{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:17:42Z","timestamp":1787836662705,"version":"build-2784847793"},"reference-count":128,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Clostridial myonecrosis, commonly known as gas gangrene (GG), is a rapidly progressing and potentially fatal bacterial infection that primarily affects muscle and soft tissue. In the United States, the incidence of GG is roughly 1000 cases per year, while, in developing countries, the incidence is higher. This condition is most often caused by Clostridium perfringens, a Gram-positive, spore-forming anaerobic bacterium widely distributed in the environment, although other Clostridium species have also been reported to cause GG. The CP genome contains over 200 transport-related genes, including ABC transporters, which facilitate the uptake of sugars, amino acids, nucleotides, and ions from the host environment. There are two main subtypes of GG: traumatic GG, resulting from injuries that introduce Clostridium spores into deep tissue, where anaerobic conditions allow for bacterial growth and toxin production, and spontaneous GG, which is rarer and often occurs in immunocompromised patients. Clostridium species produce various toxins (e.g., alpha, theta, beta) that induce specific downstream signaling changes in cellular pathways, causing apoptosis or severe, fatal immunological conditions. For example, the Clostridium perfringens alpha toxin (CPA) targets the host cell\u2019s plasma membrane, hydrolyzing sphingomyelin and phosphatidylcholine, which triggers necrosis and apoptosis. The clinical manifestations of clostridial myonecrosis vary. Some patients experience the sudden onset of severe pain, swelling, and muscle tenderness, with the infection progressing rapidly to widespread tissue necrosis, systemic toxicity, and, if untreated, death. Other patients present with discharge, pain, and features of cellulitis. The diagnosis of GG primarily involves clinical evaluation, imaging studies such as X-rays, computer tomography (CT) scans, and culture. The treatment of GG involves surgical exploration, broad-spectrum antibiotics, antitoxin, and hyperbaric oxygen therapy, which is considered an adjunctive treatment to inhibit anaerobic bacterial growth and enhance the antibiotic efficacy. Early recognition and prompt, comprehensive treatment are critical to improving the outcomes for patients affected by this severe and life-threatening condition.<\/jats:p>","DOI":"10.3390\/microorganisms12071464","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T16:51:12Z","timestamp":1721321472000},"page":"1464","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Clostridial Myonecrosis: A Comprehensive Review of Toxin Pathophysiology and Management Strategies"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-9056","authenticated-orcid":false,"given":"Hussain","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Kendall Hospital-HCA Florida Healthcare, Miami, FL 33136, USA"},{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Fadel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ocean University Medical Center\u2014Hackensack Meridian Health, Brick, NJ 08724, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrain","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kendall Hospital-HCA Florida Healthcare, Miami, FL 33136, USA"},{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahraa F.","family":"Saadoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamia","family":"Naseer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Casmartino","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Hamad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1608-6503","authenticated-orcid":false,"given":"Taylor","family":"Schnepp","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehan","family":"Sarfraz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohair","family":"Angly","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2115-7860","authenticated-orcid":false,"given":"Arumugam R.","family":"Jayakumar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"key":"ref_1","unstructured":"Yao, P.Y., and Annamaraju, P. (2024, June 29). Clostridium perfringens Infection, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559049\/."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Grenda, T., Jarosz, A., Sapa\u0142a, M., Grenda, A., Patyra, E., and Kwiatek, K. (2023). Clostridium perfringens-Opportunistic Foodborne Pathogen, Its Diversity and Epidemiological Significance. Pathogens, 12.","DOI":"10.3390\/pathogens12060768"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ohtani, K., and Shimizu, T. (2016). Regulation of Toxin Production in Clostridium perfringens. Toxins, 8.","DOI":"10.3390\/toxins8070207"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S0168-1605(01)00680-8","article-title":"Clostridium perfringens and foodborne infections","volume":"74","author":"Brynestad","year":"2002","journal-title":"Int. J. Food Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1111\/os.12804","article-title":"Clostridial Gas Gangrene\u2014A Rare but Deadly Infection: Case series and Comparison to Other Necrotizing Soft Tissue Infections","volume":"12","author":"Leiblein","year":"2020","journal-title":"Orthop. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kiu, R., and Hall, L.J. (2018). An update on the human and animal enteric pathogen Clostridium perfringens. Emerg. Microbes Infect., 7.","DOI":"10.1038\/s41426-018-0144-8"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Mansfield, K.G., and Fox, J.G. (2019). Chapter 16\u2014Bacterial Diseases. American College of Laboratory Animal Medicine. The Common Marmoset in Captivity and Biomedical Research, Academic Press.","DOI":"10.1016\/B978-0-12-811829-0.00016-9"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.anaerobe.2017.12.012","article-title":"Historical and contemporary features of infections due to Clostridium novyi","volume":"50","author":"Aronoff","year":"2018","journal-title":"Anaerobe"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"387","DOI":"10.3390\/immuno2020024","article-title":"Clostridium perfringens-Induced Necrotic Diseases: An Overview","volume":"2","author":"Fu","year":"2022","journal-title":"Immuno"},{"key":"ref_10","unstructured":"Baron, S. (2024, June 29). Clostridia: Sporeforming Anaerobic Bacilli, Medical Microbiology, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK8219\/."},{"key":"ref_11","unstructured":"Milena, B., Stefano, M., and Tiziana, S. (2022). Clostridium spp. Encyclopedia of Dairy Sciences, Academic Press. [3rd ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"36934","DOI":"10.1074\/jbc.M306562200","article-title":"Biological activities and pore formation of Clostridium perfringens beta toxin in HL 60 cells","volume":"278","author":"Nagahama","year":"2003","journal-title":"J. Biol. Chem."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1099\/jmm.0.45804-0","article-title":"Clinical features of Clostridium difficile-associated diarrhoea due to binary toxin (actin-specific ADP-ribosyltransferase)-producing strains","volume":"54","author":"Barbut","year":"2005","journal-title":"J. Med. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Li, J., and McClane, B.A. (2008). A novel small acid soluble protein variant is important for spore resistance of most Clostridium perfringens food poisoning isolates. PLoS Pathog., 4.","DOI":"10.1371\/journal.ppat.1000056"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2048","DOI":"10.1128\/AEM.02500-06","article-title":"Antisense-RNA-mediated decreased synthesis of small, acid-soluble spore proteins leads to decreased resistance of Clostridium perfringens spores to moist heat and UV radiation","volume":"73","author":"Raju","year":"2007","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.anaerobe.2012.09.001","article-title":"Identification of a lambda toxin-negative Clostridium perfringens strain that processes and activates epsilon prototoxin intracellularly","volume":"18","author":"Harkness","year":"2012","journal-title":"Anaerobe"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Forti, K., Ferroni, L., Pellegrini, M., Cruciani, D., De Giuseppe, A., Crotti, S., Papa, P., Maresca, C., Severi, G., and Marenzoni, M.L. (2020). Molecular Characterization of Clostridium perfringens Strains Isolated in Italy. Toxins, 12.","DOI":"10.3390\/toxins12100650"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1080\/21505594.2021.1886777","article-title":"Pathogenicity and virulence of Clostridium perfringens","volume":"12","author":"Li","year":"2021","journal-title":"Virulence"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"477","DOI":"10.2166\/wh.2020.029","article-title":"Inside environmental Clostridium perfringens genomes: Antibiotic resistance genes, virulence factors and genomic features","volume":"18","author":"Fourie","year":"2020","journal-title":"J. Water Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.plasmid.2019.02.002","article-title":"pCP13, a representative of a new family of conjugative toxin plasmids in Clostridium perfringens","volume":"102","author":"Watts","year":"2019","journal-title":"Plasmid"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Pahle, J., Kobelt, D., Aumann, J., Behrens, D., Daberkow, O., Mokritzkij, M., Piontek, J., Stein, U., and Walther, W. (2021). Effective Oncoleaking Treatment of Pancreatic Cancer by Claudin-Targeted Suicide Gene Therapy with Clostridium perfringens Enterotoxin (CPE). Cancers, 13.","DOI":"10.3390\/cancers13174393"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1128\/JCM.42.4.1552-1558.2004","article-title":"Multiplex PCR genotyping assay that distinguishes between isolates of Clostridium perfringens type A carrying a chromosomal enterotoxin gene (cpe) locus, a plasmid cpe locus with an IS1470-like sequence, or a plasmid cpe locus with an IS1151 sequence","volume":"42","author":"Miyamoto","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3183","DOI":"10.1007\/s00894-011-1007-6","article-title":"Exploration of the binding mode of \u03b1\/\u03b2-type small acid soluble proteins (SASPs) with DNA","volume":"17","author":"Ge","year":"2011","journal-title":"J. Mol. Model."