, F. M., A. C. Ridpath, W. E. Moore, and L. V. Moore. 1991. Identification of Clostridium botulinum, Clostridium argentinense, and related organisms by cellular fatty acid analysis. J. Clin. Microbiol. 29:1114-1124.
82. Glazunova, O. O., D. Raoult, and V. Roux. 2005. First identification of Clostridium celerecrescens in liquid drained from an abscess. J. Clin. Microbiol. 43:3007-3008.
83. Goon, P. K., M. O'Brien, and O. G. Titley. 2005. Spontaneous Clostridium septicum septic arthritis of the shoulder and gas gangrene. A case report. J. Bone Joint Surg. Am. 87:874-877.
84. Gorbach, S. L. 1998. Gas gangrene and other clostridial skin and soft tissue infections, p. 915-922. In S. L. Gorbach, J. G. Bartlett, and N. R. Blacklow (ed.), Infectious Diseases, 2nd ed. W. B. Saunders, Philadelphia, PA.
85. Griffin, P. M., C. L. Hatheway, R. B. Rosenbaum, and R. Sokolow. 1997. Endogenous antibody production to botulinum toxin in an adult with intestinal colonization botulism and underlying Crohn's disease. J. Infect. Dis. 175:633-637.
86. Grosse-Herrenthey, A., T. Maier, F. Gessler, R. Schaumann, H. Bohnel, M. Kostrzewa, and M. Kruger. 2008. Challenging the problem of clostridial identification with matrix-assisted laser desorption and ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Anaerobe 14:242-249.
87. Hahne, S. J., J. M. White, N. S. Crowcroft, M. M. Brett, R. C. George, N. J. Beeching, K. Roy, and D. Goldberg. 2006. Tetanus in injecting drug users, United Kingdom. Emerg. Infect. Dis. 12:709-710.
88. Hall, J. D., L. M. McCroskey, B. J. Pincomb, and C. L. Hatheway. 1985. Isolation of an organism resembling Clostridium baratii which produces type F botulinal toxin from an infant with botulism. J. Clin. Microbiol. 21:654-655.
89. Hall, Y. H., J. A. Chaddock, H. J. Moulsdale, E. R. Kirby, F. C. Alexander, J. D. Marks, and K. A. Foster. 2004. Novel application of an in vitro technique to the detection and quantification of botulinum neurotoxin antibodies. J. Immunol. Methods 288:55-60.
90. Hatheway, C. I. 2009. Botulism, p. 111-133. In A. Balows, W. J. Hausler, M. Ohashi, and A. Turano (ed.), Laboratory Diagnosis of Infectious Diseases. Pringer, New York, NY.
91. Hausmann, R., F. Albert, W. Geissdorfer, and P. Betz. 2004. Clostridium fallax associated with sudden death in a 16-year-old boy. J. Med. Microbiol. 53:581-583.
92. Holdeman, L. V., E. P. Cato, and W. E. C. Moore. 1977. Anaerobe Laboratory Manual. Virginia Polytechnic Institute and State University, Blacksburg.
93. Holzer, E. 1962. Botulism caused by inhalation. Med. Klin. 57:1735-1738. (In German.)
94. Hsu, H. Y., S. F. Lee, M. E. Hartstein, and G. J. Harocopos. 2008. Clostridium perfringens keratitis leading to blinding panophthalmitis. Cornea 27:1200-1203.
95. 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. 244:735-742.
96. Jacobson, M. J., G. Lin, T. S. Whittam, and E. A. Johnson. 2008. Phylogenetic analysis of Clostridium botulinum type A by multi-locus sequence typing. Microbiology 154:2408-2415.
97. Johansson, A., A. Aspan, E. Bagge, V. Baverud, B. E. Engstrom, and K. E. Johansson. 2006. Genetic diversity of Clostridium perfringens type A isolates from animals, food poisoning outbreaks and sludge. BMC Microbiol. 6:47.
98. Johnson, E. A., and M. Bradshaw. 2001. Clostridium botulinum and its neurotoxins: a metabolic and cellular perspective. Toxicon 39:1703-1722.
