Skip to main content
    • Aa
    • Aa

Spread of a large plasmid carrying the cpe gene and the tcp locus amongst Clostridium perfringens isolates from nosocomial outbreaks and sporadic cases of gastroenteritis in a geriatric hospital

  • S. KOBAYASHI (a1) (a2), A. WADA (a1), S. SHIBASAKI (a3), M. ANNAKA (a3), H. HIGUCHI (a3), K. ADACHI (a3), N. MORI (a4), T. ISHIKAWA (a4), Y. MASUDA (a4), H. WATANABE (a1), N. YAMAMOTO (a2) (a5), S. YAMAOKA (a2) and T. INAMATSU (a4)...

To investigate two clusters of diarrhoea cases observed in our geriatric hospital wards, the faecal specimens were analysed. Reversed passive latex agglutination assay revealed that 63·2% and 41·7% of the faecal specimens from each cluster were positive for Clostridium perfringens enterotoxin. PCR assay revealed that 71·4% and 68·8% of C. perfringens isolates from each cluster were positive for the enterotoxin gene (cpe). These observations suggested that both the clusters were outbreaks caused by enterotoxigenic C. perfringens. Subsequent pulsed-field gel electrophoresis analysis revealed that the two outbreaks were caused by different C. perfringens isolates. However, these outbreak isolates as well as other sporadic diarrhoea isolates shared a 75-kb plasmid on which the cpe gene and the tcp locus were located. The 75-kb plasmid had horizontally spread to various C. perfringens isolates and had caused outbreaks and sporadic infections. However, the site and time of the plasmid transfer are unclear.

Corresponding author
*Author for correspondence: Dr A. Wada, Department of Bacteriology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. AHW Hauschild , R Hilsheimer . Purification and characteristics of the enterotoxin of Clostridium perfringens type A. Canadian Journal of Microbiology 1971; 17: 14251433.

5. MR Sarker , RJ Carman , BA McClane . Inactivation of the gene (cpe) encoding Clostridium perfringens enterotoxin eliminates the ability of two cpe-positive C. perfringens type A human gastrointestinal disease isolates to affect rabbit ileal loops. Molecular Microbiology 1999; 33: 946958.

8. MM Brett , Detection of Clostridium perfringens and its enterotoxin in cases of sporadic diarrhoea. Jounal of Clinical Pathology 1992; 45: 609611.

11. R Williams , Diarrhoea due to enterotoxigenic Clostridium perfringens: clinical features and management of a cluster of ten cases. Age and Ageing 1985; 14: 296302.

13. A Wada , Nosocomial diarrhoea in the elderly due to enterotoxigenic Clostridium perfringens. Microbiology and Immunology 1996; 40: 767771.

14. T Fukao , An outbreak of diarrheal disease caused by enterotoxigenic Clostridium perfringens following exposure to a contaminated enviroment in a nursing home [in Japanese]. Kansenshogaku Zasshi 2004; 78: 3239.

15. T Yamagishi , Persistent high numbers of Clostridium perfringens in the intestines of Japanese aged adults. Japanese Journal of Microbiology 1976; 20: 397403.

17. K Miyamoto , Q Wen , BA McClane . Multiplex PCR genotyping assay that distinguishes between isolates of Clostridium perfringens type A carrying a chromosomal enterotoxin gene (cpe) locus, a plasmid cpe locus with an IS1470-like sequence, or a plasmid cpe locus with an IS1151 sequence. Journal of Clinical Microbiology 2004; 42: 15521558.

18. K Miyamoto , Complete sequencing and diversity analysis of the enterotoxin-encoding plasmids in Clostridium perfringens type A non-food-borne human gastrointestinal disease isolates. Journal of Bacteriology 2006; 188: 15851598.

19. TL Bannam , Functional identification of conjugation and replication regions of the tetracycline resistance plasmid pCW3 from Clostridium perfringens. Journal of Bacteriology 2006; 188: 49424951.

23. O Mpamugo , T Donovan , MM Brett . Enterotoxigenic Clostridium perfringens as a cause of sporadic cases of diarrhoea. Journal of Medical Microbiology 1995; 43: 442445.

26. S Brynestad , Enterotoxin plasmid from Clostridium perfringens is conjugative. Infection and Immunity 2001; 69: 34833487.

30. P Lahti , Clostridium perfringens type A strains carrying a plasmid-borne enterotoxin gene (genotype IS1151-cpe or IS1470-like-cpe) as a common cause of food poisoning. Journal of Clinical Microbiology 2008; 46: 371373.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 1
Total number of PDF views: 3 *
Loading metrics...

Abstract views

Total abstract views: 40 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd June 2017. This data will be updated every 24 hours.