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Tetanus neurotoxins (TeNT) and botulinum neurotoxins (BoNTs) are closely related ~150 kDa protein toxins that together comprise the group of clostridial neurotoxins (CNTs) expressed by various species of Clostridia. While TeNT is expressed as a single polypeptide, BoNTs are always produced alongside multiple non-toxic proteins that form a stabilizing complex with BoNT and are encoded in a conserved toxin gene cluster. It is unknown how tent evolved without a similar gene cluster and why complex-free TeNT is secreted as a stable and soluble protein by C. tetani, whereas complexing proteins appear to be essential for BoNT stability in culture supernatants of C. botulinum. To assess whether the stability of TeNT is due to an innate property of the toxin or is a result of C. tetani's intra- and extra-cellular environment, both TeNT and complex-free BoNT/A1ERY were expressed recombinantly in atoxic C. tetani and analyzed for expression and stability. The strong clostridial ferredoxin (fdx) promotor resulted in the expression of recombinant TeNT at greater levels and earlier time points than endogenously produced TeNT. Recombinant BoNT/A1ERY was similarly expressed by atoxic C. tetani, although partial degradation was observed. The rBoNT/A1ERY produced in C. tetani was also partially proteolytically processed to the dichain form. Investigations of bacterial growth media and pH conditions found that the stability of rTeNT and rBoNT/A1ERY in spent media of C. tetani or C. botulinum was affected by growth media but not by pH. These data indicate that the distinct metabolism of C. tetani or C. botulinum under various growth conditions is a primary factor in creating a more or less favorable environment for complex-free CNT stability. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a neurodegenerative disorder that progressively damages the autonomic and central nervous systems, leading to hallmark symptoms such as resting tremor, bradykinesia, and rigidity. Despite extensive research, the underlying cause of PD remains unclear, and current treatments are unable to halt the progression of the disease. In this retrospective study, based on historical electronic health records (EHR) from a national health provider covering the period from 2003 to 2023, we investigated the impact of vaccination and medication purchases on PD occurrence and severity. Methods: Using a case–control design, we compared the vaccination histories of 1446 PD patients with 7230 matched controls to assess the association between vaccination and PD onset. Additionally, we explored statistical associations between vaccination, medication purchases, and PD severity over an average of 9 years of follow-up, utilizing a machine learning algorithm to quantify disease severity based on annual antiparkinsonian medication purchases. Results: Our analysis revealed a significant reduction in PD occurrence following tetanus–diphtheria (Td) vaccination, with an adjusted odds ratio of 0.17 (95% CI [0.04, 0.70]) for PD onset within 5 years post-vaccination. Furthermore, a time-dependent relationship was identified between the duration since vaccination and both the rate of PD onset and disease progression. Notably, we observed that antimicrobial treatments significantly influenced disease severity, consistent with the antibiotic sensitivity profile of Clostridium tetani. Conclusions: These findings support the hypothesis that tetanus vaccination and/or C. tetani eradication may reduce PD occurrence and slow its progression, suggesting promising directions for future research in PD prevention and treatment. [ABSTRACT FROM AUTHOR]

Horses are exquisitely sensitive to tetanus neurotoxin and are exposed to the risk of infection with Clostridium tetani throughout life. The vaccine against tetanus is highly effective at preventing disease, whereas tetanus in unvaccinated populations is associated with high mortality rates. Current guidelines in New Zealand and Australia for the available vaccine contain contradictions and limitations surrounding the optimal tetanus immunisation protocols for both adult horses and foals. This review critically evaluates the scientific literature on tetanus prophylaxis in horses within the context of equine practice and available products in New Zealand and Australia. The review was conducted by a panel of industry and specialist veterinarians to obtain agreement on nine equine tetanus prophylaxis guidelines for practising veterinarians. The primary protocol for tetanus toxoid (TT) immunisation consists of a three-dose series IM for all horses ≥ 6 months of age, and a four-dose series IM is proposed if commencing vaccination in foals between 3 and 6 months of age. Tetanus prophylaxis in foals < 3 months of age relies on passive immunity strategies. Following the completion of the primary protocol, a TT booster dose IM should be administered within 5 years, and every 5 years thereafter. When followed, these protocols should provide adequate protection against tetanus in horses. Additional tetanus prophylaxis guidelines are provided for veterinarians attending a horse experiencing a known "risk event" (e.g. wound, hoof abscess, surgery, umbilical infection). When a correctly vaccinated horse experiences a risk event, pre-existing immunity provides protection against tetanus. When an unvaccinated horse or one with unknown vaccination status, or a foal born to an unvaccinated dam, experiences a risk event, TT IM and tetanus antitoxin (TAT) 1,500 IU SC should be administered simultaneously at separate sites, and the TT primary immunisation protocol should subsequently be completed for the horse's respective age. In previously immunised pregnant broodmares, a TT booster dose administered 4–8 weeks prior to parturition optimises the transfer of passive immunity against tetanus to the newborn foal via colostrum; provided that post-natal IgG concentration in serum is > 800 mg/dL (8 g/L), such foals should be passively protected against tetanus up to 6 months of age. Survivors of clinical tetanus must still receive the primary protocol for vaccination against tetanus. In summary, all horses in New Zealand and Australia should be vaccinated against tetanus with protection maintained throughout life via TT booster doses, facilitated by accurate medical record keeping and client education. [ABSTRACT FROM AUTHOR]

Tetanus is a toxigenic illness caused by the action of Clostridium tetani neurotoxin (TeNT), which results in partial or generalized muscle stiffness in infected mammals and birds. The disease is rarely reported in cats due to their innate resistance to the toxin. This multicentric retrospective study aimed to describe a significant population of cats with a diagnosis of tetanus and report their signalment, clinical and neurological signs, diagnostic findings, treatment, and outcome. A retrospective search through medical records from 11 referral centers in Europe resulted in the identification of 27 cases of feline tetanus from July 2005 to April 2023. These cases were further compared with previously reported cases in the veterinary literature. Young cats were more commonly represented than older cats, with a median age of 4 years. Clinical signs were initially characterized by a lame and/or stiff limb, near the primary injury site, in 17/26 (65%) cats. Signs were focal or multifocal in 21/27 (78%) cats of this study and one typical sign was the inability to flex the most severely affected limbs. Electrodiagnostic studies revealed characteristic changes, such as continuous spontaneous motor unit discharges in both agonist and antagonist muscles. Such studies are particularly useful in focal and multifocal cases and should be performed to further support the diagnosis. The toxin was successfully identified in one case using the mouse bioassay. Treatment included antibiotherapy (metronidazole) in most cases, muscle relaxants, appropriate nursing cares and handling of potential complications. Overall, the outcome appeared to be positive, with only 1/27 (3.7%) cats being euthanized due to financial restrains. 23/25 (92%) cats returned to an independent ambulatory capacity on all limbs within a median delay of 25 days. Mild to moderate longterm sequelae were reported in eight (30%) cats. This multicentric study is the first to bring together such a large number of cats affected with tetanus. Presentation of the disease in cats differs from that observed in humans and dogs, with most cats being locally affected. Compared to previous reports of tetanus, this series of cats had a better outcome overall, especially for cats affected with generalized tetanus. [ABSTRACT FROM AUTHOR]