99. Johnson, E. A., and M. C. Goodnough. 1998. Botulism, p. 723-741. In L. Collier, B. W. Mahy, and A. Balows (ed.), Topley and Wilson's Microbiology and Microbial Infections, 9th ed. Arnold Publishing, London, United Kingdom.
100. Johnson, J. L., and B. S. Francis. 1975. Taxonomy of the Clostridia: ribosomal ribonucleic acid homologies among the species. J. Gen. Microbiol. 88:229-244.
101. Johnson, S. 2009. Recurrent Clostridium difficile infection: a review of risk factors, treatments, and outcomes. J. Infect. 58:403-410.
102. Johnson, S., M. R. Driks, R. K. Tweten, J. Ballard, D. L. Stevens, D. J. Anderson, and E. N. Janoff. 1994. Clinical courses of seven survivors of Clostridium septicum infection and their immunologic responses to a toxin. Clin. Infect. Dis. 19:761-764.
103. Johnson, S., and D. N. Gerding. 1998. Clostridium difficile- associated diarrhea. Clin. Infect. Dis. 26:1027-1034.
104. 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. 135:434-438.
105. Jousimies-Somer, H. R., P. Summanen, D. M. Citron, E. J. Baron, H. M. Wexler, and S. M. Finegold. 2002. Anaerobic Bacteriology Manual. Star Publishing Company, Belmont, CA.
106. Just, I., J. Selzer, M. Wilm, C. von Eichel-Streiber, M. Mann, and K. Aktories. 1995. Glucosylation of Rho proteins by Clostridium difficile toxin B. Nature 375:500-503.
107. Killgore, G., A. Thompson, S. Johnson, J. Brazier, E. Kuijper, J. Pepin, E. H. Frost, P. Savelkoul, B. Nicholson, R. J. van den Berg, H. Kato, S. P. Sambol, W. Zukowski, C. Woods, B. Limbago, D. N. Gerding, and L. C. McDonald. 2008. Comparison of seven techniques for typing international epidemic strains of Clostridium difficile: restriction endonuclease analysis, pulsed-field gel electrophoresis, PCR-ribotyping, multilocus sequence typing, multilocus variable-number tandem-repeat analysis, amplified fragment length polymorphism, and surface layer protein A gene sequence typing. J. Clin. Microbiol. 46:431-437.
108. Kimura, A. C., J. I. Higa, R. M. Levin, G. Simpson, Y. Vargas, and D. J. Vugia. 2004. Outbreak of necrotizing fasciitis due to Clostridium sordellii among black-tar heroin users. Clin. Infect. Dis. 38:e87-e91.
109. Kliegman, R. M., and A. A. Fanaroff. 1984. Necrotizing enterocolitis. N. Engl. J. Med. 310:1093-1103.
110. Koransky, J. R., S. D. Allen, and V. R. Dowell, Jr. 1978. Use of ethanol for selective isolation of spore-forming microorganisms. Appi. Environ. Microbiol. 35:762-765.
111. Kourtis, A. P., R. Weiner, K. Belson, and F. O. Richards, Jr. 1997. Clostridium tertium meningitis as the presenting sign of a meningocele in a twelve-year-old child. Pediatr. Infect. Dis. J. 16:527-529.
112. Koussoulakos, S. 2009. Botulinum neurotoxin: the ugly duckling. Eur. Neurol. 61:331-342.
113. Kudrow, D. B., D. A. Henry, D. A. Haake, G. Marshall, and G. E. Mathisen. 1988. Botulism associated with Clostridium botulinum sinusitis after intranasal cocaine abuse. Ann. Intern. Med. 109:984-985.
114. Kudsk, K. A. 1992. Occult gastrointestinal malignancies producing metastatic Clostridium septicum infections in diabetic patients. Surgery 112:765-770.
