Volume 93, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



, the etiologic agent of tetanus, produces a toxin that causes spastic paralysis in humans and other vertebrates. This study was aimed for isolation, identification, and determination of antimicrobial susceptibility of from clinically diagnosed tetanus patients. Isolation was done from deep-punctured tissues of the foot and arm injuries of 80 clinically diagnosed tetanus patients from the Pakistan Institute of Medical Sciences hospital. We successfully screened out five isolates out of 80 samples based on the strain-specific characteristics confirmed through biochemical testing and toxin production. A disc diffusion method was used for antimicrobial susceptibilities and isolates showed susceptibility to cefoperazone, chloramphenicol, metronidazole, penicillin G, and tetracycline, but were found to be resistant to erythromycin and ofloxacin. During animal testing, all the infected mice developed symptoms of tetanus. The results showed that identification of is possible using biochemical and molecular tools and that the strains of isolated had not developed resistance against the antibiotics most often used for the treatment of tetanus.


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  1. Dietz V, Milstein JB, Loon FV, Bennett J, , 1996. Performance and potency of tetanus toxoid implications for eliminating neonatal tetanus. WHO 74: 619628. [Google Scholar]
  2. Thwaites CL, Yen LM, Nga NT, Parry J, Binh NT, Loan HT, Thuy TT, Bethell D, Parry CM, White NJ, Day NP, Farrar JJ, , 2004. Impact of improved vaccination programme and intensive care facilities on incidence and outcome of tetanus in southern Vietnam, 1993–2002. Trans R Soc Trop Med Hyg 98: 671677. [Google Scholar]
  3. Whitman C, Belgharbi L, Gasse F, Torel C, Mattei V, Zoffmann H, , 1992. Progress towards the global elimination of neonatal tetanus. World Health Stat Q 45: 248256. [Google Scholar]
  4. Quddus AS, Luby M, Rahbar Y, Pervaiz Y, , 2002. Neonatal tetanus: mortality and risk factor in Loralai district Pakistan. Int J Epidemiol 31: 648653. [Google Scholar]
  5. Owusu-Darko S, Diouf K, Nour N, , 2012. Elimination of maternal and neonatal tetanus. A 21st-century challenge. Rev Obstet Gynecol 5: 151157. [Google Scholar]
  6. Udwadia FE, , 1994. Tetanus. Oxford, United Kingdom: Oxford University Press. [Google Scholar]
  7. Bruggemann H, Baumer S, Fricke WF, Wiezer A, Liesegang H, Decker I, Herzberg C, Martinez-Arias R, Merkl R, Henne A, Gottschalk G, , 2003. The genome sequence of Clostridium tetani the causative agent of tetanus disease. Proc Natl Acad Sci USA 100: 13161321. [Google Scholar]
  8. Mellanby J, Green J, , 1981. How does tetanus toxin act? Neuroscience 6: 281300. [Google Scholar]
  9. Hatheway CL, , 1990. Toxigenic clostridia. J Micro Rev 3: 6698. [Google Scholar]
  10. Richard F, Edlich MD, Lisa G, Chandra A, Daniel G, Larry S, , 2003. Management and prevention of tetanus. J Long Term Eff Med Implants 13: 139154. [Google Scholar]
  11. Farrar JJ, Yen LM, Cook T, Fairweather N, Binh N, Parry JCM, , 2000. Neurological aspects of tropical disease: tetanus. J Neurol Neurosurg Psychiatry 69: 292301. [Google Scholar]
  12. Cook TM, Protheroe RT, Handel JM, , 2001. Tetanus: a review of the literature. Br J Anaesth 87: 477487. [Google Scholar]
  13. Bruggemann H, Baumer S, Fricke WF, Wiezer A, , 2003. The genome sequence of Clostridium tetani, the causative agent of tetanus disease. Proc Natl Acad Sci USA 100: 13161321. [Google Scholar]
  14. Lambo JA, Memon MI, Khahro ZH, , 2011. Epidemiology of neonatal tetanus in rural Pakistan. J Pak Med Assoc 61: 10991103. [Google Scholar]
  15. Fairweather NF, Lyness VA, , 1986. The complete nucleotide sequence of tetanus toxin. Nucleic Acids Res 14: 78097812. [Google Scholar]
  16. Campbell JI, Lam TM, Huynh TL, To SD, Tran TT, Nguyen VM, Le TS, Nguyen vV, Parry C, Farrar JJ, Tran TH, Baker S, , 2009. Microbiologic characterization and antimicrobial susceptibility of Clostridium tetani isolated from wounds of patients with clinically diagnosed tetanus. Am J Trop Med Hyg 80: 827831. [Google Scholar]
  17. Sanford JP, , 1995. Tetanus-forgotten but not gone. N Engl J Med 332: 812813. [Google Scholar]
  18. WHO Technical Note, 2010. Current Recommendations for Treatment of Tetanus During Humanitarian Emergencies. Geneva, Switzerland: WHO Communicable Diseases Working Group on Emergencies, Communicable Diseases Surveillance and Response, WHO Regional Office for the Americas. [Google Scholar]
  19. Abrutyn E, Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, , 1995. Tetanus. , eds. Harrison's Principles of Internal Medicine. New York, NY: McGraw-Hill. [Google Scholar]
  20. Cary SG, Blair EB, , 1964. New transport medium for shipment of clinical specimens. J Bacteriol 88: 9698. [Google Scholar]
  21. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, , 1995. Manual of Clinical Microbiology, 6th edition. Washington, DC: ASM Press. [Google Scholar]
  22. Clinical and Laboratory Standards Institute, 2007. Performance Standards for Antimicrobial Susceptibility Testing; 17th Informational Supplement. MS100-S17. Wayne, PA: CLSI. [Google Scholar]
  23. Nagao K, Mori T, Sawada C, Sasakawa C, Kanezaki Y, , 2007. Detection of the tetanus toxin gene by polymerase chain reaction: a case study. Jpn J Infect Dis 60: 149150. [Google Scholar]
  24. Bruggemann H, , 2005. Genomics of clostridial pathogens: implication of extrachromosomal elements in pathogenicity. Curr Opin Microbiol 8: 601605. [Google Scholar]
  25. Bukar A, Mukhtar MD, Adam SA, , 2008. Current trend in antimicrobial susceptibility pattern of Clostridium tetani isolated from soil samples in Kano Bay. J Pure and App Sci 1: 112115. [Google Scholar]
  26. Brazier JS, Duerden BI, Hall V, Salmon JE, , 2002. Isolation and identification of Clostridium spp. from infections associated with the injection of drugs: experiences of a microbiological investigation team. J Med Microbiol 51: 985989. [Google Scholar]
  27. Izurieta HS, Sutter RW, Strebel PM, , 1997. Tetanus surveillance—United States 1991–1994. In: CDC Surveillance Summaries. MMWR Morb Mortal Wkly Rep 46: 1525. [Google Scholar]
  28. Mukhtar MD, Adam SA, Almustapha H, , 2008. Study on the toxigenicity of C. tetani isolated from soil around Kano. Nig J Microbiol 20: 14661471. [Google Scholar]
  29. Sebaihia M, Wren BW, Mullany P, Fairweather NF, Minton N, , 2006. The multidrug-resistant human pathogen Clostridium difficile has a highly mobile, mosaic genome. Nat Genet 38: 779786. [Google Scholar]
  30. Public health agency of Canada, 2012. Clostridium tetani. Available at: http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/clostridium-tetani. Accessed April 28, 2015. [Google Scholar]

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  • Received : 15 Jan 2015
  • Accepted : 16 Jun 2015
  • Published online : 07 Oct 2015

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