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Camargo, A., Ram\u00edrez, J.D., Kiu, R., Hall, L.J., and Mu\u00f1oz, M. (2024). Unveiling the pathogenic mechanisms of Clostridium perfringens toxins and virulence factors. Emerg. Microbes Infect., 13.","DOI":"10.1080\/22221751.2024.2341968"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Azimirad, M., Gholami, F., Yadegar, A., Knight, D.R., Shamloei, S., Aghdaei, H.A., and Zali, M.R. (2019). Prevalence and characterization of Clostridium perfringens toxinotypes among patients with antibiotic-associated diarrhea in Iran. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-44281-5"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1139\/m77-087","article-title":"Clostridium perfringens--specific lysin","volume":"23","author":"Nakamura","year":"1977","journal-title":"Can. J. Microbiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.resmic.2014.09.010","article-title":"Regulation of toxin gene expression in Clostridium perfringens","volume":"166","author":"Ohtani","year":"2015","journal-title":"Res. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.anaerobe.2018.04.011","article-title":"Expansion of the Clostridium perfringens toxin-based typing scheme","volume":"53","author":"Rood","year":"2018","journal-title":"Anaerobe"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.resmic.2014.09.004","article-title":"Clostridium perfringens type A-E toxin plasmids","volume":"166","author":"Freedman","year":"2015","journal-title":"Res. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"D44","DOI":"10.1016\/j.vaccine.2009.07.047","article-title":"Clostridium perfringens vaccines","volume":"27","author":"Titball","year":"2009","journal-title":"Vaccine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6232","DOI":"10.1016\/j.vaccine.2019.08.032","article-title":"Clostridium perfringens enterotoxin-based protein engineering for the vaccine design and delivery system","volume":"37","author":"Lan","year":"2019","journal-title":"Vaccine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1264\/jsme2.ME12002","article-title":"Enterotoxigenic Clostridium perfringens: Detection and identification","volume":"27","author":"Miyamoto","year":"2012","journal-title":"Microbes Environ."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Jang, Y.S., Kim, D.H., Bae, D., Kim, S.H., Kim, H., Moon, J.S., Song, K.Y., Chon, J.W., and Seo, K.H. (2020). Prevalence, toxin-typing, and antimicrobial susceptibility of Clostridium perfringens from retail meats in Seoul, Korea. Anaerobe, 64.","DOI":"10.1016\/j.anaerobe.2020.102235"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Alimolaei, M., and Afzali, S. (2023). Prevalence of Clostridium perfringens toxinotypes in antibiotic-associated diarrheal (AAD) patients in Iranian hospitals; can toxinotype D serve as a possible zoonotic agent for humans?. Acta Trop., 247.","DOI":"10.1016\/j.actatropica.2023.107002"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Neumann, T., Kr\u00fcger, M., Weisemann, J., Mahrhold, S., Stern, D., Dorner, M.B., Feraudet-Tarisse, C., P\u00f6hlmann, C., Schulz, K., and Messelh\u00e4u\u00dfer, U. (2021). Innovative and Highly Sensitive Detection of Clostridium perfringens Enterotoxin Based on Receptor Interaction and Monoclonal Antibodies. Toxins, 13.","DOI":"10.3390\/toxins13040266"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0966-842X(98)01430-9","article-title":"Clostridium perfringens: Toxinotype and genotype","volume":"7","author":"Petit","year":"1999","journal-title":"Trends Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"396","DOI":"10.3390\/toxins7020396","article-title":"Recent insights into Clostridium perfringens beta-toxin","volume":"7","author":"Nagahama","year":"2015","journal-title":"Toxins"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1292\/jvms.20-0623","article-title":"The cytotoxicity and molecular mechanisms of the Clostridium perfringens NetB toxin","volume":"83","author":"Islam","year":"2021","journal-title":"J. Vet. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Duracova, M., Klimentova, J., Myslivcova Fucikova, A., Zidkova, L., Sheshko, V., Rehulkova, H., Dresler, J., and Krocova, Z. (2019). Targeted Mass Spectrometry Analysis of Clostridium perfringens Toxins. Toxins, 11.","DOI":"10.3390\/toxins11030177"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.anaerobe.2014.08.016","article-title":"Clostridium perfringens epsilon toxin: The third most potent bacterial toxin known","volume":"30","author":"Alves","year":"2014","journal-title":"Anaerobe"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1128\/MMBR.00062-12","article-title":"Toxin plasmids of Clostridium perfringens","volume":"77","author":"Li","year":"2013","journal-title":"Microbiol. Mol. Biol. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0378-1135(01)00372-8","article-title":"Clostridium perfringens beta toxin and Clostridium septicum alpha toxin: Their mechanisms and possible role in pathogenesis","volume":"82","author":"Tweten","year":"2001","journal-title":"Vet. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.anaerobe.2016.06.003","article-title":"Gene regulation by the VirS\/VirR system in Clostridium perfringens","volume":"41","author":"Ohtani","year":"2016","journal-title":"Anaerobe"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/jpn.13274","article-title":"Molecular structure and function of the carboxy-terminus of the alpha-toxin from Clostridium perfringens type A","volume":"104","author":"Xu","year":"2020","journal-title":"J. Anim. Physiol. Anim. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Saadat, A., and Melville, S.B. (2021). Holin-Dependent Secretion of the Large Clostridial Toxin TpeL by Clostridium perfringens. J. Bacteriol., 203.","DOI":"10.1128\/JB.00580-20"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Ogbu, C.P., Kapoor, S., and Vecchio, A.J. (2023). Structural Basis of Clostridium perfringens Enterotoxin Activation and Oligomerization by Trypsin. Toxins, 15.","DOI":"10.3390\/toxins15110637"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Nagahama, M., Takehara, M., Seike, S., and Sakaguchi, Y. (2023). Cellular Uptake and Cytotoxicity of Clostridium perfringens Iota-Toxin. Toxins, 15.","DOI":"10.3390\/toxins15120695"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1177\/10406387231176995","article-title":"Enterotoxemia produced by lambda toxin-positive Clostridium perfringens type D in 2 neonatal goat kids","volume":"35","author":"Acevedo","year":"2023","journal-title":"J. Vet. Diagn. Invest."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1006\/mpat.1996.0115","article-title":"Isolation of alpha-toxin, theta-toxin and kappa-toxin mutants of Clostridium perfringens by Tn916 mutagenesis","volume":"22","author":"Awad","year":"1997","journal-title":"Microb. Pathog."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"496","DOI":"10.2460\/ajvr.1996.57.04.496","article-title":"Hybridization of 2,659 Clostridium perfringens isolates with gene probes for seven toxins (alpha, beta, epsilon, iota, theta, mu, and enterotoxin) and for sialidase","volume":"57","author":"Daube","year":"1996","journal-title":"Am. J. Vet. Res."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Kiu, R., Sim, K., Shaw, A., Cornwell, E., Pickard, D., Kroll, J.S., and Hall, L.J. (2019). Genomic Analysis of Clostridium perfringens BEC\/CPILE-Positive, Toxinotype D and E Strains Isolated from Healthy Children. Toxins, 11.","DOI":"10.3390\/toxins11090543"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4161\/gmic.26854","article-title":"Clostridium difficile binary toxin CDT: Mechanism, epidemiology, and potential clinical importance","volume":"5","author":"Gerding","year":"2014","journal-title":"Gut Microbes"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.2217\/fmb.09.72","article-title":"Clostridial toxins","volume":"4","author":"Popoff","year":"2009","journal-title":"Future Microbiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"5268","DOI":"10.3390\/toxins7124880","article-title":"Membrane-Binding Mechanism of Clostridium perfringens Alpha-Toxin","volume":"7","author":"Oda","year":"2015","journal-title":"Toxins"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Navarro, M.A., McClane, B.A., and Uzal, F.A. (2018). Mechanisms of action and cell death associated with Clostridium perfringens toxins. Toxins, 10.","DOI":"10.3390\/toxins10050212"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"4949","DOI":"10.1016\/j.vaccine.2021.07.019","article-title":"Clostridium septicum: A review in the light of alpha-toxin and development of vaccines","volume":"39","author":"Alves","year":"2021","journal-title":"Vaccine"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Ou, L., Ye, B., Sun, M., Qi, N., Li, J., Lv, M., Lin, X., Cai, H., Hu, J., and Song, Y. (2024). Mechanisms of intestinal epithelial cell damage by Clostridium perfringens. Anaerobe, 87.","DOI":"10.1016\/j.anaerobe.2024.102856"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1128\/iai.21.2.678-680.1978","article-title":"Some properties of the beta toxin produced by Clostridium perfringens type C","volume":"21","author":"Sakurai","year":"1978","journal-title":"Infect. Immun."