Traditionally, diphtheria-tetanus-pertussis (DTwP or DTaP) as pediatric vaccines are produced from the corresponding inactivated toxins or whole -cell pathogenic bacteria of Corynebacterium diphtheria toxin (Tox), Clostridium tetani toxin (TetX) and Bordetella pertussis. There are major concerns in the classic or acellular DTP (DTaP) vaccine production processes from native live bacterial sources as it may raise concerns on adverse effects and safety issues, complexity of the purifications for each agent as well as cost. Here, we designated a recombinant multi-epitope vaccine candidates by vaccinoinformatics study to address the mentioned issues and to develop a single trivalent fusion protein as a potent recombinant DTP vaccine. To achieve these goals, stages of immunebioinformatics were retrieved using proteinaceous toxins sequences, predicting secondary/tertiary structure and transmembrane topology, energy minimization, and model validation. Then, conformational and linear Bcell epitope prediction by several servers, mapping of consensus linear/discontinuous immunogenic regions and construction synthetic fusion vaccine candidates in respect to optimal immunogenic, physicochemical properties and high expression in prokaryote host were achieved. Finally, reverse translation, codon optimization, addition of cloning tags for pet 28a vector and optimization of physicochemical properties of synthetic trivalent fusion protein were performed. Through various hybrid immuno-informatics and structural bioinformatics analysis of predicted and experimental epitopes finally, 12 new consensus highly immunogenic linear and discontinuous epitopes in Tox, TetX and PTXa proteins were selected. The peptide sequences of these immunogenic regions were as follows: PTXA (AA34-64, AA184-256 and AA98-116), Tox (AA47-76, AA117-159, AA515- 557 and AA245-265) and TetX (AA226-249, AA819-844, AA923-967, AA1009-1067 and AA1225-1315). In addition, the characteristics of the recombinant trivalent fusion construct were; 546 residue length, soluble (Grand average of hydropathicity (GRAVY) was -0.475), estimated half-life was >10 hours in Escherichia coli, pI 5.94 (a little acidic), stable protein (The instability index (II) 35.58) as well as thermally stable (Aliphatic index (AI) 71.67). The putative antigenic epitopes from different organisms in a single protein, as in the current study, will possibly improve the protective efficacy as novel potent, safe, cheap and broad-spectrum vaccines for better prevention of diphtheria, tetanus and pertussis infections in the future. [ABSTRACT FROM AUTHOR]

Tetanus has become an increasingly rare infectious disease due to the development of successful vaccination programs in the mid-20th century. In resource-rich countries, mainly unvaccinated or partly vaccinated risk groups are affected, whereas tetanus still remains prevalent in resource-limited countries. The decreasing incidence in developed countries has hindered clinical trials evaluating the best treatment modalities for tetanus infections. Current guidelines are based on a small number of studies and case reports. So far, these studies have shown potential benefits of treating tetanus infections with benzodiazepines, magnesium sulfate and baclofen. Additionally, several treatments have been shown to be useful in stabilizing and supporting patients with tetanus. However, each treatment modality has limitations, from negative side effects to logistical challenges, especially in developing countries. Therefore, further knowledge is required to evaluate the best use of each treatment and to further optimize patient care. This knowledge can contribute to the reduction of the burden of disease in countries where tetanus remains prevalent and where resources are limited, though vaccination is the most effective method to achieve this. This case report describes the treatment of a Dutch patient with tetanus infection and illustrates the role of benzodiazepines as well as other key aspects of treating patients with tetanus. [ABSTRACT FROM AUTHOR]

A 10-month-old, 3  kg, female spayed Domestic Shorthair cat was presented with a chronic, infected wound at the level of the proximo-lateral left pelvic limb. General physical examination revealed a weight-bearing lameness of the left pelvic limb, which was moderately and circumferentially swollen and edematous proximal to the tarsal joint. On the lateral aspect of the proximal thigh, there was a chronic wound of 1  cm in diameter and an additional exudative skin lesion was present throughout the whole length of the caudo-lateral thigh. Complete blood count and serum biochemistry profile revealed mild anemia, increased serum amyloid A, hyponatraemia, hypochloraemia, hypocalcaemia, hyperkalaemia, hypermagnesaemia, hyperglycaemia, increased creatine kinase, and increased liver parameters. Surgical exploration of the wound was performed, and necrotizing fasciitis was suspected. The affected limb was amputated and swabs for bacterial culture were taken from both the skin lesions and surgical site before wound closure. One day after surgery, mild muscular contractions on the forehead and an increased muscle tone of the right pelvic limb were evident. One day later, the cat developed a generalized increase in extensor tone, with intermittent opisthotonos, resulting in lateral recumbency. Based on these clinical signs, a diagnosis of generalized tetanus was made and treatment with midazolam, methocarbamol, and metronidazole was started. Despite an improvement of all blood parameters, the cat progressively deteriorated and 4  days after surgery, it developed episodes of tetanic convulsions, associated with hyperthermia and ventricular arrhythmias. Despite intensive care and medical management, the cat died following a cardio-respiratory arrest 3  days later. This case report describes a rare case of severe generalized tetanus in a young cat. [ABSTRACT FROM AUTHOR]

Background: The incidence of tetanus has significantly declined in developed countries owing to widespread vaccination efforts. However, it remains a threat worldwide, including in Japan, because of the sharp decline in antibody titers against tetanus in adults. Animal bites, including canine bites, are potential sources of tetanus infection. This case highlights the rarity of tetanus caused by canine bites and the need for continued vigilance for tetanus prevention. This case report and literature review aimed to shed light on the clinical course and outcomes of tetanus following a canine bite.Case Presentation: A 46-year-old Japanese man with no medical history presented with symptoms of tetanus, such as difficulty in opening his mouth, 19 days after a canine bite on his right hand. He was born and brought up in Japan. He had never been vaccinated against tetanus. Despite washing the wound and receiving human tetanus immunoglobulin (HTIG) and a tetanus toxoid vaccine, the patient developed tetanus. After intravenous metronidazole and HTIG were administered, the symptoms improved gradually. The patient was discharged after a 12-day hospital stay.Discussion: This is the first reported case of canine bite-induced tetanus in Japan, where tetanus toxoid vaccination is provided routinely. This case highlights the waning immunity in adults and the critical need for education on tetanus immunization, including catch-up immunization, particularly for adults and individuals in high-risk occupations. A review of the existing literature revealed only four cases of tetanus following canine bites between 1889 and 2018. All patients experienced symptom onset between 3 and 19 days post injury. Treatment typically involved HTIG, metronidazole, and toxoid administration. A higher risk of mortality is seen in unvaccinated individuals than in vaccinated individuals, highlighting the critical role of tetanus vaccination.Conclusion: Physicians should consider canine bite-induced tetanus in the differential diagnosis when patients exhibit relevant symptoms. [ABSTRACT FROM AUTHOR]

