Epidemiologic, Clinical and Laboratory Aspects of Wound Botulism

Merson, Michael H.; Dowell, V. R.

doi:10.1056/nejm197311082891904

Cited by 137 publications

(36 citation statements)

References 25 publications

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“…A total of 224 strains of Clostridium botulinum (including isolates from 14 patients with infant botulism and 4 with wound botulism) and 15 strains of C. sporogenes were tested by agar dilution for susceptibility to tetracycline, metronidazole, erythromycin, penicillin, rifampin, chloramphenicol, clindamycin, cephalothin, cefoxitin, vancomycin, sulfamethoxazole-trimethoprim, nalidixic acid, and gentamicin. At least 90% of the C. botulinum strains tested (except for nonproteolytic strains of toxin type F with penicillin) were susceptible to all drugs except sulfamethoxazole-trimethoprim, nalidixic acid, and gentamicin.…”

mentioning

confidence: 99%

Susceptibility of Clostridium botulinum to thirteen antimicrobial agents

Swenson¹,

Thornsberry²,

McCroskey³

et al. 1980

Antimicrob Agents Chemother

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A total of 224 strains of Clostridium botulinum (including isolates from 14 patients with infant botulism and 4 with wound botulism) and 15 strains of C. sporogenes were tested by agar dilution for susceptibility to tetracycline, metronidazole, erythromycin, penicillin, rifampin, chloramphenicol, clindamycin, cephalothin, cefoxitin, vancomycin, sulfamethoxazole-trimethoprim, nalidixic acid, and gentamicin. At least 90% of the C. botulinum strains tested (except for nonproteolytic strains of toxin type F with penicillin) were susceptible to all drugs except sulfamethoxazole-trimethoprim, nalidixic acid, and gentamicin. Minimal inhibitory concentrations for strains from patients with infant and wound botulism were similar to those for other C. botulinum strains.Botulism is a neuroparalytic disease caused by neurotoxin produced by Clostridium botulinum. In 1951, the first three cases of wound botulism (two of the cases had occurred several years earlier) were reported (7,12,26). Before that, botulism .was considered strictly a foodborne illness. In 1976 another form of the disease known as infant botulism was recognized as a clinical entity (16,18). Foodborne botulism involves ingestion of preformned toxin in contaminated food. In vivo growth of C. botulinum is generally not considered to be a factor in the illness, although the possibility has been suggested on the basis of some clinical and laboratory observations (15,17). Although antimicrobial therapy is at present not recommended for botulism, the recognition of wound botulism and infant botulism has revived interest in its possible role for treatment of these infections (6). Because of the attention on these more recently recognized forms of botulism and because antimicrobial therapy might be considered, we felt it appropriate to determine the susceptibility of these organisms to antimicrobial agents. The information should also be useful in comparing isolates of C. botulinum from different sources and in formulating selective media for isolation of these organisms. MATERIALS AND METHODSMedia and characterization procedures. Fortions for media used in these studies for the isolation, characterization, and storage of anaerobic bacteria are given by Dowell and Hawkins (9

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mentioning

confidence: 99%

Susceptibility of Clostridium botulinum to thirteen antimicrobial agents

Swenson¹,

Thornsberry²,

McCroskey³

et al. 1980

Antimicrob Agents Chemother

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“…Merson and Dowell summarized the first 3 decades in 1973. 3 Of nine reported cases, six were laboratory-confirmed (all type A). The median age was 15 years.…”

Section: Discussionmentioning

confidence: 96%

“…Gastrointestinal symptoms do not occur in wound botulism, in contrast to food-borne botulism. 3 The median incubation period is longer (7 days, range ‫ס‬ 4-14 days) in wound botulism 3 than in food-borne botulism (median 1 day, range 6 hours to 8 days) 26 because C. botulinum must multiply within the wound to elaborate sufficient toxin to cause symptoms. In injection drug users, however, the incubation period is difficult to determine because chronic injection wounds may be present, or the duration of a small subcutaneous wound may be unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Infant botulism results from intestinal colonization by C. botulinum and toxin production, 2 whereas wound botulism results from wound colonization by C. botulinum and toxin production. 3 The resulting paralysis may last weeks to months. The foundations of treatment are meticulous intensive care, with ventilatory support when required, and early administration of botulinum antitoxin to neutralize circulating toxin before binding and uptake by neurons.…”

Section: Introductionmentioning

confidence: 99%

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Wound Botulism Acquired in the Amazonian Rain Forest of Ecuador

Reller

Douce

Maslanka³

et al. 2006

The American Journal of Tropical Medicine and Hygiene

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“…Although never reported in the UK, the association of wound botulism and injecting drug addiction has been described in the USA. In the 10 years to 1996, 78 cases were reported in the USA, the majority linked to`black tar heroin' and`skin popping' [3,14]. Of these, 66 patients were Type A, nine were Type B and three were unknown.…”

Section: Discussionmentioning

confidence: 99%

Wound botulism in drug addicts in the United Kingdom

Mulleague¹,

Bonner²,

Samuel³

et al. 2001

Anaesthesia

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Clostridium novyi has recently been identified as the causative organism responsible for the deaths of 35 heroin addicts who had injected themselves intramuscularly. We present two heroin addicts who developed C. botulinum infection following intramuscular or subcutaneous injection of heroin. Like C. novyi, this grows under anaerobic conditions and clinical presentation may be similar; however, descending motor or autonomic signs are invariably present in botulism. The prognosis is good if the diagnosis is made early and appropriate treatment commenced.

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Epidemiologic, Clinical and Laboratory Aspects of Wound Botulism

Cited by 137 publications

References 25 publications

Susceptibility of Clostridium botulinum to thirteen antimicrobial agents

Susceptibility of Clostridium botulinum to thirteen antimicrobial agents

Wound Botulism Acquired in the Amazonian Rain Forest of Ecuador

Wound botulism in drug addicts in the United Kingdom

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