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3958","DOI":"10.1128\/iai.61.9.3958-3965.1993","article-title":"Molecular genetic analysis of beta-toxin of Clostridium perfringens reveals sequence homology with alpha-toxin, gamma-toxin, and leukocidin of Staphylococcus aureus","volume":"61","author":"Hunter","year":"1993","journal-title":"Infect. Immun."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1016\/j.bbagen.2015.08.011","article-title":"Role of P2X7 receptor in Clostridium perfringens beta-toxin-mediated cellular injury","volume":"1850","author":"Nagahama","year":"2015","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.chom.2020.05.003","article-title":"CD31 (PECAM-1) Serves as the Endothelial Cell-Specific Receptor of Clostridium perfringens \u03b2-Toxin","volume":"28","author":"Bruggisser","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Hoonakker, M., Zariri, A., de Brouwer, L., David, D., Borgman, A., and Sloots, A. (2024). An in vitro assay for toxicity testing of Clostridium perfringens type C \u03b2-toxin. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1373411"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.1128\/IAI.01284-09","article-title":"Rapid cytopathic effects of Clostridium perfringens beta-toxin on porcine endothelial cells","volume":"78","author":"Gurtner","year":"2010","journal-title":"Infect. Immun."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Autheman, D., Wyder, M., Popoff, M., D\u2019Herde, K., Christen, S., and Posthaus, H. (2013). Clostridium perfringens beta-toxin induces necrostatin-inhibitable, calpain-dependent necrosis in primary porcine endothelial cells. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0064644"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"3150","DOI":"10.1016\/j.bbamem.2016.10.003","article-title":"Role of pannexin 1 in Clostridium perfringens beta-toxin-caused cell death","volume":"1858","author":"Seike","year":"2016","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1128\/IAI.02864-14","article-title":"Identification and characterization of Clostridium perfringens beta toxin variants with differing trypsin sensitivity and in vitro cytotoxicity activity","volume":"83","author":"Theoret","year":"2015","journal-title":"Infect. Immun."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"5291","DOI":"10.1128\/IAI.00825-09","article-title":"Development and application of new mouse models to study the pathogenesis of Clostridium perfringens type C Enterotoxemias","volume":"77","author":"Uzal","year":"2009","journal-title":"Infect. Immun."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jmb.2011.07.066","article-title":"Structure of the food-poisoning Clostridium perfringens enterotoxin reveals similarity to the aerolysin-like pore-forming toxins","volume":"413","author":"Briggs","year":"2011","journal-title":"J. Mol. Biol."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Freedman, J.C., Shrestha, A., and McClane, B.A. (2016). Clostridium perfringens enterotoxin: Action, genetics, and translational applications. Toxins, 8.","DOI":"10.3390\/toxins8030073"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1083\/jcb.136.6.1239","article-title":"Molecular cloning and functional characterization of the receptor for Clostridium perfringens enterotoxin","volume":"136","author":"Katahira","year":"1997","journal-title":"J. Cell Biol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.anaerobe.2016.04.011","article-title":"The interaction of Clostridium perfringens enterotoxin with receptor claudins","volume":"41","author":"Shrestha","year":"2016","journal-title":"Anaerobe."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1126\/science.1261833","article-title":"Tight junctions. Structural insight into tight junction disassembly by Clostridium perfringens enterotoxin","volume":"347","author":"Saitoh","year":"2015","journal-title":"Science"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2390","DOI":"10.1128\/IAI.01759-14","article-title":"BEC, a novel enterotoxin of Clostridium perfringens found in human clinical isolates from acute gastroenteritis outbreaks","volume":"82","author":"Yonogi","year":"2014","journal-title":"Infect. Immun."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"13778","DOI":"10.1074\/jbc.M011527200","article-title":"Cleavage of a C-terminal peptide is essential for heptamerization of Clostridium perfringens epsilon-toxin in the synaptosomal membrane","volume":"276","author":"Miyata","year":"2001","journal-title":"J. Biol. Chem."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1111\/j.1348-0421.1997.tb01888.x","article-title":"Lambda-toxin of Clostridium perfringens activates the precursor of epsilon-toxin by releasing its N- and C-terminal peptides","volume":"41","author":"Minami","year":"1997","journal-title":"Microbiol. Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"208","DOI":"10.3390\/toxins1020208","article-title":"Clostridium perfringens iota-toxin: Structure and function","volume":"1","author":"Sakurai","year":"2009","journal-title":"Toxins"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"3848","DOI":"10.1128\/IAI.68.7.3848-3853.2000","article-title":"Clostridium perfringens iota-toxin requires activation of both binding and enzymatic components for cytopathic activity","volume":"68","author":"Gibert","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Nagahama, M., Takekara, M., and Kobayashi, K. (2018). Interaction of Clostridium perfringens iota toxin and lipolysis-stimulated lipoprotein receptor (LSR). Toxins, 10.","DOI":"10.3390\/toxins10100405"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1046\/j.1365-2958.2002.02806.x","article-title":"Transcytosis of iota-toxin across polarized CaCo-2 cells","volume":"43","author":"Richard","year":"2002","journal-title":"Mol. Microbiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"5593","DOI":"10.1128\/IAI.00710-09","article-title":"The long-lived nature of Clostridium perfringens iota toxin in mammalian cells induces delayed apoptosis","volume":"77","author":"Hilger","year":"2009","journal-title":"Infect. Immun."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Manich, M., Knapp, O., Gibert, M., Maier, E., Jolivet-Reynaud, C., Geny, B., Benz, R., and Popoff, M.R. (2008). Clostridium perfringens delta toxin is sequence related to beta toxin, NetB, and Staphylococcus pore-forming toxins, but shows functional differences. PLoS ONE, 3.","DOI":"10.1371\/journal.pone.0003764"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Seike, S., Takehara, M., Kobayashi, K., and Nagahama, M. (2019). Clostridium perfringens Delta-Toxin Damages the Mouse Small Intestine. Toxins, 11.","DOI":"10.3390\/toxins11040232"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Mehdizadeh Gohari, I., Kropinski, A.M., Weese, S.J., Parreira, V.R., Whitehead, A.E., Boerlin, P., and Prescott, J.F. (2016). Plasmid Characterization and Chromosome Analysis of Two netF+ Clostridium perfringens Isolates Associated with Foal and Canine Necrotizing Enteritis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0148344"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1097\/00000433-199906000-00011","article-title":"Nontraumatic clostridial myonecrosis","volume":"2","author":"Burke","year":"1999","journal-title":"Am. J. Forensic Med. Pathol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1016\/S1473-3099(22)00590-4","article-title":"Infections caused by Clostridium perfringens and Paeniclostridium sordellii after unsafe abortion","volume":"23","author":"Aronoff","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Suzaki, A., and Hayakawa, S. (2023). Clinical and Microbiological Features of Fulminant Haemolysis Caused by Clostridium perfringens Bacteraemia: Unknown Pathogenesis. Microorganisms, 11.","DOI":"10.3390\/microorganisms11040824"},{"key":"ref_87","first-page":"757","article-title":"Gas composition in Clostridium septicum gas gangrene","volume":"94","author":"Chi","year":"1995","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Li, D., Li, D., Chen, A., He, L., Luo, J., and Tao, L. (2022). LDLR, LRP1, and Megalin redundantly participate in the uptake of Clostridium novyi alpha-toxin. Commun. Biol., 5.","DOI":"10.1038\/s42003-022-03873-0"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1001\/archsurg.138.3.272","article-title":"Hyperbaric oxygen for treating wounds: A systematic review of the literature","volume":"138","author":"Wang","year":"2003","journal-title":"Arch. Surg."},{"key":"ref_90","first-page":"7","article-title":"Hyperbaric oxygen therapy in acute necrotizing infections. With a special reference to the effects on tissue gas tensions","volume":"89","author":"Korhonen","year":"2000","journal-title":"Ann. Chir. Gynaecol."},{"key":"ref_91","first-page":"1","article-title":"Hyperbaric oxygen in the treatment of gas gangrene and perineal necrotizing fasciitis. A clinical and experimental study","volume":"570","author":"Hirn","year":"1993","journal-title":"Eur. J. Surg. Suppl."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0378-1119(97)00493-9","article-title":"Beta2 toxin, a novel toxin produced by Clostridium perfringens","volume":"203","author":"Gibert","year":"1997","journal-title":"Gene"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1128\/IAI.73.1.652-656.2005","article-title":"Atypical cpb2 genes, encoding beta2-toxin in Clostridium perfringens isolates of nonporcine origin","volume":"73","author":"Jost","year":"2005","journal-title":"Infect. Immun."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.vetmic.2012.04.007","article-title":"The majority of atypical cpb2 genes in Clostridium perfringens isolates of different domestic animal origin are expressed","volume":"159","author":"Kircanski","year":"2012","journal-title":"Vet. Microbiol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jiac.2019.07.019","article-title":"Clinical features of Clostridium bacteremia in cancer patients: A case series review","volume":"26","author":"Yamamoto","year":"2020","journal-title":"J. Infect. Chemother."