The worsening of antibiotic resistance is a multifactorial process. One aspect of this is the counterfeiting of antibiotic medications. This is supposed to be particularly high in developing countries, including Nigeria. Therefore, the potency of some antibiotic drugs dispensed in community pharmacies in Gwale, Kano, Nigeria, was investigated in this case study. Three products, each from different manufacturers, with the active ingredients of ceftriaxone, gentamicin, ciprofloxacin, and metronidazole, respectively, were included in this study. By means of a disc-diffusion assay, the effect against the typed strains Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) as well as Clostridium tetani isolated from soil was tested. Clinical isolates of S. aureus and E. coli were also used. While antibiotics, with the exception of ciprofloxacin-containing preparations against C. tetani, showed acceptable efficacy against the typed strains by comparison with the clinical science laboratory references, a predominant failure was observed with the clinical isolates. Thus, the investigated drug preparations can be considered of acceptable quality for the treatment of susceptible bacterial infections. This excludes counterfeits in the sampled preparations. However, the insufficient efficacy against clinical isolates further documents the severity of nosocomial bacteria. [ABSTRACT FROM AUTHOR]

Tetanus is an infectious disease caused by Clostridium tetani toxin. Although easily preventable through vaccination, over 73,000 new infections and 35,000 deaths due to tetanus occurred worldwide in 2019, with higher rates in countries with healthcare barriers. Here, we present a clinical case of C. tetani infection in an 85-year-old patient. Patient robustness and high functional reserve before infection are favorable predictors of survival for an otherwise fatal disease. However, the patient did not experience any severe complications. Therefore, this report is a strong call for tetanus vaccination. [ABSTRACT FROM AUTHOR]

Tetanus is an acute and often fatal infectious disease caused by Clostridium tetani. Tetanus toxin (TT) is responsible for spastic paralysis observed in tetanus. Anti-tetanus antibodies obtained from horses and humans are the most antitoxins used for tetanus treatment, although some clinical side effects and disadvantages have been reported in their application. The aim of this study is the production of anti-TT IgY and evaluation of its protective effects in a mouse model. Anti-TT IgY was purified from the egg yolk using PEG6000 precipitation and water dilution methods, and its purity was verified by SDS-PAGE. Finally, the potency of purified anti-TT IgY in neutralizing the lethal effects of TT was studied in vivo using a mouse model. PEG6000 precipitation method had better results. Animal studies showed that the purified IgY neutralized the toxic effects of 100 MLD of TT and multiple intravenous-dose injections of anti-TT IgY also had a continuous effect of TT neutralization. The purified anti-TT IgY was effective in neutralizing the lethal activity of TT in a mouse model. Our results suggested that IgY could be an alternative therapeutic source for the management of tetanus in the future. Abbreviations Anti-TT, Anti-tetanus toxin; ELISA, Enzyme-linked immunosorbent assay; IgY, Immunoglobulin Y; MLD, Minimum lethal dose; PBS, Phosphate buffer solution; PEG, Polyethylene glycol; SDS-PAGE, Sodium dodecyl sulfate polyacrylamide gel electrophoresis; TIG, Tetanus immune globulin; TT, Tetanus toxin; WD, Water dilution; RT, Room temperature. [ABSTRACT FROM AUTHOR]

Case Summary: A 3‐month‐old Airedale dog with clinically diagnosed generalized tetanus was investigated for the occurrence of excessive paddling and chewing movements when sleeping. Electroencephalogram (EEG) with time‐locked video over 31 hours determined occurrence of the abnormal movements to be within 20 to 180 seconds of the onset of rapid eye movement (REM) sleep, but not at any other stage of wakefulness or sleep. No epileptiform activity was noted. Clinical signs of generalized tetanus resolved over 8 weeks with antimicrobial and symptomatic treatment, and sleep‐associated movements resolved 6 weeks after presentation. Clinical Relevance: Rapid eye movement sleep behavior disorder (RBD) has been suspected in dogs with generalized tetanus but not confirmed by correlation of repeated episodes of vocalization or motor behaviors or both with REM sleep defined by an EEG. The case further defines RBD in dogs with tetanus, and highlights the value of EEG to differentiate among different parasomnias and epileptiform activity. [ABSTRACT FROM AUTHOR]

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Clostridium is a genus comprising Gram-positive, rod-shaped, spore-forming, anaerobic bacteria that cause a variety of diseases. However, there is a shortage of information regarding antibiotic resistance in the genus in Saudi Arabia. This comprehensive analysis of research results published up until December 2021 intends to highlight the incidence of antibiotic resistance in Clostridium species in Saudi Arabia. PubMed, Google Scholar, Web of Science, SDL, and ScienceDirect databases were searched using specific keywords, and ten publications on antibiotic resistance in Clostridium species in Saudi Arabia were identified. We found that the rates of resistance of Clostridium difficile to antibiotics were as follows: 42% for ciprofloxacin, 83% for gentamicin, 28% for clindamycin, 25% for penicillin, 100% for levofloxacin, 24% for tetracycline, 77% for nalidixic acid, 50% for erythromycin, 72% for ampicillin, and 28% for moxifloxacin; whereas those of C. perfringens were: 21% for metronidazole, 83% for ceftiofur, 39% for clindamycin, 59% for penicillin, 62% for erythromycin, 47% for oxytetracycline, and 47% for lincomycin. The current findings suggest that ceftiofur, erythromycin, lincomycin, and oxytetracycline should not be used in C. perfringens infection treatments in humans or animals in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Tetanus is an acute infectious disease, caused by spores of the bacterium Clostridium tetani. The spores are found everywhere in the environment, particularly in soil, ash, intestinal tracts/faeces of animals and humans, on the surfaces of skin and rusty tools like nails, needles, barbed wires, etc. Being very resistant to heat and most antiseptics, the spores can survive for years. Anyone can get tetanus, but the disease is particularly common and serious in new born babies and pregnant women, who have not been sufficiently immunised with Tetanus Toxoid (TT) containing vaccines. The disease remains an important public health problem in many parts of the world, but especially in low income countries or districts, where immunisation coverage is low and unclean birth practices are common. There are no particular diagnostic tests for tetanus, the diagnosis is made clinically. Hence, early identification of cases of tetanus becomes important for early intervention. Herein, the authors reported four cases (1 male and 3 females) of tetanus, with varied clinical manifestations, management and outcome. The patients were diagnosed with severe generalised tetanus, otogenic tetanus, mild generalised tetanus and severe generalised tetanus respectively. The patients were treated with inj. diazepam, inj. tetanus toxoid, inj. methocarbamol. Two of them recovered completely and two could not be revived. [ABSTRACT FROM AUTHOR]

Clostridium botulinum and Clostridium tetani are Gram-positive, spore-forming, and anaerobic bacteria that produce the most potent neurotoxins, botulinum toxin (BoNT) and tetanus toxin (TeNT), responsible for flaccid and spastic paralysis, respectively. The main habitat of these toxigenic bacteria is the environment (soil, sediments, cadavers, decayed plants, intestinal content of healthy carrier animals). C. botulinum can grow and produce BoNT in food, leading to food-borne botulism, and in some circumstances, C. botulinum can colonize the intestinal tract and induce infant botulism or adult intestinal toxemia botulism. More rarely, C. botulinum colonizes wounds, whereas tetanus is always a result of wound contamination by C. tetani. The synthesis of neurotoxins is strictly regulated by complex regulatory networks. The highest levels of neurotoxins are produced at the end of the exponential growth and in the early stationary growth phase. Both microorganisms, except C. botulinum E, share an alternative sigma factor, BotR and TetR, respectively, the genes of which are located upstream of the neurotoxin genes. These factors are essential for neurotoxin gene expression. C. botulinum and C. tetani share also a two-component system (TCS) that negatively regulates neurotoxin synthesis, but each microorganism uses additional distinct sets of TCSs. Neurotoxin synthesis is interlocked with the general metabolism, and CodY, a master regulator of metabolism in Gram-positive bacteria, is involved in both clostridial species. The environmental and nutritional factors controlling neurotoxin synthesis are still poorly understood. The transition from amino acid to peptide metabolism seems to be an important factor. Moreover, a small non-coding RNA in C. tetani, and quorum-sensing systems in C. botulinum and possibly in C. tetani, also control toxin synthesis. However, both species use also distinct regulatory pathways; this reflects the adaptation of C. botulinum and C. tetani to different ecological niches. [ABSTRACT FROM AUTHOR]

Tetanus is extremely rare in developed countries. We report the first documented case of tetanus in the province of Alberta since 2016: a farmer that developed trismus, shoulder stiffness, and fevers eight days following orthopedic surgery. Tetanus immunoglobulin elicited rapid recovery. We highlight risk factors, pathogenesis, epidemiology, and diagnostic challenges. [ABSTRACT FROM AUTHOR]

Aim: Severe tetanus can be fatal, even with the latest drug treatments and artificial respiration. Nevertheless, combining Western and Kampo medicine may be beneficial for tetanus treatment. Methods: We summarise the benefits of applying Kampo medicine in tetanus, especially referring to using shakuyakukanzoto (SKT) from the aspect of controlling myospasms. SKT is a Kampo formula used for the treatment of pain associated with sudden myospasms. Results: SKT, kakkonto, daisaikoto, and daijokito have been used to successfully treat patients with generalised convulsions caused by generalised tetanus, without the use of a muscle relaxant. However, hypokalaemia, oedema, and hypertension caused by pseudo‐aldosteronism, which may result from an adverse reaction to licorice, should be monitored when using SKT. Conclusion: A large randomised controlled trial may be necessary to establish a treatment for tetanus using both Western and Kampo medicines. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the seasonality of canine tetanus in England. Methods: Medical records of a single referral hospital in England were reviewed. Dogs diagnosed with localized or generalized tetanus between January 2006 and June 2017 were studied. Results: Forty‐nine cases were included. The prevalence of tetanus in England was significantly higher in the winter when compared with the summer (P = 0.002) and autumn (P = 0.024), with the highest number of cases recorded in February. Conclusions: The prevalence of canine tetanus in England was significantly higher in winter months, especially in February. [ABSTRACT FROM AUTHOR]

Background: Clostridium tetani is the etiologic agent of tetanus which is a hyper acute disease affecting various animal species. Tetanus distributes worldwide However its occurrence highly depends on the vaccination programs and the level of hygiene in a flock. There are a lot of flocks in Iran which have not been received vaccine. The aim of the present study is to illustrate the importance of tetanus as a cause of high mortality in small ruminants. Methods: In a flock consisting 600 sheep, all the animal’s ears were tagged. A total of 50 animals showed clinical signs of tetanus. The wound exudates were collected from deep parts of the injured ears. The samples were stained by gram staining and were cultured on blood agar media. Then biochemical tests were conducted on the suspected colonies. Results: The animal’s symptoms included limb stiffness, spasticity, trismus, sternal recumbency, lateral recumbency and opisthotonus were observed. The laboratory results confirmed the presence of Clostridium tetani. Conclusion: According to the present study, consideration should be given to the tetanus vaccination which is crucial in high susceptible species and flocks managed base on traditional methods. Using ear tags in a clean and hygienic manner and spraying antibiotics on the wounds during the process may also decrease the probability of tetanus. [ABSTRACT FROM AUTHOR]

This article aims at the reviewing current measures in prophylaxis and treatment of tetanus, well known neuroinfection, frequently met in farm animals and also in companion animals. Tetanus is a common neurologic disease, occurring as well in humans and characterized by spastic paralysis. It is caused by tetanus toxin, tetanospasmin, produced by Clostridium tetani, environmental, soil borne, anaerobic, Gram-positive, sporulating bacterium.Horses and humans appear to be the most susceptible of all mammals, whereas cattle, dogs, and cats are more resistant. The usual route of infection is a soil-contaminated injury, particularly deep, penetrating wounds, where necrotic tissues promote germination of spores, multiplication of anaerobic C. tetani and toxin production. The wound may be trivial, even unnoticed. The diagnosis of tetanus is mainly based on the typical clinical signs: jaw cramping, muscle spasm, painful muscle stiffness, seizures, changes in blood pressure and heart rate, and also on ELISA testing for tetanospasmin. Identification of C. tetani at the portal of entry is often difficult. Prevention of tetanus depends on the regular immunization with tetanus toxoid. Treatment consists of wound care, medications to ease symptoms and supportive care. [ABSTRACT FROM AUTHOR]