115. Kuijper, E. J., B. Coignard, J. S. Brazier, C. Suetens, D. Drudy, C. Wiuff, H. Pituch, P. Reichert, F. Schneider, A. F. Widmer, K. E. Olsen, F. Allerberger, D. W. Notermans, F. Barbut, M. Delmee, M. Wilcox, A. Pearson, B. C. Patel, D. J. Brown, R. Frei, T. Akerlund, I. R. Poxton, and P. Tull. 2007. Update of Clostridium difficile-associated disease due to PCR ribotype 027 in Europe. Euro Surveill. 12:E1-E2.
116. Kyne, L., M. B. Hamel, R. Polavaram, and C. P. Kelly. 2002. Health care costs and mortality associated with nosocomial diarrhea due to Clostridium difficile. Clin. Infect. Dis. 34:346-353.
117. Lacy, D. B., and R. C. Stevens. 1999. Sequence homology and structural analysis of the clostridial neurotoxins. J. Mol. Biol. 291:1091-1104.
118. Lacy, D. B., W. Tepp, A. C. Cohen, B. R. DasGupta, and R. C. Stevens. 1998. Crystal structure of botulinum neurotoxin type A and implications for toxicity. Nat. Struct. Biol. 5:898-902.
119. Lalli, G., S. Bohnert, K. Deinhardt, C. Verastegui, and G. Schiavo. 2003. The journey of tetanus and botulinum neurotoxins in neurons. Trends Microbiol. 11:431-437.
120. Lassmann, B., D. R. Gustafson, C. M. Wood, and J. E. Rosenblatt. 2007. Reemergence of anaerobic bacteremia. Clin. Infect. Dis. 44:895-900.
121. Lau, S. K., P. C. Woo, G. K. Woo, A. M. Fung, A. H. Ngan, Y. Song, C. Liu, P. Summanen, S. M. Finegold, and K. Yuen. 2006. Bacteraemia caused by Anaerotruncus colihominis and emended description of the species. J. Clin. Pathol. 59:748-752.
122. Lawrence, G. W., D. Lehmann, G. Anian, C. A. Coakley, G. Saleu, M. J. Barker, and M. W. Davis. 1990. Impact of active immunisation against enteritis necroticans in Papua New Guinea. Lancet 336:1165-1167.
123. Lawson, P. A., Y. Song, C. Liu, D. R. Molitoris, M. L. Vaisanen, M. D. Collins, and S. M. Finegold. 2004. Anaerotruncus colihominis gen. nov., sp. nov., from human faeces. Int. J. Syst. Evol. Microbiol. 54:413-417.
124. Leal, J., D. B. Gregson, T. Ross, D. L. Church, and K. B. Laupland. 2008. Epidemiology of Clostridium species bacteremia in Calgary, Canada, 2000-2006. J. Infect. 57:198-203.
125. Leclair, D., F. Pagotto, J. M. Farber, B. Cadieux, and J. W. Austin. 2006. Comparison of DNA fingerprinting methods for use in investigation of type E botulism outbreaks in the Canadian Arctic. J. Clin. Microbiol. 44:1635-1644.
126. Leegaard, T. M., P. Sandven, and P. Gaustad. 2005. Clostridium tertium: 3 case reports. Scand. J. Infect. Dis. 37:230-232.
127. Li, D. Y., A. O. Scheimann, J. G. Songer, R. E. Person, M. Horwitz, L. Resar, and K. B. Schwarz. 2004. Enteritis necroticans with recurrent enterocutaneous fistulae caused by Clostridium perfringens in a child with cyclic neutropenia. J. Pediatr. Gastroenterol. Nutr. 38:213-215.
128. Liebetrau, A., A. C. Rodloff, J. Behra-Miellet, and L. Dubreuil. 2003. In vitro activities of a new des-fluoro(6) quinolone, garenoxacin, against clinical anaerobic bacteria. Antimicrob. Agents Chemother. 47:3667-3671.
129. Lindstrom, M. K., H. M. Jankola, S. Hielm, E. K. Hyytia, and H. J. Korkeala. 1999. Identification of Clostridium botulinum with API 20 A, Rapid ID 32 A and RapID ANA II. FEMS Immunol. Med. Microbiol. 24:267-274.