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Sheff, B. (2004). Clostridium perfringens. Nursing, 34.","DOI":"10.1097\/00152193-200408000-00031"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Redondo, L.M., Carrasco, J.M., Redondo, E.A., Delgado, F., and Miyakawa, M.E. (2015). Clostridium perfringens type E virulence traits involved in gut colonization. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0121305"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"4354","DOI":"10.1128\/IAI.00818-12","article-title":"Genotypic and phenotypic characterization of Clostridium perfringens isolates from Darmbrand cases in post-World War II Germany","volume":"80","author":"Ma","year":"2012","journal-title":"Infect. Immun."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"3833","DOI":"10.3760\/cma.j.issn.0366-6999.20121279","article-title":"Comprehensive treatment for gas gangrene of the limbs in earthquakes","volume":"126","author":"Wang","year":"2013","journal-title":"Chin. Med. J."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jvs.2022.02.029","article-title":"Systematic literature review and meta-analysis of Clostridium septicum aortitis","volume":"76","author":"Kirchweger","year":"2022","journal-title":"J. Vasc. Surg."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Kawamura, T., Prah, I., Mahazu, S., Ablordey, A., and Saito, R. (2023). Types A and F Clostridium perfringens in healthcare wastewater from Ghana. Appl. Environ. Microbiol., 89.","DOI":"10.1128\/aem.01619-23"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3947\/ic.2014.46.3.199","article-title":"A Fatal Spontaneous Gas Gangrene due to Clostridium perfringens during Neutropenia of Allogeneic Stem Cell Transplantation: Case Report and Literature Review","volume":"46","author":"Lee","year":"2014","journal-title":"Infect. Chemother."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/BLO.0b013e318073c273","article-title":"Spontaneous Clostridium perfringens myonecrosis of the shoulder: A case report","volume":"461","author":"Lanting","year":"2007","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1128\/IAI.00778-09","article-title":"Identification of a claudin-4 residue important for mediating the host cell binding and action of Clostridium perfringens enterotoxin","volume":"78","author":"Robertson","year":"2010","journal-title":"Infect. Immun."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Mehdizadeh Gohari, I., Li, J., Navarro, M., Uzal, F., and McClane, B. (2019). Effects of Claudin-1 on the Action of Clostridium perfringens Enterotoxin in Caco-2 Cells. Toxins, 11.","DOI":"10.3390\/toxins11100582"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"4078","DOI":"10.1128\/IAI.00069-12","article-title":"Cysteine-scanning mutagenesis supports the importance of Clostridium perfringens enterotoxin amino acids 80 to 106 for membrane insertion and pore formation","volume":"80","author":"Chen","year":"2012","journal-title":"Infect. Immun."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Benz, R., and Popoff, M.R. (2018). Clostridium perfringens enterotoxin. The toxin forms highly cation-selective channels in lipid bilayers. Toxins, 10.","DOI":"10.3390\/toxins10090341"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"4260","DOI":"10.1128\/IAI.71.8.4260-4270.2003","article-title":"Death pathways activated in CaCo-2 cells by Clostridium perfringens enterotoxin","volume":"71","author":"Chakarbarti","year":"2003","journal-title":"Infect. Immun."},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Mehdizadeh Gohari, I., Parreira, V.R., Nowell, V.J., Nicholson, V.M., Oliphant, K., and Prescott, J.F. (2015). A novel pore-forming toxin in type A Clostridium perfringens is associated with both fatal canine hemorrhagic gastroenteritis and fatal foal necrotizing enterocolitis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0122684"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"4860","DOI":"10.1128\/IAI.00715-10","article-title":"Characterization of toxin plasmids in Clostridium perfringens type C isolates","volume":"78","author":"Gurjar","year":"2010","journal-title":"Infect. Immun."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.plasmid.2015.04.004","article-title":"Plasmid partitioning systems of conjugative plasmids from Clostridium perfringens","volume":"80","author":"Adams","year":"2015","journal-title":"Plasmid"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0378-1135(03)00081-6","article-title":"Prevalence of cpb2, encoding beta2 toxin, in Clostridium perfringens field isolates: Correlation of genotype with phenotype","volume":"94","author":"Bueschel","year":"2003","journal-title":"Vet. Microbiol."