title: Prevalence of Clostridium perfringens enterotoxin and Clostridium difficile toxin A in feces of horses with diarrhea and colic.
abstract: OBJECTIVE
  To determine prevalence of clostridial enterotoxins in feces of horses with diarrhea and colic, and to determine whether an association exists between detection of clostridial enterotoxins in feces and development of diarrhea as a complication of colic.
  
  
  METHODS
  Prospective case series and case-control study.
  
  
  METHODS
  174 horses with diarrhea, colic, or problems not related to the gastrointestinal tract.
  
  
  METHODS
  Horses were assigned to 1 of 4 groups: colic with diarrhea (group 1; n = 30); colic without diarrhea (group 2; 30); diarrhea without colic (group 3; 57); and control (group 4; 57). Feces were evaluated by use of ELISA to detect Clostridium perfringens enterotoxin (CPE) and C difficile toxin A (TOXA). Frequency of detection of CPE or TOXA in groups 1 and 3 was compared with that in groups 2 and 4, respectively.
  
  
  RESULTS
  Prevalence of enteric clostridiosis in horses in group 3 was 25%. Clostridium perfringens enterotoxin was detected in 9 of 57 (16%), TOXA in 8 of 57 (14%), and both toxins in 3 of 57 (5%) fecal samples collected from these horses. Neither toxin was detected in feces of the age-matched horses in group 4. Clostridial enterotoxins were detected in feces of 7 of 60 (12%) horses with colic (groups 1 and 2), however, a significant association was not found between detection of enterotoxins in feces and development of diarrhea as a complication of colic.
  
  
  CONCLUSIONS
  Clostridia are important etiologic agents of diarrhea in horses. Additionally, changes in intestinal flora of horses with colic may allow for proliferation of clostridia and elaboration of enterotoxins regardless of whether diarrhea develops.
authors.affiliation: Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Donaldson
authors.forename: J E
authors.initials: JE
authors.lastname: Palmer
mesh_terms: D000818:Animals; D001427:Bacterial Toxins; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000472:pathogenicity; D003015:Clostridium Infections / Q000453:epidemiology / Q000662:veterinary*; D003016:Clostridium perfringens / Q000472:pathogenicity; D003085:Colic / Q000382:microbiology / Q000662:veterinary*; D003967:Diarrhea / Q000382:microbiology / Q000662:veterinary*; D004768:Enterotoxins / Q000302:isolation & purification; D004797:Enzyme-Linked Immunosorbent Assay / Q000662:veterinary; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000382:microbiology / Q000662:veterinary*; D006734:Horse Diseases / Q000453:epidemiology* / Q000382:microbiology; D006736:Horses; D015995:Prevalence; D011446:Prospective Studies; D012475:Salmonella / Q000472:pathogenicity
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; C035598:enterotoxin, Clostridium; C041348:tcdA protein, Clostridium difficile