{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:21:06Z","timestamp":1774444866742,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Clostridium tertium is an emerging opportunistic pathogen typically associated with immunocompromised hosts, yet it can also cause serious infections in non-neutropenic individuals. We present a case of postoperative peritonitis and bacteremia caused by C. tertium in a non-neutropenic 75-year-old woman following emergency obturator hernia repair. Diagnosis was confirmed by matrix-assisted laser desorption\/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and successful treatment was achieved with piperacillin\u2013tazobactam combined with levornidazole alongside surgical source control. A review of 128 cumulative cases (including ours) revealed two distinct patterns: bacteremia in severely neutropenic patients versus a broader spectrum of localized and bloodstream infections in non-neutropenic hosts, often linked to intestinal barrier disruption. Mortality was largely driven by underlying comorbidities and polymicrobial sepsis. These findings indicate that C. tertium infection should be considered in non-neutropenic patients with postoperative or gastrointestinal barrier-disruptive infections, especially when there is a poor response to initial empiric therapy. Consequently, in such clinical scenarios, empirical therapy should be guided by its unique resistance pattern, favoring carbapenems, vancomycin, or piperacillin\u2013tazobactam, often combined with a nitroimidazole, alongside urgent source control.<\/jats:p>","DOI":"10.3390\/pathogens15040348","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:07:13Z","timestamp":1774433233000},"page":"348","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Intra-Abdominal Clostridium tertium Infection Following Obstructed Obturator Hernia Repair: A Case Report and Literature Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Jin","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Jiangbei District of Zhongda Hospital Affiliated to Southeast University, Nanjing 210048, China"},{"name":"Department of Pharmacy, Nanjing Dachang Hospital, Nanjing 210048, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanjun","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongjing","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Jiangbei District of Zhongda Hospital Affiliated to Southeast University, Nanjing 210048, China"},{"name":"Department of Pharmacy, Nanjing Dachang Hospital, Nanjing 210048, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuchen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Jiangbei District of Zhongda Hospital Affiliated to Southeast University, Nanjing 210048, China"},{"name":"Department of Pharmacy, Nanjing Dachang Hospital, Nanjing 210048, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-0580","authenticated-orcid":false,"given":"Xiangkai","family":"Zhuge","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, School of Public Health, Nantong University, Nantong 226019, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/IPC.0000000000000373","article-title":"Sustained Clostridium tertium Bacteremia in a Nonneutropenic Patient: A Case Report and a Review of the Literature","volume":"24","author":"Nambiar","year":"2016","journal-title":"Infect. 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