130. Linscott, A. J., R. B. Flamholtz, D. Shukla, Y. Song, C. Liu, and S. M. Finegold. 2005. Fatal septicemia due to Clostridium hathewayi and Campylobacter hominis. Anaerobe 11:97-98.
131. Loo, V. G., L. Poirier, M. A. Miller, M. Oughton, M. D. Libman, S. Michaud, A. M. Bourgault, T. Nguyen, C. Frenette, M. Kelly, A. Vibien, P. Brassard, S. Fenn, K. Dewar, T. J. Hudson, R. Horn, P. Rene, Y. Monczak, and A. Dascal. 2005. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N. Engl. J. Med. 353:2442-2449.
132. 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. 36:184-190.
133. Lyras, D., J. R. O'Connor, P. M. Howarth, S. P. Sambol, G. P. Carter, T. Phumoonna, R. Poon, V. Adams, G. Vedantam, S. Johnson, D. N. Gerding, and J. I. Rood. 2009. Toxin B is essential for virulence of Clostridium difficile. Nature 458:1176-1179.
134. Macdonald, T. E., C. H. Helma, L. O. Ticknor, P. J. Jackson, R. T. Okinaka, L. A. Smith, T. J. Smith, and K. K. Hill. 2008. Differentiation of Clostridium botulinum serotype A strains by multiple-locus variable-number tandemrepeat analysis. Appl. Environ. Microbiol. 74:875-882.
135. MacLennan, J. D. 1962. The histotoxic clostridial infections of man. Bacteriol. Rev. 26:177-276.
136. Marler, L. M., J. A. Siders, L. C. Wolters, Y. Pettigrew, B. L. Skitt, and S. D. Allen. 1991. Evaluation of the new RapID-ANA II system for the identification of clinical anaerobic isolates. J. Clin. Microbiol. 29:874-878.
137. Maselli, R. A., W. Ellis, R. N. Mandler, F. Sheikh, G. Senton, S. Knox, H. Salari-Namin, M. Agius, R. L. Wollmann, and D. P. Richman. 1997. Cluster of wound botulism in California: clinical, electrophysiologic, and pathologic study. Muscle Nerve 20:1284-1295.
138. Massey, V., D. B. Gregson, A. H. Chagla, M. Storey, M. A. John, and Z. Hussain. 2003. Clinical usefulness of components of the Triage immunoassay, enzyme immunoassay for toxins A and B, and cytotoxin B tissue culture assay for the diagnosis of Clostridium difficile diarrhea. Am. J. Clin. Pathol. 119:45-49.
139. Matamouros, S., P. England, and B. Dupuy. 2007. Clostridium difficile toxin expression is inhibited by the novel regulator TcdC. Mol. Microbiol. 64:1274-1288.
140. Matsuda, T., Y. Okada, E. Inagi, Y. Tanabe, Y. Shimizu, K. Nagashima, J. Sakurai, M. Nagahama, and S. Tanaka. 2007. Enteritis necroticans 'pigbel' in a Japanese diabetic adult. Pathol. Int. 57:622-626.
141. McDonald, L. C., G. E. Killgore, A. Thompson, R. C. Owens, Jr., S. V. Kazakova, S. P. Sambol, S. Johnson, and D. N. Gerding. 2005. An epidemic, toxin gene-variant strain of Clostridium difficile. N. Engl. J. Med. 353:2433-2441.
142. McFarland, L. V., M. E. Mulligan, R. Y. Kwok, and W. E. Stamm. 1989. Nosocomial acquisition of Clostridium difficile infection. N. Engl. J. Med. 320:204-210.
143. Modi, N., and M. H. Wilcox. 2001. Evidence for antibiotic induced Clostridium perfringens diarrhoea. J. Clin. Pathol. 54:748-751.
144. Mory, F., C. Alauzet, C. Matuszeswski, P. Riegel, and A. Lozniewski. 2009. Evaluation of the new Vitek 2 ANC card for identification of medically relevant anaerobic bacteria. J. Clin. Microbiol. 47:1923-1926.
