title: Non-toxigenic Clostridium sordellii: clinical and microbiological features of a case of cholangitis-associated bacteremia.
abstract: Toxigenic Clostridium sordellii strains are increasingly recognized to cause highly lethal infections in humans that are typified by a toxic shock syndrome (TSS). Two glucosylating toxins, lethal toxin (TcsL) and hemorrhagic toxin (TcsH) are believed to be important in the pathogenesis of TSS. While non-toxigenic strains of C. sordellii demonstrate reduced cytotoxicity in vitro and lower virulence in animal models of infection, there are few data regarding their behavior in humans. Here we report a non-TSS C. sordellii infection in the context of a polymicrobial bacterial cholangitis. The C. sordellii strain associated with this infection did not carry either the TcsL-encoding tcsL gene or the tcsH gene for TcsH. In addition, the strain was neither cytotoxic in vitro nor lethal in a murine sepsis model. These results provide additional correlative evidence that TcsL and TcsH increase the risk of mortality during C. sordellii infections.
authors: The Department of Internal Medicine, University of Michigan Health System, Ann Arbor, 48109, USA.
authors: Seth T
authors: ST
authors: Walk
authors: Ruchika
authors: R
authors: Jain
authors: Itishree
authors: I
authors: Trivedi
authors: Sylvia
authors: S
authors: Grossman
authors: Duane W
authors: DW
authors: Newton
authors: Tennille
authors: T
authors: Thelen
authors: Yibai
authors: Y
authors: Hao
authors: J Glenn
authors: JG
authors: Songer
authors: Glen P
authors: GP
authors: Carter
authors: Dena
authors: D
authors: Lyras
authors: Vincent B
authors: VB
authors: Young
authors: David M
authors: DM
authors: Aronoff
mesh_terms: D000369:Aged, 80 and over; D000818:Animals; D016470:Bacteremia / Q000382:microbiology*; D001427:Bacterial Toxins / Q000235:genetics / Q000378:metabolism*; D002761:Cholangitis / Q000382:microbiology*; D047989:Paraclostridium sordellii / Q000378:metabolism / Q000472:pathogenicity*; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D051379:Mice; D008810:Mice, Inbred C57BL; D010538:Peritonitis / Q000382:microbiology; D014774:Virulence
chemical_list: D001427:Bacterial Toxins