title: Microbiologic characterization and antimicrobial susceptibility of Clostridium tetani isolated from wounds of patients with clinically diagnosed tetanus.
abstract: Clostridium tetani is the etiologic agent of the muscle-spasming disease tetanus. Despite an effective vaccine, tetanus is an ongoing problem in some developing countries. Diagnosis by bacterial culture is not done because it is generally unnecessary and the entry of route of the bacteria can be inapparent. We attempted to isolate and evaluate C. tetani from the wounds of 84 patients with tetanus. We effectively isolated C. tetani from 45 patients. All strains tested positive by polymerase chain reaction for the gene encoding tetanus neurotoxin. Antimicrobial susceptibilities were determined by disc diffusion and E-test. All C. tetani isolates were susceptible to penicillin and metronidazole but resistant to co-trimoxazole. Despite treatment with high doses of penicillin, C. tetani was isolated after 16 days of intravenous penicillin in two cases. These data show that the intravenous route for penicillin may be inadequate for clearing the infection and emphasizes wound debridement in the treatment of tetanus.
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam.
authors.forename: James I
authors.initials: JI
authors.lastname: Campbell
authors.forename: Thi Minh Yen
authors.initials: TM
authors.lastname: Lam
authors.forename: Thi Loan
authors.initials: TL
authors.lastname: Huynh
authors.forename: So Diep
authors.initials: SD
authors.lastname: To
authors.forename: Thi Thu Nga
authors.initials: TT
authors.lastname: Tran
authors.forename: Van Minh Hoang
authors.initials: VM
authors.lastname: Nguyen
authors.forename: Thanh Son
authors.initials: TS
authors.lastname: Le
authors.forename: van Vinh Chau
authors.initials: vV
authors.lastname: Nguyen
authors.forename: Christopher
authors.initials: C
authors.lastname: Parry
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Farrar
authors.forename: Tinh Hien
authors.initials: TH
authors.lastname: Tran
authors.forename: Stephen
authors.initials: S
authors.lastname: Baker
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D003017:Clostridium tetani / Q000187:drug effects* / Q000302:isolation & purification; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D013742:Tetanus / Q000382:microbiology*; D014744:Vietnam; D014946:Wound Infection / Q000382:microbiology*; D014947:Wounds and Injuries / Q000150:complications / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents