The clinical significance, taxonomy and special methodological problems of the pathogenic clostridia.

The clinical significance of clostridia is much greater than is generally recognized. The organisms are a major cause of septic abortion, Clostridium perfringens being the most important single organism. This species is also the principle agent in food-poisoning. Clostridium botulinum is considered to be one of the main causes of the sudden death syndrome in infants. As clostridia are universally distributed in nature and the human body, the isolation of an organism of this group from the human body is significant only if it can be linked with pathological changes. In the case of histotoxic disease, a direct gramstained smear from the lesion is of paramount importance, since the pathogens are always present in large numbers. Generally, a few simple procedures and tests ensure the rapid isolation and identification of the main pathogenic clostridia. C. perfringens, by far the most important species, may be identified by its ability to produce lecithinase on egg yolk-glucose agar and stormy clot in litmus milk. However, strain identification of this microorganism is much more complicated.