145. Mory, F., A. Lozniewski, V. David, J. P. Carlier, L. Dubreuil, and R. Leclercq. 1998. Low-level vancomycin resistance in Clostridium innocuum. J. Clin. Microbiol. 36:1767-1768.
146. Mulligan, M. E., L. R. Peterson, R. Y. Kwok, C. R. Clabots, and D. N. Gerding. 1988. Immunoblots and plasmid fingerprints compared with serotyping and polyacrylamide gel electrophoresis for typing Clostridium difficile. J. Clin. Microbiol. 26:41-46.
147. Neumann, A. P., and T. G. Rehberger. 2009. MLST analysis reveals a highly conserved core genome among poultry isolates of Clostridium septicum. Anaerobe 15:99-106.
148. Obladen, M. 2009. Necrotizing enterocolitis-150 years of fruitless search for the cause. Neonatology 96:203-210.
149. Olsen, S. J., L. C. MacKinnon, J. S. Goulding, N. H. Bean, and L. Slutsker. 2000. Surveillance for foodborne- disease outbreaks-United States, 1993-1997. MMWR Sur- veill. Summ. 49:1-62.
150. Paerregaard, A., O. Angen, M. Lisby, K. Molbak, M. E. Clausen, and J. J. Christensen. 2008. Denmark: botulism in an infant or infant botulism? Euro Surveill. 13:pii=19072.
151. Paisley, J. W., B. A. Lauer, and S. S. Arnon. 1995. A second case of infant botulism type F caused by Clostridium baratii. Pediatr. Infect. Dis. J. 14:912-914.
152. Pepersack, F., M. Labbe, C. Nonhoff, and E. Schoutens. 1983. Use of gas-liquid chromatography as a screening test for toxigenic Clostridium difficile in diarrhoeal stools. J. Clin. Pathol. 36:1233-1236.
153. Petrillo, T. M., C. M. Beck-Sague, J. G. Songer, C. Abramowsky, J. D. Fortenberry, L. Meacham, A. G. Dean, H. Lee, D. M. Bueschel, and S. R. Nesheim. 2000. Enteritis necroticans (pigbel) in a diabetic child. N. Engl. J. Med. 342:1250-1253.
154. Pitt, M. L., and R. D. LeClaire. 2005. Pathogenesis by aerosol, p. 65-78. In L. E. Lindler, F. J. Lebeda, and G. W. Korch (ed.), Biological Weapons Defense. Infectious Diseases and Counterbioterrorism. Humana Press, Inc., Totowa, NJ.
155. Reineke, J., S. Tenzer, M. Rupnik, A. Koschinski, O. Hasselmayer, A. Schrattenholz, H. Schild, and C. von Eichel-Streiber. 2007. Autocatalytic cleavage of Clostridium difficile toxin B. Nature 446:415-419.
156. Rennie, R. P., C. Brosnikoff, L. Turnbull, L. B. Reller, S. Mirrett, W. Janda, K. Ristow, and A. Krilcich. 2008. Multicenter evaluation of the Vitek 2 anaerobe and Corynebac- terium identification card. J. Clin. Microbiol. 46:2646-2651.
157. Roberts, S. A., K. P. Shore, S. D. Paviour, D. Holland, and A. J. Morris. 2006. Antimicrobial susceptibility of anaerobic bacteria in New Zealand: 1999-2003. J. Antimicrob. Chemother. 57:992-998.
158. Sawires, Y. S., and J. G. Songer. 2005. Multiple-locus variable-number tandem repeat analysis for strain typing of Clostridium perfringens. Anaerobe 11:262-272.
159. Sayeed, S., F. A. Uzal, D. J. Fisher, J. Saputo, J. E. Vidal, Y. Chen, P. Gupta, J. I. Rood, and B. A. McClane. 2008. Beta toxin is essential for the intestinal virulence of Clostridium perfringens type C disease isolate CN3685 in a rabbit ileal loop model. Mol. Microbiol. 67:15-30.
