PSEUDOMEMBRANOUS COLITIS - ISOLATION OF 2 SPECIES OF CYTOTOXIC CLOSTRIDIA AND SUCCESSFUL TREATMENT WITH VANCOMYCIN

  • 1 January 1978
    • journal article
    • research article
    • Vol. 119  (9) , 1058-1060
Abstract
Lincomycin-resistant Clostridium sporogenes obtained from the stools of a patient with lincomycin-associated pseudomembranous colitis produced a heat-stable cytotoxin in low titer when grown in chopped meat medium. Vancomycin eradicated this strain and all other clostridia and controlled the symptoms. When diarrhea recurred 7 days after treatment with vancomycin was stopped, clostridia including C. sporogenes and C. difficile were again isolated. The C. difficile produced a heat-labile cytotoxin in high titer that was unaffected by growth in various media and induced colitis in hamsters. Treatment with vancomycin, to which all the clostridia were sensitive, eradicated both toxic species and controlled the diarrhea. Antibiotic-induced pseudomembranous colitis may be associated with more than 1 sp. of toxin-producing clostridia. Vancomycin therapy should be continued for 10 days or more in patients with severe disease to eradicate the responsible organism.