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C L Hatheway

Publications and source records attributed to C L Hatheway.

At least 37 records · Page 2Linked to original sources

Genetic confirmation of identities of neurotoxigenic Clostridium baratii and Clostridium butyricum implicated as agents of infant botulism.

Two unusual neurotoxigenic clostridia isolated from fecal specimens from patients with type F and type E infant botulism were phenotypically identical to the existing species Clostridium baratii and C. butyricum, respectively. DNA hybridization experiments confirmed that one strain was C. baratii and that the other was C. butyricum. These species therefore do contain neurotoxigenic strains and are possible causes of infant botulism.

Botulism↗

Multilocus enzyme electrophoresis of Clostridium argentinense (Clostridium botulinum toxin type G) and phenotypically similar asaccharolytic clostridia.

Twenty-three strains of Clostridium argentinense, C. subterminale, C. hastiforme, and other phenotypically similar asaccharolytic clostridia recently placed in seven DNA hybridization groups were compared by multilocus enzyme electrophoresis. The three nontoxigenic strains of C. argentinense were most closely related to the toxigenic strains of this species. All nine toxigenic strains of C. argentinense belonging to a single DNA hybridization group had identical enzyme types on the basis of nine enzymes. All other strains except for two derived from the type strain of C. subterminale were differentiable. Overall, there was excellent agreement between DNA relatedness and multilocus enzyme electrophoresis results.

Clostridium↗

Laboratory findings in four cases of adult botulism suggest colonization of the intestinal tract.

There was laboratory evidence of intestinal colonization in four cases of adult botulism confirmed by the Centers for Disease Control. No performed toxin was detected in available foods, but Clostridium botulinum was isolated from foods in two instances. Botulinal toxin was detected in the sera of all four patients, in one case at 47 days after ingestion of suspected food. C. botulinum was demonstrated in the stool of all four patients and persisted for 119 days after the onset of illness in one patient. Two patients had surgical alterations of the gastrointestinal tract, which may have promoted the colonization. The apparent lack of ingestion of performed toxin in these cases and the persistence of botulinal toxin or C. botulinum, or both, for long periods in three of the patients suggest that colonization of the intestinal tract occurred.

Adult↗

Examination of feces and serum for diagnosis of infant botulism in 336 patients.

In the 12-year period 1975 to 1987, feces from 336 infants were examined for botulinal neurotoxin and Clostridium botulinum. All the infants had illnesses which prompted their physicians to consider infant botulism in the diagnosis. Stool specimens from 113 of the infants yielded organisms that produced botulinal neurotoxins assumed to be responsible for the illness. The types of botulinal toxin in the confirmed cases were distributed as follows: 38 A, 69 B, 2 atypical B, 1 E, 1 F, 1 A + B, and 1 B + F. The type A and B toxins in a single infant were produced by two different strains of organism, and the type B and F toxins in another infant were produced by a single strain. The physiological characteristics of all the isolated toxigenic organisms except two were consistent with those of group I (proteolytic) C. botulinum. The toxigenic isolate from the infant with type E botulism was identified as C. butyricum, and that from the infant with type F botulism was identified as C. barati. Toxin of the same type as produced by the isolated organisms was identified in feces of 98 of 111 culture-positive infants. Botulinal toxin was identified in the serum of 9 of 67 culture-positive infants (8 of 22 infants with type A organisms; 1 of 43 infants with type B organisms; neither of 2 infants with A + B or atypical type B organisms). Botulinal toxin was not detected in feces (206 infants) or in serum (114 infants) of the culture-negative infants. The culture-positive infants had clinical features and a course of illness consistent with those of infant botulism. Most of the culture-negative infants probably had illnesses other than botulism, but specimens might have been obtained late in some infants' illnesses, when the organism had disappeared.

Botulinum Toxins↗

Infant botulism. Three cases in a small town.

Through Dec 31, 1985, there have been six cases of infant botulism reported in Colorado. Three of these infants have lived in the same town of 800 people in western Colorado. Two of these three infants developed infant botulism within a six-month period in late 1981. The infants lived approximately 400 m apart; they had used the same crib at the time each developed botulism. A specimen from the crib yielded Clostridium botulinum, as did four soil samples from the town and house-dust samples from the home of a relative of the second infant. The third infant developed infant botulism in September 1984. This infant had not shared the crib. In this case, all seven samples of soil from various locations in the town yielded C botulinum, as did a sample of house dust from the home of this infant. The occurrence of these three cases in such a small town seems unlikely to be only coincidental. Investigations and reports of other such clusters may provide insight into modes of transmission of infant botulism.

Beds↗

Two cases of type E infant botulism caused by neurotoxigenic Clostridium butyricum in Italy.