Clostridium tetani produces the tetanus toxin (TeNT), one of the most powerful bacterial toxins known to humankind and responsible for tetanus. The regulation of toxin expression is complex and involves the alternative sigma factor TetR as well as other regulators. Here, a transcriptional analysis of the TeNT-encoding large plasmid of C. tetani identified a putative non-coding small RNA (sRNA), located in close vicinity of the 3′ untranslated region of the tent gene. A northern blot experiment could identify a respective sRNA with a size of approx. 140 nucleotides. Sequence analysis showed that the sRNA contains a 14-nucleotide region that is complementary to a 5′ located region of tent. In order to investigate the function of the sRNA, we applied a RNA interference approach targeting the sRNA in two C. tetani wild-type strains; the constructed antisense C. tetani strains showed an approx. threefold increase in both extracellular and total TeNT production compared to the respective wild-type strains. In addition, recombinant C. tetani strains were constructed that contained tent-locus harboring plasmids with and without the sRNA. However, the introduction of the tent-locus without the sRNA in a C. tetani strain lacking the wild-type TeNT-encoding large plasmid resulted in a lower TeNT production compared to the same strain with recombinant tent-locus with the sRNA. This suggests that the expression or the effect of the sRNA is modulated by the C. tetani genetic background, notably that of the wild-type TeNT-encoding large plasmid. In addition, some recombinant strains exhibited modulated growth patterns, characterized by premature bacterial cell lysis. Taken together, our data indicate that the sRNA acts as a negative regulator of TeNT synthesis, with a possible impact on the growth of C. tetani. We hypothesize that the role of this sRNA is to limit toxin levels in the exponential growth phase in order to prevent premature bacterial lysis. [ABSTRACT FROM AUTHOR]

Tetanus is a life-threatening neurologic disease caused by an infectious agent, Clostridium Tetani, and is one of the infectious diseases that is preventable by vaccination. Tetanus is characterized by painful muscle spasm and increased muscle tone, that is caused by tetanospasmin, a powerful toxin elaborated by Clostridium tetani. Due to worldwide regular vaccination, this disease rarely seen recently. The case we present here is a patient admitted in Shohadaye khalije Fars hospital with severe generalized tetanus due to incomplete vaccination. [ABSTRACT FROM AUTHOR]

Tetanus is a disease caused by tetanotoxin produced in necrotic wounds by Clostridium tetani. It is a very rare disease in Czechia due to successful and effective population-wide vaccination programme, despite the fact that spores of C. tetani are permanently present in the environment. Groups with the highest risk of clinical tetanus include elderly people, immunocompromised individuals, residents of foreign origin with unclear vaccination history, and unvaccinated children. We present four case studies of severe and mild form of tetanus, wound infection with the presence of C. tetani without the development of clinical tetanus in a fully vaccinated individual, and unexpected risk of tetanus in an unvaccinated child. Due to the rare occurrence of tetanus in Czechia, the clinical awareness of the risk of tetanus decreases as well as the clinical experience with diagnosis of early or mild forms of tetanus. Communication skills during the management of contaminated wounds play a critical role in the decision who should get tetanus anatoxin only and who should get antitetanus immunoglobulin along with the active immunization by tetanus anatoxin. [ABSTRACT FROM AUTHOR]

Tetanus is a neurologic disease of humans and animals characterized by spastic paralysis. Tetanus is caused by tetanus toxin (TeNT) produced by Clostridium tetani, an environmental soilborne, gram-positive, sporulating bacterium. The disease most often results from wound contamination by soil containing C. tetani spores. Horses, sheep, and humans are highly sensitive to TeNT, whereas cattle, dogs, and cats are more resistant. The diagnosis of tetanus is mainly based on the characteristic clinical signs. Identification of C. tetani at the wound site is often difficult. [ABSTRACT FROM AUTHOR]

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Abnormal sleep behavior has been reported in 5 dogs during recovery from tetanus. Hypothesis: REM sleep behavior disorder (RBD) is a more common consequence of tetanus than previously reported in veterinary literature and easily confused for epileptic seizures. Animals Sixty‐one client‐owned dogs diagnosed with tetanus at 2 UK referral centers. Methods: A retrospective review of medical records was combined with a questionnaire sent to owners of surviving dogs, to identify cases that developed clinically probable RBD and determine its clinical progression and effect on quality of life of affected dogs and their owners. Descriptive statistical evaluation was performed. Results: Eleven dogs (18%) died or were euthanized before discharge. At least 46% surviving dogs developed abnormal "dream enactment" clinically consistent with RBD. Twitching, running, and vocalization were new sleep behaviors in 53, 80, and 60% of affected dogs. Clinically probable RBD was described as violent or "nightmare"‐like in 36% affected dogs, and like an epileptic seizure in 40% affected dogs. When trialed, antiepileptic medications were ineffective. Onset occurred before discharge in 25% cases. For dogs that developed clinically probable RBD postdischarge, onset occurred within 2 weeks of discharge in 77% dogs. Clinically probable RBD did not worsen in severity or frequency in any dog, and spontaneously resolved within 6 months in 43% cases. Conclusions and Clinical Importance: Clinically probable RBD is a common sequel to canine tetanus with many clinical similarities to epileptic seizure activity. Owners should be made aware of its potential development and care taken to avoid misdiagnosis with epileptic seizure activity. [ABSTRACT FROM AUTHOR]

Introduction. Tetanus, also known as lockjaw, is a very dangerous, infectious, acute, usually afebrile disease characterised by muscle spasms. The causative agent of the disease is the bacterium Clostridium tetani. This pathogen produces a specific neurotoxin, termed tetanus toxin, with two components: tetanospasmin and tetanolysin. Light chains of tetanospasmin cleavage synaptobrevin, which in turn prevent release of the inhibitory neurotransmitter GABA into the synaptic cleft. The α-motor neurons are, therefore, under no inhibitory control, as a result of which they undergo sustained excitatory discharge causing the characteristic motor spasms of tetanus. Materials and Methods. In this research, we attempted to normalise disorders caused by tetanus toxin by using haloperidol (at doses of 4, 5, 6, 7 and 8 mg/kg b.w.), alone and in combination with (-)-nuciferine (at a dose of 5 mg/kg b.w.) or aminooxyacetic acid (at a dose of 20 mg/kg b.w.). Experiments were conducted on albino mice. Experimental tetanus was induced by application of tetanus toxin. Results and Conclusions. Application of haloperidol (alone and in combination with (-)-nuciferine and aminooxyacetic acid) was carried out 24 h following the application of tetanus toxin. It was found that haloperidol, given alone in a dose of 4 mg/kg, prolonged the average survival time of mice with experimental tetanus by 24.35 h compared to the control animals. Additionally, the combination of haloperidol with (-)-nuciferine slightly, but non-significantly, extended survival time, while the combination of haloperidol with aminooxyacetic acid produced the best effect on extension of survival time (mice survived on average 27.74 h longer than control mice). [ABSTRACT FROM AUTHOR]