},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Serroni, A., Colabella, C., Cruciani, D., Ciullo, M., Crotti, S., Papa, P., Di Paolo, A., Gobbi, M., Forti, K., and Pellegrini, M. (2022). Identification and Characterization of Clostridium perfringens Atypical CPB2 Toxin in Cell Cultures and Field Samples Using Monoclonal Antibodies. Toxins, 14.","DOI":"10.3390\/toxins14110796"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.anaerobe.2017.07.008","article-title":"Spontaneous C. septicum gas gangrene: A literature review","volume":"48","author":"Srivastava","year":"2017","journal-title":"Anaerobe"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s40261-019-00867-5","article-title":"Collagenase Clostridium Histolyticum: A Review in Peyronie\u2019s Disease","volume":"40","author":"Hoy","year":"2020","journal-title":"Clin. Drug Investig."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Van Asbroeck, E., Vasileiadou, O., De Laere, S., Van Hedent, E., and Devue, K. (2022). Clostridium myonecrosis-a rare and underdiagnosed condition in the elderly: A case with severe skipping lesions and an overview of treatment guidelines. Int. J. Emerg. Med., 15.","DOI":"10.1186\/s12245-022-00458-w"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.ijantimicag.2018.07.009","article-title":"Comparative efficacy of antibiotics in treating experimental Clostridium septicum infection","volume":"52","author":"Aldape","year":"2018","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1093\/cid\/ciu296","article-title":"Wade Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America","volume":"59","author":"Dennis","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Alves, G.G., Gon\u00e7alves, L.A., Assis, R.A., Oliveira J\u00fanior, C.A., Silva, R.O.S., Heneine, L.G.D., and Lobato, F.C.F. (2021). Production and purification of Clostridium perfringens type D epsilon toxin and IgY antitoxin. Anaerobe, 69.","DOI":"10.1016\/j.anaerobe.2021.102354"},{"key":"ref_120","first-page":"CD010577","article-title":"Interventions for treating gas gangrene","volume":"3","author":"Yang","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.12968\/jowc.2021.30.Sup9.S8","article-title":"Early wound bed preparation: Irrigation and debridement","volume":"30","author":"Stiehl","year":"2021","journal-title":"J. Wound Care"},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Zhong, J.X., Zheng, H.R., Wang, Y.Y., Bai, L.L., Du, X.L., Wu, Y., and Lu, J.X. (2023). Molecular characteristics and phylogenetic analysis of Clostridium perfringens from different regions in China, from 2013 to 2021. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1195083"},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Vela, S., Mart\u00ednez-Sancho, A., Said, L.B., Torres, C., and Fliss, I. (2023). Pathogenicity and Antibiotic Resistance Diversity in Clostridium perfringens Isolates from Poultry Affected by Necrotic Enteritis in Canada. Pathogens, 12.","DOI":"10.3390\/pathogens12070905"},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Forti, K., Cagiola, M., Pellegrini, M., Anzalone, L., Di Paolo, A., Corneli, S., Severi, G., and De Giuseppe, A. (2020). Generation of recombinant baculovirus expressing atoxic C-terminal CPA toxin of Clostridium perfringens and production of specific antibodies. BMC Biotechnol., 20.","DOI":"10.1186\/s12896-019-0597-4"},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Ha, E., Son, B., and Ryu, S. (2018). Clostridium perfringens Virulent Bacteriophage CPS2 and Its Thermostable Endolysin LysCPS2. Viruses, 10.","DOI":"10.3390\/v10050251"},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Hamid, S., Gadr\u00e9, A., Fornander, L., Sj\u00f6wall, J., and Muhrbeck, M. (2023). Clostridium septicum myonecrosis following gardening: A case report. Int. J. Surg. Case Rep., 105.","DOI":"10.1016\/j.ijscr.2023.108000"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1742-481X.2012.01072.x","article-title":"Spontaneous clostridial myonecrosis after pregnancy-emergency treatment to the limb salvage and functional recovery: A case report","volume":"11","author":"Cerulli","year":"2014","journal-title":"Int. Wound J."},{"key":"ref_128","doi-asserted-by":"crossref","unstructured":"Gray, K.M., Padilla, P.L., Sparks, B., and Dziewulski, P. (2020). Distant myonecrosis by atraumatic Clostridium septicum infection in a patient with metastatic breast cancer. IDCases, 20.","DOI":"10.1016\/j.idcr.2020.e00784"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/7\/1464\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:19:18Z","timestamp":1760109558000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/7\/1464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,18]]},"references-count":128,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["microorganisms12071464"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms12071464","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,18]]}}}