Antibiotic-induced colitis implication of a toxin neutralised by Clostridium sordellii antitoxin

Abstract

A toxin(s) has been demonstrated in the stools of two patients with antibiotic-associated colitis. This toxin(s) was heat-labile, was rapidly lethal for hamsters, increased vascular permeability in rabbit skin, and was cytotoxic for cells in tissue-culture. It was neutralised by Clostridium sordellii antitoxin but not by antitoxins prepared against other clostridia; Escherichia coli, and Vibrio cholerae toxins. These characteristics were identical to those of a toxin implicated in the aetiology of antibiotic-induced colitis in the hamster. One patient improved rapidly after treatment with oral vancomycin, and at the same time the toxin disappeared from the stool.