Background: Tetanus, caused by Clostridium tetani neurotoxin, is still an important cause of morbidity and mortality in children in developing countries. Children usually present with trismus followed by spasms of skeletal muscles. Tetanus infection can easily be prevented through immunization. However, despite provision of routine immunization schedule by government-based hospital at all levels of care, there is still poor immunization uptake which in association with dangerous traditional practices in the area leads to high burden of the disease. Materials and Methods: This was a retrospective hospital-based study. It was conducted at the Department of Paediatric of Rasheed Shekoni Specialist Hospital, Dutse, Nigeria. Medical records of all children between the ages of 1 month and 13 years, who were admitted between May 2014 and April 2017, with a diagnosis of tetanus were retrieved and analyzed. Diagnosis of tetanus is clinical based on the presence of trismus and spasms. Information obtained included biodata, immunization status, onset and duration of symptoms, length of hospitalization, and outcome. Results: Children admitted with tetanus in the period of study were 25, but only 20 qualified for analysis. The prevalence of tetanus was 1.03%. Twelve (60%) were in the 5–9 years age group. Majority (75%) were males, from rural areas (75%), and did not receive any immunization (65%). Circumcision was the portal of entry in 30%. All had generalized tetanus, and mortality rate was 25%. Conclusion: There is need to strengthen routine immunization and introduce booster immunization into the area to prevent post-neonatal tetanus. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Tetanus has become rare in countries with high levels of vaccination coverage and hygiene but may still occur in adults without booster vaccination. In addition to the expanded program on immunization for children and maternal immunization against neonatal tetanus, a systematic vaccination of the population, including boosters, is recommended. [ABSTRACT FROM AUTHOR]

This report presents the case of a Japanese patient who developed Lyme disease. The patient was a 44-year-old woman who had general fatigue and the inability to open her mouth. She was initially suspected of having mild tetanus with lockjaw; however, she reported a past history of a tick bite while camping in the USA and had erythema migrans 2 months before this visit. Finally, Lyme disease was serologically confirmed. A few cases of Lyme disease are annually reported in Japan; however, this infectious disease should also be suspected. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Razi Institute is the property of Institut Razi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A novel and efficient headspace solid-phase microextraction (HS-SPME) method, followed by gas chromatography mass spectrometry (GC-MS), was developed to study volatile organic compounds (VOCs) emerging from microorganisms. Two homemade SPME fibers, a semi-polar poly (dimethylsiloxane) (PDMS) fiber, and a polar polyethylene glycol (PEG) fiber, along with two commercial fibers (PDMS and PDMS/DVB) were used to collect VOCs emerging from Clostridium tetani which was cultured in different media. The adsorbed VOCs were desorbed and identified, in vitro, using GC-MS. The adsorption efficiency was improved by optimizing the time duration of adsorption and desorption. About 50 components were identified by the proposed method. The main detected compounds appeared to be sulfur containing compounds such as butanethioic acid S-methyl ester, dimethyl trisulfide, and dimethyl tetrasulfide. These volatile sulfur containing compounds are derived from amino acids containing the sulfur element, which probably coexist in the mentioned bacterium or are added to the culture media. The developed HS-SPME-GC-MS method allowed the determination of the chemical fingerprint of Clostridium tetani volatile constituents, and thus provides a new, simple, and reliable tool for studying the growth of microorganisms. [ABSTRACT FROM AUTHOR]

Objective To identify prognostic variables for adult equids and foals with tetanus. Design Multicenter retrospective study (2000-2014). Setting Twenty Western, Northern, and Central European university teaching hospitals and private referral centers. Animals One hundred fifty-five adult equids and 21 foals with tetanus. Interventions None. Measurements and Main Results Variables from history and clinical examination were statistically compared between survivors and nonsurvivors (adults: 49 survivors, 85 nonsurvivors; foals: 7 survivors, 10 nonsurvivors). Cases euthanized for financial reasons were excluded. Mortality rates in adults and foals were 68.4% and 66.7%, respectively. Variables associated with survival in adults included: standing, normal intestinal sounds and defecation, voluntarily drinking, eating soft or normal food, lower heart and respiratory rates, high base excess on admission, longer diagnosis time, treatment and hospitalization delay, and mild severity grade. Variables associated with death included: anorexia, dysphagia, dyspnea, low blood potassium concentration on admission, moderate and severe disease grading, development of dysphagia, dyspnea, recumbency and seizures during hospitalization, treatment with glycerol guaiacolate, intravenous fluids, and intravenous glucose solutions. Variables associated with survival in foals included standing on admission, voluntarily eating soft food and drinking, older age, and longer hospitalization delay. Outcome was not different between different tetanus antitoxin (TAT) dosages, although there was a trend of increasing survival rate with increasing TAT dosages. Cases with appropriate vaccination prior to development of tetanus were rare, but had improved outcome and shorter hospitalization. Conclusions Prognosis for equine tetanus is poor with similar outcome and prognostic factors in foals and adults. The prognostic assessment of cases with tetanus provides clinicians with new evidence-based information related to patient management. Several prognostic indicators relate to the ability to eat or drink, and more severe clinical signs relate to poor outcome. Increasing intravenous dosages of TAT has no significant effect on outcome, but the positive trend identified may support a recommendation for high intravenous TAT dosages. Further evaluation is warranted. [ABSTRACT FROM AUTHOR]