160. Schiavo, G., M. Matteoli, and C. Montecucco. 2000. Neurotoxins affecting neuroexocytosis. Physiol. Rev. 80:717-766.
161. Schreckenberger, P. C., D. M. Celig, and W. M. Janda. 1988. Clinical evaluation of the Vitek ANI card for identification of anaerobic bacteria. J. Clin. Microbiol. 26:225-230.
162. Sharma, S. K., and R. C. Whiting. 2005. Methods for detection of Clostridium botulinum toxin in foods. J. Food Prot. 68:1256-1263.
163. Shepard, L. A., A. P. Heuck, B. D. Hamman, J. Rossjohn, M. W. Parker, K. R. Ryan, A. E. Johnson, and R. K. Tweten. 1998. Identification of a membrane-spanning domain of the thiol-activated pore-forming toxin Clostridium perfringens perfringolysin O: an alpha-helical to beta-sheet transition identified by fluorescence spectroscopy. Biochemistry 37:14563-14574.
164. Sheth, A. N., P. Wiersma, D. Atrubin, V. Dubey, D. Zink, G. Skinner, F. Doerr, P. Juliao, G. Gonzalez, C. Burnett, C. Drenzek, C. Shuler, J. Austin, A. Ellis, S. Maslanka, and J. Sobel. 2008. International outbreak of severe botulism with prolonged toxemia caused by commercial carrot juice. Clin. Infect. Dis. 47:1245-1251.
165. Shimizu, S., M. Ootsubo, Y. Kubosawa, I. Fuchizawa, Y. Kawai, and K. Yamazaki. 2009. Fluorescent in situ hybridization in combination with filter cultivation (FISHFC) method for specific detection and enumeration of viable Clostridium perfringens. Food Microbiol. 26:425-431.
166. 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 99:996-1001.
167. Shukla, H. D., and S. K. Sharma. 2005. Clostridium botulinum: a bug with beauty and weapon. Crit. Rev. Microbiol. 31:11-18.
168. Simmon, K. E., S. Mirrett, L. B. Reller, and C. A. Petti. 2008. Genotypic diversity of anaerobic isolates from bloodstream infections. J. Clin. Microbiol. 46:1596-1601.
169. Smedley, J. G., III, D. J. Fisher, S. Sayeed, G. Chakrabarti, and B. A. McClane. 2004. The enteric toxins of Clostridium perfringens. Rev. Physiol. Biochem. Pharmacol. 152:183-204.
170. Smith, G. R. 1987. Botulism in water birds and its relation to comparative medicine, p. 73-86. In M. W. Elklund and V. R. Dowell, Jr. (ed.), Avian Botulism. Charles C Thomas, Springfield, IL.
171. Smith, L. D. S. 1975. Clostridium, p. 109-114. In L. D. S. Smith (ed.), The Pathogenic Anaerobic Bacteria. Charles C Thomas, Springfield, IL.
172. Smith, L. D. S., and H. Sugiyama. 1988. Botulism. The Organism, Its Toxins, the Diseases. Charles C Thomas, Springfield, IL.
173. Smith, L. D. S., and B. L. Williams. 1984. The Pathogenic Anaerobic Bacteria. Charles C Thomas, Springfield, IL.
174. Sobel, J., C. G. Mixter, P. Kolhe, A. Gupta, J. Guarner, S. Zaki, N. A. Hoffman, J. G. Songer, M. Fremont-Smith, M. Fischer, G. Killgore, P. H. Britz, and C. MacDonald. 2005. Necrotizing enterocolitis associated with Clostridium perfrin- gens type A in previously healthy north american adults. J. Am. Coll. Surg. 201:48-56.
175. Song, Y., C. Liu, D. R. Molitoris, T. J. Tomzynski, P. A. Lawson, M. D. Collins, and S. M. Finegold. 2003. Clostridium bolteae sp. nov., isolated from human sources. Syst. Appl. Microbiol. 26:84-89.
