Question

Please use the picture of Clostridium difficile pathogenesis to fill in the following table: ( VF-- Virulence Factors)

Clostridium difficile spores and vegetative cells are ingested • Spores Vegetative cells Most vegetative cells are killed in the stomach, but spores can survive the acid environment C. difficile multiplies in the colon Stomach Colon Small bowel Gut mucosa facilitates adherence to the colonic epithelium Flagellae facilitate C. difficile movement; a polysaccharide capsule discourages phagocytosis C. difficile spores germinate in the small bowel upon exposure to bile acids Pseudomembrane Fibrin A A A AB R B. Colonic epithelial cells A B ᎧᎧDᏗ Ꭰ27 Mucin Ꮧ Mucosa Blood vessel Neutrophils and monocytes C. difficile vegetative cells produce toxins A and B and hydrolytic enzymes (1). Local production of toxins A and B leads to production of tumour necrosis factor-alpha and proinflammatory interleukins, increased vascular permeability, neutrophil and monocyte recruitment (2), opening of epithelial cell junctions (3) and epithelial cell apoptosis (4). Local production of hydrolytic enzymes leads to connective tissue degradation, leading to colitis, pseudomembrane formation (5) and watery diarrhea.

VF Factor	Molecule/Structure	Ability/Action	VF Characteristic
		Allows C. difficile to move through mucous
Hydrolytic enzymes
		Survive acid of stomach
Capsule
		Increase vascular permeability

Answer 1

6466 cu ve factor Melecule/Structure flagellat for metility and adherence Ability lathon Alloux diffected move through mec Hydrolyte egyme I Enfyme Spores • Heat rehilant) Capsule Vi character Rasprouble for bacterium Lithild, reedel for adhe Vand calonuation deads to connective of puthetium 7 the matestinal tau degradation, pendo membrane Keration Catud watey liarrhea Survive aud Stomat Heat ruhlant sooner.enchler the suruwe harth conotition Coole pettide dacouragt Marder eliminati phagocytuno and polysaccharide capsule Chemiotaxis du courage phagocytos Increase vascular facilitate tissue damage caud necrosis permeability produce tumor necraus factor alpha and proinflammat ory interleutin Toxin - enketown toxin 8- Cytotelin (polysaccharide capsule) Toxin A and A 8 Toxin B Entertorin