Objective To describe clinical data of hospitalized adult equids and foals with tetanus. Design Multicenter retrospective study (2000-2014). Setting Twenty Western, Northern, and Central European university teaching hospitals and private referral centers. Animals One hundred fifty-five adult equids (>6 months) and 21 foals (<6 months) with tetanus. Interventions None. Measurements and Main Results Information on geographic, annual and seasonal data, demographic- and management-related data, clinical history, clinical examination and blood analysis on admission, complications, treatments, and outcomes were described and statistically compared between adults and foals. The described cases were often young horses. In 4 adult horses, tetanus developed despite appropriate vaccination and in 2 foals despite preventive tetanus antitoxin administration at birth. Castration, hoof abscesses, and wounds were the most common entry sites for adults; umbilical cord infections and wounds for foals. Stiffness was the commonest observed initial clinical sign. Blood analyses frequently revealed an inflammatory response, hemoconcentration, muscle damage, azotemia, negative energy balance, liver damage, and electrolyte and acid base disturbances. Common complications or clinical signs developing during hospitalization included dysphagia, dyspnea, recumbency, hyperthermia, seizures, hyperlipemia, gastrointestinal impactions, dysuria, and laryngeal spasms. Cases were supported with wound debridement, antimicrobial treatment, tetanus antitoxin, muscle spasm and seizure control, analgesia, anti-inflammatory drugs, fluid therapy, and nutritional support. Mortality rates were 68.4% in adult horses and 66.7% in foals. Foals differed from adult horses with respect to months of occurrence, signalment, management-related data, potential causative events, clinical signs on admission, blood analysis, complications, and severity grades. Conclusions This is the first study that rigorously describes a large population of equids affected by tetanus. The information provided is potentially useful to clinicians for early recognition and case management of tetanus in adult horses and foals. Tetanus affects multiple organ systems, requiring broad supportive and intensive care. Neonatal and adult tetanus in the horse should be considered as distinct syndromes, as in human medicine. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências Veterinárias e Zoologia da Unipar is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Tetanus is a vaccine-preventable infectious disease. It is caused by the bacterium Clostridium tetani. The aim of this study was to investigate tetanus immunity among adult trauma patients. Material and methods: This study was performed with 267 trauma patients who were admitted to the emergency department of Tepecik Training and Research Hospital in Izmir City, Turkey over a six month period. After obtaining a written informed consent from each patient, a questionnaire concerning demographic information and tetanus vaccination history was filled in by the physician. Patient's blood samples (4-5 cc) were drawn into a test tube while creating an intravenous (IV) access prior to making any attempt for therapy. And the tetanus antibody level (IgG) was measured using the enzyme-linked immunosorbent assay method. Tetanus antibody levels ⩾0.1 IU/mL were considered protective. Results: Among 267 patients, 192 and 75 of the cases (71.9% and 28.1%) were male and female, respectively. The median age of the patients was 39 (IQRs = 28-52). Seventy-five percent of the patients (n = 201) had protective immunity rates for tetanus. Discussion and conclusion: In our study, which was conducted among adults, it was found that the protective ratio of tetanus immunity decreased with age with an additional, significant decline in elderly patients. [ABSTRACT FROM AUTHOR]

Clostridium tetani and Clostridium botulinum produce two of the most potent neurotoxins known, tetanus neurotoxin and botulinum neurotoxin, respectively. Extensive biochemical and genetic investigation has been devoted to identifying and characterizing various C. botulinum strains. Less effort has been focused on studying C. tetani likely because recently sequenced strains of C. tetani show much less genetic diversity than C. botulinum strains and because widespread vaccination efforts have reduced the public health threat from tetanus. Our aim was to acquire genomic data on the U.S. vaccine strain of C. tetani to better understand its genetic relationship to previously published genomic data from European vaccine strains. We performed high throughput genomic sequence analysis on two wild-type and two vaccine C. tetani strains. Comparative genomic analysis was performed using these and previously published genomic data for seven other C. tetani strains. Our analysis focused on single nucleotide polymorphisms (SNP) and four distinct constituents of the mobile genome (mobilome): a hypervariable flagellar glycosylation island region, five conserved bacteriophage insertion regions, variations in three CRISPR (clustered regularly interspaced short palindromic repeats)-Cas (CRISPR-associated) systems, and a single plasmid. Intact type IA and IB CRISPR/Cas systems were within 10 of 11 strains. A type IIIA CRISPR/Cas system was present in two strains. Phage infection histories derived from CRISPR-Cas sequences indicate C. tetani encounters phages common among commensal gut bacteria and soil-borne organisms consistent with C. tetani distribution in nature. All vaccine strains form a clade distinct from currently sequenced wild type strains when considering variations in these mobile elements. SNP, flagellar glycosylation island, prophage content and CRISPR/Cas phylogenic histories provide tentative evidence suggesting vaccine and wild type strains share a common ancestor. [ABSTRACT FROM AUTHOR]

Recycling human waste for beneficial use has been practiced for millennia. Aerobic (thermophilic) composting of sewage sludge has been shown to reduce populations of opportunistically pathogenic bacteria and to inactivate both Ascaris eggs and culturable Escherichia coli in raw waste, but there is still a question about the fate of most fecal bacteria when raw material is composted directly. This study undertook a comprehensive microbial community analysis of composting material at various stages collected over 6 months at two composting facilities in Haiti. The fecal microbiota signal was monitored using a high-density DNA microarray (PhyloChip). Thermophilic composting altered the bacterial community structure of the starting material. Typical fecal bacteria classified in the following groups were present in at least half the starting material samples, yet were reduced below detection in finished compost: Prevotella and Erysipelotrichaceae (100% reduction of initial presence), Ruminococcaceae (98–99%), Lachnospiraceae (83–94%, primarily unclassified taxa remained), Escherichia and Shigella (100%). Opportunistic pathogens were reduced below the level of detection in the final product with the exception of Clostridium tetani, which could have survived in a spore state or been reintroduced late in the outdoor maturation process. Conversely, thermotolerant or thermophilic Actinomycetes and Firmicutes (e.g., Thermobifida, Bacillus, Geobacillus) typically found in compost increased substantially during the thermophilic stage. This community DNA-based assessment of the fate of human fecal microbiota during thermophilic composting will help optimize this process as a sanitation solution in areas where infrastructure and resources are limited. [ABSTRACT FROM AUTHOR]

In developing countries, trauma patients and neonates are vulnerable to Staphylococcus aureus (S. aureus) and Clostridium tetani infections. It has been suggested that a combined vaccine against the two infections may be a reliable and cost-effective strategy. Previous studies have indicated that the S. aureus surface protein A (SasA) and the C fragment of tetanus neurotoxin (TeNT-Hc) may be suitable candidates for a vaccine against S. aureus and tetanus infections, respectively. In the present study, mice were immunized with a combined vaccine containing SasA and TeNT-Hc, which induced a robust immune response to both antigens, and mutual interference between SasA and TeNT-Hc was not observed. In the S.aureus challenge model, the combined vaccine fully protected BALB/c mice against lethal intraperitoneal challenges with 3x109 colony-forming units of a methicillin-resistant S. aureus USA300 strain. In the TeNT challenge model, the combined vaccine conferred complete protection against a lethal dose of (2x10³) xLD50 tetanus toxin. These results implied that SasA and TeNT-Hc promising components for a combined vaccine against S. aureus and tetanus infections. [ABSTRACT FROM AUTHOR]

