Clostridium botulinum

R.Varidianto Yudo T., dr.,MKes

Lab. Mikrobiologi
Fakultas Kedokteran Universitas Hang Tuah

Clostridium botulinum dengan pengecatan spora.

Tampak batang pleomorphic dengan spora

Koloni C.botulinum

Transmission
Spores, widespread in soil,
contaminte foods.
Foods are canned or vacuum-packed
without adequate sterilization, spores
survive and germinate in the
anaerobic environment.
Toxin is produced and ingested
preformed.

Toxin
The toxin is a polypeptide encoded by a
lysogenic phage
The very strong botulinum neurotoxin is a
heat-labile protein.
7-8 toxigenic types are differentiated, each
of which produces an immunologically
distinct form of botulinum toxin.
Types A, B, and E cause poisoning in
humans.

The toxin is a metalloprotease that

catalyzes the proteolysis of components of
the neuro-exocytosis apparatus in the
motor end plates, resulting in flaccid
paralysis of the musculature.
Minute amounts of the toxin are effective in
the treatment of certain spasmodic muscle
disorders such as torticollis and
blepharospasm.

Pathogenesis and clinical picture.

Classic botulism results from eating spoiled
foods in which the toxin has been produced
under anaerobic conditions by C.botulinum.
The toxin is absorbed in the gastro-intestinal
tract, and then transported to the peripheral
nervous system in the bloodstream.
It blocks release of acetylcholine in
peripheral nerve synapses
Within a matter of hours or days paralysis
symptoms occur, especially in the nerves of
the head.

Frequent symptoms include seeing double

(diplopia), difficulty swallowing
(dysphagia) and speaking, constipation,
and dry mucosa.
Lethality rates range from 2570%,
depending on the amount of toxin ingested.
Death usually results from respiratory
paralysis.
Wound botulism results from wound
infection by C. botulinum and is very rare.

Infant botulism, results from ingestion of

spores with food (e.g., honey).
Probably due to the conditions prevailing in
the intestines of infants up to the age of six
months, the spores are able to proliferate
there and produce the toxin.
The lethality of infant botulism is low
(<1%).

Diagnosis
The organism is usually not cultured.
Botulinum toxin is demonstrable in
uneaten food and the patients serum
based on mouse neutralization test.
Mice are inoculated with a sample of
the clinical specimen and will die
unless protected by antitoxin.

Therapy.
Urgent administration of a polyvalent
antitoxin (A,B,E).
Respiratory support