The first two confirmed cases of type E infant botulism occurred in two 16-week-old girls in Rome, Italy. The original diagnosis for the first patient was intestinal blockage due to an ileocecal invagination, which was treated surgically. Postoperatively, the patient became unresponsive and required ventilatory assistance. A diagnosis of infant botulism was then made. The second infant presented to the same hospital 7 1/2 months later with profound weakness, hypotonicity, mydriasis, and areflexia. This case was recognized as possible botulism at admission. Both cases were confirmed by detection and identification of type E botulinal toxin in stool specimens and in enrichment cultures of those specimens. The toxigenic organisms isolated were quite different from Clostridium botulinum type E. The apparent causative organism in each case resembles Clostridium butyricum but produces a neurotoxin that is indistinguishable from type E botulinal toxin by its effects on mice and by its neutralization with type E botulinal antitoxin.

Botulinum Toxins↗

Characterization of an organism that produces type E botulinal toxin but which resembles Clostridium butyricum from the feces of an infant with type E botulism.

The apparent causative organism from the only reported case of type E infant botulism was isolated and characterized. Except for its ability to produce type E botulinal toxin, this organism (strain 5262) would be unquestionably identified as Clostridium butyricum. This is the second time an organism resembling a defined Clostridium species other than a member of the C. botulinum group has been implicated in infant botulism.

Botulinum Toxins↗

Type A botulism from sauteed onions. Clinical and epidemiologic observations.

Twenty-eight persons were hospitalized in Illinois with neurologic signs and symptoms compatible with botulism in October 1983. Twelve patients required ventilatory support, and 20 patients were treated with trivalent ABE antitoxin; one patient died while still in the hospital six months after onset of illness. Type A toxin and/or type A Clostridium botulinum were subsequently identified in specimens from 18 patients. Case-control studies implicated sauteed onions made from fresh raw onions and served on a patty-melt sandwich in a local restaurant as the vehicle of transmission. Although the original sauteed onions were not available for toxin testing, type A toxin was detected in washings from a wrapper in which a patty-melt sandwich was taken home by one of the ill persons. Also, type A C botulinum was cultured from five of 75 raw onions taken from the restaurant. This outbreak implicated an unusual vehicle for botulinal toxin that was initially not suspected and demonstrates the importance of considering all theoretically possible food items as potential vehicles for toxin until epidemiologic and laboratory data have been collected and analyzed.

Adult↗

Isolation and enumeration of Clostridium botulinum by direct inoculation of infant fecal specimens on egg yolk agar and Clostridium botulinum isolation media.

Direct plating of stool specimens on selective (Clostridium botulinum isolation) and nonselective (egg yolk agar) media was evaluated as an aid in confirming infant botulism. C. botulinum was isolated from 13 of 14 culture-positive specimens with C. botulinum isolation and from 8 of 14 egg yolk agar. No lipase reaction was seen on plates of 31 culture-negative specimens.

Agar↗

Isolation of an organism resembling Clostridium barati which produces type F botulinal toxin from an infant with botulism.

All reported cases of infant botulism except one have been caused by proteolytic strains (group I) of Clostridium botulinum, toxin types A or B. We describe the cultural and biochemical characteristics of the causative organism of this singular case of infant botulism, caused by type F botulinal toxin. Although this organism produces type F botulinal toxin, it is quite different from proteolytic (group I) C. botulinum, being more closely related to Clostridium barati.

Botulinum Toxins↗

Enzyme-linked immunosorbent assay for detection of Clostridium botulinum type A and type B toxins in stool samples of infants with botulism.

An enzyme-linked immunosorbent assay (ELISA) for Clostridium botulinum type A and type B toxins was assessed for diagnostic accuracy in cases of infant botulism. This test was positive in all 22 cases confirmed by the conventional tests, which included the mouse lethality assay and stool culture. Stool specimens from five cases were positive by culture, but the mouse lethality bioassay was either negative or toxicity was judged nonspecific since it could not be neutralized by specific antitoxin. The positive ELISA results in these specimens suggested that this assay may be more reliable, in some cases, than the mouse bioassay. Of the 21 fecal specimens from suspected foodborne cases, 2 contained botulinal toxin demonstrable by the mouse assay and the ELISA. With regard to specificity, 35 fecal specimens from infants and 19 from suspected foodborne cases which were negative in the bioassay for botulinal toxins A and B were also negative in the ELISA. Only two fecal specimens with negative bioassay gave positive ELISA readings, providing a specificity rate of 96%. These results suggest that the ELISA may serve as a useful screening test to detect C. botulinum toxin in clinical specimens.

Adolescent↗

Evaluation of fluorescent-antibody tests as a means of confirming infant botulism.