176. Song, Y. L., C. X. Liu, M. McTeague, P. Summanen, and S. M. Finegold. 2004. Clostridium bartlettii sp. nov., isolated from human faeces. Anaerobe 10:179-184.
177. Songer, J. G. 1997. Molecular and immunological methods for the diagnosis of clostridial diseases, p. 491-503. In J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (ed.), The Clostridia: Molecular Biology and Pathogenesis. Academic Press, New York, NY.
178. Spigaglia, P., F. Barbanti, P. Mastrantonio, J. S. Brazier, F. Barbut, M. Delmee, E. Kuijper, and I. R. Poxton. 2008. Fluoroquinolone resistance in Clostridium difficile isolates from a prospective study of C. difficile infections in Europe. J. Med. Microbiol. 57:784-789.
179. Stackebrandt, E., and F. A. Rainey. 1997. Phylogenic relationships, p. 3-19. In J. I. Rood, B. A. McClane, J. G. Songer, and R. W. Titball (ed.), The Clostridia: Molecular Biology and Pathogenesis, 1st ed. Academic Press, New York, NY.
180. Statius van Eps, R. G., and G. M. LaMuraglia. 1997. Photodynamic therapy inhibits transforming growth factor beta activity associated with vascular smooth muscle cell injury. J. Vasc. Surg. 25:1044-1052.
181. Steer, T., M. D. Collins, G. R. Gibson, H. Hippe, and P. A. Lawson. 2001. Clostridium hathewayi sp. nov., from human faeces. Syst. Appl. Microbiol. 24:353-357.
182. Stevens, D. L., A. L. Bisno, H. F. Chambers, E. D. Everett, P. Dellinger, E. J. Goldstein, S. L. Gorbach, J. V. Hirschmann, E. L. Kaplan, J. G. Montoya, and J. C. Wade. 2005. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin. Infect. Dis. 41:1373-1406.
183. Stevens, D. L., D. M. Musher, D. A. Watson, H. Eddy, R. J. Hamill, F. Gyorkey, H. Rosen, and J. Mader. 1990. Spontaneous, nontraumatic gangrene due to Clostridium septicum. Rev. Infect. Dis. 12:286-296.
184. Stevens, D. L., R. K. Tweten, M. M. Awad, J. I. Rood, and A. E. Bryant. 1997. Clostridial gas gangrene: evidence that alpha and theta toxins differentially modulate the immune response and induce acute tissue necrosis. J. Infect. Dis. 176:189-195.
185. Steyaert, S., R. Peleman, M. Vaneechoutte, B. T. De, G. Claeys, and G. Verschraegen. 1999. Septicemia in neutropenic patients infected with Clostridium tertium resistant to cefepime and other expanded-spectrum cephalosporins. J. Clin. Microbiol. 37:3778-3779.
186. Sugahara, T., T. Takahashi, Yamaya S, and A. Ohsaka. 1976. In vitro aggregation of platelets induced by alpha toxin (phospholipase C) of Clostridium perfringens. Jpn. J. Med. Sci. Biol. 29:255-263.
187. Sunenshine, R. H., and L. C. McDonald. 2006. Clostridium difficile-associated disease: new challenges from an established pathogen. Cleve. Clin. J. Med. 73:187-197.
188. Swaminathan, S., and S. Eswaramoorthy. 2000. Structural analysis of the catalytic and binding sites of Clostridium botulinum neurotoxin B. Nat. Struct. Biol. 7:693-699.
189. Torres, J., M. Camorlinga-Ponce, and O. Munoz. 1992. Sensitivity in culture of epithelial cells from rhesus monkey kidney and human colon carcinoma to toxins A and B from Clostridium difficile. Toxicon 30:419-426.
190. Underwood, K., S. Rubin, T. Deakers, and C. Newth. 2007. Infant botulism: a 30-year experience spanning the introduction of botulism immune globulin intravenous in the intensive care unit at Childrens Hospital Los Angeles. Pediatrics 120:e1380-e1385.
