Paper I
2021 February (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Nagler reaction

Q122 marksShort Notes

Answer

Nagler’s reaction is a laboratory test that demonstrates lecithinase (phospholipase C/alpha-toxin) activity, used most classically to identify Clostridium perfringens and confirm its role in gas gangrene.

Principle: alpha-toxin (lecithinase C) hydrolyses lecithin present in egg-yolk agar, producing an opaque zone of turbidity around bacterial growth. This lecithinase activity can be specifically inhibited by pre-treating half of an egg-yolk agar plate with Clostridium perfringens type A antitoxin.

Procedure: an egg-yolk agar plate is divided into two halves — one spread with specific antitoxin, the other left untreated; the test organism is streaked across both halves and incubated anaerobically. On the untreated half, the organism produces an opaque zone of lecithinase-mediated precipitation; on the antitoxin-treated half, this opacity is inhibited.

Interpretation: a positive Nagler reaction (opacity on the untreated half, inhibited on the antitoxin half) confirms lecithinase (alpha-toxin) production, supporting identification of C. perfringens.

Clinical significance: alpha-toxin is the principal virulence factor in C. perfringens gas gangrene, causing membrane damage, tissue necrosis, and haemolysis — Nagler’s reaction links laboratory identification directly to the organism’s pathogenic mechanism.

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