Fluorescent-antibody techniques were evaluated for confirming infant botulism. Seventy-seven stool specimens from suspected cases were examined. All 34 specimens containing viable Clostridium botulinum at time of study gave positive results (29 on direct smears and 34 on enrichments). Two false-positive reactions were observed.

Botulism↗

Fluorescent-antibody reagents for the identification of Clostridium botulinum.

Fluorescent-antibody reagents were prepared against vegetative cells of representative strains of each physiological group and toxin type of Clostridium botulinum known to have caused botulism in humans. A fluorescent-antibody reagent was also prepared for C. botulinum type G, which has been isolated from autopsy specimens but which has not clearly been implicated in botulism. These fluorescent-antibody reagents were evaluated against 200 strains of C. botulinum and 64 strains of other clostridia. Each reagent reacted with at least a 2+ intensity with all of the strains in its same toxin type and physiological group. Ninety-seven percent of the strains gave at least a 3+ reaction with the homologous group or toxin type reagent. Some cross-reactions occurred with reagents against different toxin type strains within a physiological group; there was less cross-reaction between physiological groups and very little reactivity of C. botulinum reagents with nontoxigenic organisms. Absorption of cross-reacting antibodies was not successful. Certain reagents could be used for presumptive laboratory identification of C. botulinum strains causing botulism, especially in infants. The type G reagent provided a good means of identifying C. botulinum type G, which lacks the lipase marker and whose toxigenicity may be more difficult to demonstrate in mixed cultures. There was a serological relationship between C. botulinum type G and some strains of Clostridium subterminale. This relationship provided evidence of differences between strains of C. botulinum type G isolated in two different countries.

Antibodies, Bacterial↗

Laboratory diagnosis in a large outbreak of type A botulism: confirmation of the value of coproexamination.

Coproexamination is a vital component of the laboratory evaluation of botulism and is an essential part of the investigation of suspected botulism cases. In April 1978, type A botulism developed in 34 persons who had eaten at a restaurant in a town in New Mexico. Pretreatment serum specimens, along with stool specimens for toxin assay and culture for Clostridium botulinum, were obtained. At least one specimen (serum or stool) was available for each patient. Of 30 serum specimens, 16 (53%) were toxin positive; seven (32%) of 22 stools were toxin positive; and C. botulinum type A was cultured from 19 (79%) of 24 stool specimens. Overall laboratory confirmation was available for 26 cases (76%). Serum and stool toxin detection was related both to the time elapsed between symptom onset and specimen collection and to the severity of illness, with shorter times and severe illness associated with higher rates of toxin detection. Recovery of C. botulinum type A did not vary appreciably according to these factors. In 18 cases, both serum and stool specimens were available; the proportion of suspected cases that could be laboratory-proven increased by 46% when patients' feces, and not just their sera, were subjected to botulism testing procedures.

Adolescent↗

Restaurant-associated type A botulism: transmission by potato salad.

In the period November 13-18, 1978, seven cases of type A botulism occurred in persons who had eaten in a restaurant in Colorado. The outbreak was recognized when two persons who had independently eaten at the restaurant were hospitalized with an illness compatible with botulism. Surveillance efforts identified five additional cases. Potato salad made at the restaurant and available for service during an 11-day period was epidemiologically incriminated as the vehicle of botulinal toxin transmission (p less than 0.00001). Laboratory studies showed that Clostridium botulinum spores on the surface of potatoes could survive baking in the manner used by the restaurant and that botulinal toxin could be produced in potatoes contaminated with C. botulinum spores.

Botulism↗

Common polysaccharide antigens from the cell envelope of Clostridium perfringens type A.

Soluble antigens were obtained by extracting five serotype strains of Clostridium perfringens type A with water at 100 degrees C. The type-specific polysaccharides were precipitated with ethanol, and the common antigens were recovered from the ethanol supernatants by concentration, dialysis, and lyophilization. Refluxing the water-extracted cell residues with 1% acetic acid followed by concentration, dialysis, and lyophilization gave additional common antigen fractions. A comprehensive, side-by-side comparison of the antigen fractions, the ethanol precipitate, the ethanol supernatant, and the acetic acid supernatant, revealed that common antigens were recovered in all three fractions, and that three distinct entities were responsible for the formation of the observed common immunoprecipitin lines; whereas many fractions possessed all three immunoprecipitin lines, others contained only one or two. The serological homology observed between the various antigen fractions was apparently a consequence of N-acetylglucosamine- and N-acetylmannosamine-containing polymers. The common antigens were presumably associated with the cell envelope and may be the type of markers sought previously by others for the serological identification of C. perfringens.

Antigens, Bacterial↗