191. Valiquette, L., B. Cossette, M. P. Garant, H. Diab, and J. Pepin. 2007. Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile- associated disease caused by the hypervirulent NAP1/027 strain. Clin. Infect. Dis. 45(Suppl. 2):S112-S121.
192. Vanpoucke, H., B. T. De, G. Claeys, M. Vaneechoutte, and G. Verschraegen. 2001. Evaluation of six commercial assays for the rapid detection of Clostridium difficile toxin and/or antigen in stool specimens. Clin. Microbiol. Infect. 7:55-64.
193. von Eichel-Streiber, C., P. Boquet, M. Sauerborn, and M. Thelestam. 1996. Large clostridial cytotoxins-a family of glycosyltransferases modifying small GTP-binding proteins. Trends Microbiol. 4:375-382.
194. Voth, D. E., and J. D. Ballard. 2005. Clostridium difficile toxins: mechanism of action and role in disease. Clin. Microbiol. Rev. 18:247-263.
195. Wang, R. F., M. L. Beggs, B. D. Erickson, and C. E. Cerniglia. 2004. DNA microarray analysis of predominant human intestinal bacteria in fecal samples. Mol. Cell. Probes 18:223-234.
196. Warny, M., J. Pepin, A. Fang, G. Killgore, A. Thompson, J. Brazier, E. Frost, and L. C. McDonald. 2005. Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 366:1079-1084.
197. Weber, J. T., H. C. Goodpasture, H. Alexander, S. B. Werner, C. L. Hatheway, and R. V. Tauxe. 1993. Wound botulism in a patient with a tooth abscess: case report and review. Clin. Infect. Dis. 16:635-639.
198. Wein, L. M., and Y. Liu. 2005. Analyzing a bioterror attack on the food supply: the case of botulinum toxin in milk. Proc. Natl. Acad. Sci. USA 102:9984-9989.
199. Wheeler, C., G. Inami, J. Mohle-Boetani, and D. Vugia. 2009. Sensitivity of mouse bioassay in clinical wound botulism. Clin. Infect. Dis. 48:1669-1673.
200. Wilkins, T. D., and D. M. Lyerly. 2003. Clostridium difficile testing: after 20 years, still challenging. J. Clin. Microbiol. 41:531-534.
201. Williamson, E. D., and R. W. Titball. 1993. A genetically engineered vaccine against alpha-toxin of Clostridium per- fringens protects against experimental gas gangrene. Vaccine 11:1253-1258.
202. Wilson, J. R., and A. P. Limaye. 2004. Risk factors for mortality in patients with anaerobic bacteremia. Eur. J. Clin. Microbiol. Infect. Dis. 23:310-316.
203. Winn, W. C., S. D. Allen, W. M. Janda, E. W. Koneman, G. Procop, P. C. Schrechenberger, and G. Woods. 2005. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. Lippincott Williams & Wilkins, Philadelphia, PA.
204. Woo, P. C., S. K. Lau, J. L. Teng, H. Tse, and K. Y. Yuen. 2008. Then and now: use of 16S rDNA gene sequencing for bacterial identification and discovery of novel bacteria in clinical microbiology laboratories. Clin. Microbiol. Infect. 14:908-934.
205. Woo, P. C., S. K. Lau, G. K. Woo, A. M. Fung, V. P. Yiu, and K. Y. Yuen. 2004. Bacteremia due to Clostridium hathe- wayi in a patient with acute appendicitis. J. Clin. Microbiol. 42:5947-5949.
206. Woodruff, B. A., P. M. Griffin, L. M. McCroskey, J. F. Smart, R. B. Wainwright, R. G. Bryant, L. C. Hutwagner, and C. L. Hatheway. 1992. Clinical and laboratory comparison of botulism from toxin types A, B, and E in the United States, 1975-1988. J. Infect. Dis. 166:1281-1286.
207. Zink, J. M., R. Singh-Parikshak, A. Sugar, and M. W. Johnson. 2004. Clostridium sordellii endophthalmitis after suture removal from a corneal transplant. Cornea 23:522-523.