Characteristics of the Toxins of Clostridium Difficile

Abstract

The production of toxin by Clostridium difficile was first described by Hall and O’Toole (1935) who noted that subcutaneous injections of cell-free filtrates into guinea pigs caused edema, respiratory arrest, and death. These observations were confirmed two years later by Snyder (1937). Almost 40 years later, Hafiz and Oakley (1976) reported that 5 of 30 strains of C. difficile which they isolated produced very small amounts of toxin that was lethal and necrotizing. They did not study the toxin further, in part because their strains produced only 4 mouse lethal doses per ml. Then, in the late 1970’s, the results from a series of studies implicated C. difficile as the causative agent of antibiotic-associated colitis and these findings resulted in the initiation of a number of studies on the toxins of the organism (Bartlett et al. 1977a, 1978 a, c, d; Browne et al. 1977a; Larson et al. 1977, 1978; Larson and Price, 1977; Rifkin et al. 1977, 1978a; Chang et al. 1978a, b; George et al. 1978a, c; Katz et al. 1978; Allo et al. 1979; Willey and Bartlett, 1979; Rehg, 1980).