Background: Although preventable, tetanus still claims tens of thousands of deaths each year. The patterns and distribution of mortality from tetanus have not been well characterized. We identified the global, regional, and national levels and trends of mortality from neonatal and non-neonatal tetanus based on the results from the Global Burden of Disease Study 2015.Methods: Data from vital registration, verbal autopsy studies and mortality surveillance data covering 12,534 site-years from 1980 to 2014 were used. Mortality from tetanus was estimated using the Cause of Death Ensemble modeling strategy.Results: There were 56,743 (95% uncertainty interval (UI): 48,199 to 80,042) deaths due to tetanus in 2015; 19,937 (UI: 17,021 to 23,467) deaths occurred in neonates; and 36,806 (UI: 29,452 to 61,481) deaths occurred in older children and adults. Of the 19,937 neonatal tetanus deaths, 45% of deaths occurred in South Asia, and 44% in Sub-Saharan Africa. Of the 36,806 deaths after the neonatal period, 47% of deaths occurred in South Asia, 36% in sub-Saharan Africa, and 12% in Southeast Asia. Between 1990 and 2015, the global mortality rate due to neonatal tetanus dropped by 90% and that due to non-neonatal tetanus dropped by 81%. However, tetanus mortality rates were still high in a number of countries in 2015. The highest rates of neonatal tetanus mortality (more than 1,000 deaths per 100,000 population) were observed in Somalia, South Sudan, Afghanistan, and Kenya. The highest rates of mortality from tetanus after the neonatal period (more than 5 deaths per 100,000 population) were observed in Somalia, South Sudan, and Kenya.Conclusions: Though there have been tremendous strides globally in reducing the burden of tetanus, tens of thousands of unnecessary deaths from tetanus could be prevented each year by an already available inexpensive and effective vaccine. Availability of more high quality data could help narrow the uncertainty of tetanus mortality estimates. [ABSTRACT FROM AUTHOR]

It's known that diphtheria and tetanus are a contagious lethal diseases over the years, they caused by pathogenic microbes corynebacterium diphtheria and Clostridium tetani, respectively. The diseases result from the production of bacterial toxin. Vaccination with bacterial toxoid vaccines adsorbed on particulates adjuvants still are the best way to prevent this epidemic diseases from spread. The particulate vaccines have been shown to be more efficient than soluble one for the induction of the immune responses. Nanoparticles can be engineered to enhance the immune responses. As well known the immune response to inactivate killed and subunit vaccine enhances by alum adjuvants. The adjuvants examined and tested after reducing its size to particle size, thus mimic size of viruses which is considered smallest units can derive the immune system. The major issue is minimizing the adjuvant particles, to gain insight of resulting immunity types and impact on immune response. The adjuvant effect of micro/nanoparticles appears to largely be a consequence of their uptake into antigen presenting cells. [ABSTRACT FROM AUTHOR]

India was declared free of maternal and neonatal tetanus on 15th May, 2015. The journey towards its elimination from India has not been easy, and sustained efforts will be required to maintain this status. As the schedule of tetanus vaccination during pregnancy has been same across various health programs by the Government of India, we deliberated to find out other factors that contributed to a decline in maternal and neonatal tetanus in India. The emphasis on augmenting antenatal care services, increasing institutional deliveries and improving routine vaccination coverage are factors that might have led to a reduction in cases of neonatal tetanus. [ABSTRACT FROM AUTHOR]

Background: Tetanus is an acute, often fatal, disease caused by an exotoxin produced by the bacterium Clostridium tetani. It is characterized by generalized rigidity and convulsive spasms of skeletal muscles. Tetanus remains a major public health problem in Ethiopia like other developed nations. The aim of the present study was to assess the clinical profile and outcome of tetanus patients in a referral hospital, Northwest Ethiopia. Methods: This is a retrospective cross sectional study in which we collected, compiled and analyzed medical records of patients aged greater than 15 years who were admitted at Felege Hiwot Referral Hospital from Sep 2012 to Sep 2015. Tetanus was diagnosed using clinical observations. Data were entered, cleared, and analyzed using SPSS statistical software package. Results: Among 110 tetanus cases 84 (76.4 %) were males. Trauma was the most common antecedent cause. Most of the patients had no history of tetanus toxoid immunization. Aspiration pneumonia at 34.5 % and dysautonomia at 11.8 % were found to be the most frequently observed complications. About 36 (32.7 %) patients were died due to tetanus and the most common immediate cause of death was respiratory failure at (83.3 %). Patients' area of residence (p = 0.004), type of complications (p = 0.00) and severity of tetanus (p = 0.00) were found statistically associated with the type of treatment outcomes. Conclusions: In the study, the case-fatality rate was found to be very high. Therefore, there is a need to universal tetanus immunization and health information dissemination. [ABSTRACT FROM AUTHOR]

Clostridium tetani, a spore-forming anaerobic bacterium, and a casein-based semisynthetic medium were used to produce tetanus toxin in this study. N-Z-Case TT (casein hydrolysate) solution and glucose stock media were mixed and autoclaved, which resulted in tetanus toxin expression. The toxin was expressed when the N-Z-Case TT solution reacted with the glucose stock at a high temperature, creating an adequate amount of Maillard reaction products (MRPs). After accumulating in C. tetani cells, tetanus toxin was secreted into the medium when cell lysis was induced by surface aeration. C. tetani was cultivated and tetanus toxin was expressed in a single-use bioreactor, which produced 80 Lf/mL of tetanus toxin in a medium with MRPs. While using the correct medium to induce tetanus toxin was important, other factors played a part in achieving the desired concentration of the toxin, including the medium processing and culture methods inside the bioreactor. Tetanus toxoid with a purity level greater than 2,500 Lf/mgPN was obtained by detoxifying and purifying the toxin recovered from the fermenter or single-use bioreactor. A single-use bioreactor could be used in a limited space without the need for constructing a large scale production facility, to produce the tetanus toxoid antigen for clinical trials. [ABSTRACT FROM AUTHOR]

Background: Tetanus is an acute, often fatal, disease caused by an exotoxin produced by the bacterium Clostridium tetani. It is characterized by generalized rigidity and convulsive spasms of skeletal muscles. Tetanus remains a major public health problem in Ethiopia like other developed nations. The aim of the present study was to assess the clinical profile and outcome of tetanus patients in a referral hospital, Northwest Ethiopia. Methods: This is a retrospective cross sectional study in which we collected, compiled and analyzed medical records of patients aged greater than 15 years who were admitted at Felege Hiwot Referral Hospital from Sep 2012 to Sep 2015. Tetanus was diagnosed using clinical observations. Data were entered, cleared, and analyzed using SPSS statistical software package. Results: Among 110 tetanus cases 84 (76.4 %) were males. Trauma was the most common antecedent cause. Most of the patients had no history of tetanus toxoid immunization. Aspiration pneumonia at 34.5 % and dysautonomia at 11.8 % were found to be the most frequently observed complications. About 36 (32.7 %) patients were died due to tetanus and the most common immediate cause of death was respiratory failure at (83.3 %). Patients' area of residence (p = 0.004), type of complications (p = 0.00) and severity of tetanus (p = 0.00) were found to be statistically associated with the type of treatment outcomes. Conclusions: In the study, the case-fatality rate was found to be very high. Therefore, there is a need to universal tetanus immunization and health information dissemination. [ABSTRACT FROM AUTHOR]