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Clostridium tetani

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Clostridium tetani is a common bacterium found in soil and animal intestines. It is the causative agent of tetanus, a severe disease that affects the nervous system. This Gram-positive bacterium is typically rod-shaped. It measures up to 2.5 micrometers in length and 0.5 micrometers in width.

Clostridium Tetani
Clostridium Tetani

These cells are motile, meaning they can move using various flagella that surround their bodies. Clostridium tetani is an anaerobe, so it cannot grow in the presence of oxygen. It grows most effectively at temperatures between 33 and 37 °C.

To survive harsh environments, C. tetani can form a spore. When exposed to different conditions, the cell sheds its flagella and creates a single spore. This spore usually forms at one end of the cell. This process gives the bacterium a distinctive shape like a drumstick or a tennis racket.

Clostridium Tetani
Clostridium Tetani

These spores are extremely hardy. They can resist heat, various antiseptics, and even boiling for several minutes. Because they are so tough, they are distributed globally in soil and in the gastrointestinal tracts of livestock and companion animals.

Disease begins when these spores enter the body through a wound. Deep wounds, such as punctures or contaminated needle injections, are particularly dangerous. In these wounds, tissue death and limited air exposure create a low-oxygen environment. This allows the spores to germinate and grow into active vegetative cells. As the cells grow and lyse, or break open, they release toxins. One of these is tetanolysin, which may help the infection establish itself. The most dangerous substance released is tetanospasmin, also known as tetanus toxin.

Tetanospasmin is a potent toxin with a very low lethal dose. It is estimated to be less than 2.5 nanograms per kilogram of body weight. Once released, the toxin spreads through the lymphatic system and the bloodstream. It eventually enters the nervous system. In the nervous system, tetanospasmin blocks the release of inhibitory neurotransmitters called glycine and gamma-aminobutyric acid at motor nerve endings. This blockade causes motor neurons to stay active, leading to widespread muscle spasms.

Opisthotonus in a patient suffering from tetanus - Painting by Sir Charles Bell - 1809
Opisthotonus in a patient suffering from tetanus - Painting by Sir Charles Bell - 1809

These spasms often start at the top of the body and move down. Symptoms like lockjaw can appear about 8 days after infection. Spasms of the abdomen and limbs can continue for several weeks.

The ability to produce this toxin depends on a specific gene. This gene is located on a plasmid, which is a small piece of DNA carried by many strains. Strains of C. tetani that lack this plasmid cannot produce the toxin. Within the broader scientific classification, C. tetani belongs to the genus Clostridium. This genus includes over 150 species of Gram-positive bacteria. C. tetani is part of a cluster of nearly 100 closely related species. This group includes other pathogens like C. botulinum and C. perfringens. Its closest relative is C. cochlearium.

History shows that humans have known about tetanus for centuries. Clinical descriptions of the disease appear in the writings of Hippocrates in the 4th century BCE. In 1884, Arthur Nicolaier proved the connection to soil by injecting soil into animals. In 1889, Kitasato Shibasaburō isolated the bacterium from a human victim. He also discovered that specific antibodies could neutralize the toxin. Later, in 1897, Edmond Nocard showed that antitoxin could provide passive immunity for treatment. During World War I, doctors used horse-derived antiserum to protect wounded soldiers. This led to a dramatic decrease in tetanus cases during the war.

Modern prevention relies on the tetanus toxoid vaccine. This vaccine uses tetanospasmin that has been inactivated by formaldehyde. To make it, scientists grow large quantities of C. tetani in fermenters. They then purify the toxin and treat it with 40% formaldehyde for 4 to 6 weeks. This toxoid is often given as part of the DPT or DTaP vaccine. These vaccines include protection against diphtheria and pertussis. They are given in several doses over months or years to build an immune response. This protects the body from the effects of the toxin if an infection occurs.

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File:Clostridium Tetani.svg
Clostridium Tetani.svg
File:Opisthotonus in a patient suffering from tetanus - Painting by Sir Charles Bell - 1809.jpg
Opisthotonus in a patient suffering from...
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