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Stools from a patient with antibiotic-associated colitis and cecal contents from a hamster with clindamycin-induced enterocolitis were compared in a cytotoxicity assay to determine common properties. Both specimens produced actinomorphic changes in human amnion cells at 10(-7) dilutions. The toxin was acid labile, heat labile, nonether extractable, non-dialyzable, and produced maximum activity at 60% with ammonium sulfate precipitation. Cytotoxicity was neutralized with clostridial antitoxin but not with equine serum. Clostridium difficile was recovered in high concentrations in specimens from both the hamster and patients. The supernatants of these C. difficile strains produced cytoxic effects which were also neutralized by clostridial antitoxins. These results indicate that clindamycin-induced enterocolitis in hamsters is a model of human disease and implicate toxin-producing clostridia as responsible agents.
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Chang et al. (1978) studied this question.
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