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Clostridium perfringens Food Poisoning

by Joseph R. Lentino, MD, PhD

Clostridium perfringens food poisoning is acute gastroenteritis caused by ingestion of contaminated food.

C. perfringens is widely distributed in feces, soil, air, and water. Contaminated meat has caused many outbreaks. Because C. perfringens spores sometimes survive cooking, they can germinate and produce toxin when cooked meat that is contaminated with C. perfringens is left at room temperature or even up to 60° C (140°F, as on a warming table) for a period of time. Outbreaks typically occur in commercial establishments and rarely at home. Once inside the GI tract, C. perfringens produces an enterotoxin that acts on the small bowel. Only C. perfringens type A has been definitively linked to this food poisoning syndrome. The enterotoxin produced is sensitive to heat (> 75° C).

Mild gastroenteritis is most common, with onset of symptoms 6 to 24 h after ingestion of contaminated food. The most common symptoms are watery diarrhea and abdominal cramps. Vomiting is unusual. Symptoms typically resolve within 24 h; severe or fatal cases rarely occur.

Diagnosis is based on epidemiologic evidence and isolation of large numbers of organisms from contaminated food or from stools of affected people or on direct identification of enterotoxin in stool samples.

To prevent disease, people should promptly refrigerate leftover cooked meat and reheat it thoroughly (internal temperature, 75° C) before serving.

Treatment is supportive (see Overview of Gastroenteritis : Treatment); antibiotics are not given.

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