Isolation and identification of Clostridium spp. from infections associated with the injection of drugs: experiences of a microbiological investigation team

PHLS Anaerobe Reference Unit, University Hospital of Wales, Cardiff CF14 4XW, *Department of Microbiology, Glasgow Royal Infirmary, Glasgow G4 0SF, Food Safety Microbiology Laboratory and Respiratory and Systemic Infection Laboratory, Central Public Health Laboratory, 61 Colindale Avenue London NW9 5DF Corresponding author: Dr J. S. Brazier (e-mail: brazier{at}cardiff.ac.uk ). Received 8 July 2002; accepted 21 July 2002. Abstract Pathogenic species of the genus Clostridium may contaminate the materials used in the injection of drugs and under the right conditions may cause serious or life-threatening disease. C. novyi type A was implicated in an outbreak of severe infection with high mortality in injecting drug users who injected heroin extravascularly. The isolation of such highly oxygen-sensitive clostridia from clinical material may require adherence to enhanced methods and, once isolated, commercially available anaerobe identification kits alone may not give an accurate identification. Additional phenotypic tests that are useful in recognising the main pathogenic species are described. Differentiation of C. novyi type A from C. botulinum type C in reference laboratories was based on 16S rDNA sequence data and specific neutralisation of cytopathic effects in tissue culture.