What is Clostridium perfringens (formerly known as Clostridium welchii)?

From the Guidelines

Clostridium perfringens is a gram-positive, rod-shaped, anaerobic bacterium that forms spores and is commonly found in soil, sewage, and the intestinal tracts of humans and animals, known for causing food poisoning, gas gangrene, and necrotic enteritis, particularly in individuals with impaired intestinal motility. The bacterium produces numerous toxins, with the potential to cause severe intestinal damage and death, as seen in outbreaks of foodborne illness caused by C. perfringens type A, where fatalities were attributed to necrotizing colitis 1.

Key Characteristics of C. perfringens

• Forms spores, allowing it to survive in harsh environments
• Produces toxins, including alpha toxin, which causes tissue damage
• Commonly found in soil, sewage, and the intestinal tracts of humans and animals
• Can cause a variety of diseases, including food poisoning, gas gangrene, and necrotic enteritis ### Disease Prevention and Management
• Proper food handling, thorough cooking, and rapid cooling of prepared foods can help prevent C. perfringens food poisoning 1
• Individuals with impaired intestinal motility, such as those taking anticholinergic medications, are at increased risk for severe outcomes from C. perfringens intoxication 1
• Institutions should ensure that precautions to prevent C. perfringens and other causes of foodborne illness are in place, particularly in settings where patients may have impaired intestinal motility 1

From the Research

Characteristics of Clostridium perfringens

• Clostridium perfringens is an absolutely anaerobic, rod-shaped, spore-forming bacterium 2
• It is a major cause of gas gangrene, a disease associated with wound infection, and can lead to potentially fatal prognosis if treatment is delayed 2
• The bacterium is also responsible for local outbreaks of food poisoning associated with eating contaminated food that was improperly heat-treated 2, 3, 4, 5

Toxins and Pathogenicity

• Clostridium perfringens produces toxins that are responsible for its pathogenicity, including epsilon toxin, which is considered the third most powerful bacterial toxin 2
• The bacterium can be divided into five serotypes (A-E) depending on the type of toxin produced 2
• C. perfringens type A is one of the four most important bacterial agents causing food poisoning, and its enteropathy is mediated through enterotoxin synthesized in vivo during sporulation 3
• The production of C. perfringens toxins is highly regulated via processes involving two-component regulatory systems, quorum sensing, and/or sporulation-related alternative sigma factors 6

Foodborne Infections and Outbreaks

• Clostridium perfringens is a common cause of foodborne illnesses, particularly in Japan, where it is the top 5th or 6th pathogen of foodborne illnesses 4
• Inappropriate food handling practices, such as inadequate heating, cooling, and reheating, can lead to outbreaks of C. perfringens food poisoning 4, 5
• The diagnosis of C. perfringens food poisoning is based on either quantitative cultures of implicated foods or enterotoxin-positive stool specimens 4