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Two cases of type E infant botulism caused by neurotoxigenic Clostridium butyricum in Italy. J Infect Dis

The Journal of Infectious Diseases (Impact Factor: 5.78). 09/1986; 154(2):207-11. DOI: 10.1093/infdis/154.2.207
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ABSTRACT The first two confirmed cases of type E infant botulism occurred in two 16-week-old girls in Rome, Italy. The original diagnosis for the first patient was intestinal blockage due to an ileocecal invagination, which was treated surgically. Postoperatively, the patient became unresponsive and required ventilatory assistance. A diagnosis of infant botulism was then made. The second infant presented to the same hospital 7 1/2 months later with profound weakness, hypotonicity, mydriasis, and areflexia. This case was recognized as possible botulism at admission. Both cases were confirmed by detection and identification of type E botulinal toxin in stool specimens and in enrichment cultures of those specimens. The toxigenic organisms isolated were quite different from Clostridium botulinum type E. The apparent causative organism in each case resembles Clostridium butyricum but produces a neurotoxin that is indistinguishable from type E botulinal toxin by its effects on mice and by its neutralization with type E botulinal antitoxin.

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    • "Clostridium botulinum is a taxonomic designation for three Groups of anaerobic spore-forming bacteria that share the common characteristic of production of one or more botulinum neurotoxins (BoNTs) having conserved modes of action but widely varying genetic sequences (Collins and East, 1998). In addition, certain Clostridium argentinense, Clostridium baratii and Clostridium butyricum strains have been isolated that produce BoNTs (Aureli et al., 1986; Gimenez and Ciccarelli, 1970; Hall et al., 1985). BoNTs are extremely potent toxins that are of concern in public health and food safety, and they are also monitored for national security reasons. "
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    ABSTRACT: The whole genomes for six botulinum neurotoxin-producing clostridial strains were sequenced to provide references for under-represented toxin types, bivalent strains or unusual toxin complexes associated with a bont gene. The strains include three Clostridium botulinum Group I strains (CDC297, CDC 1436, and Prevot 594), a Group II C. botulinum strain (Eklund 202F), a Group IV Clostridium argentinense strain (CDC 2741), and a Group V Clostridium baratii strain (Sullivan). Comparisons of the Group I genomic sequences revealed close relationships and conservation of toxin gene locations with previously published Group I C. botulinum genomes. The bont/F6 gene of strain Eklund 202F was determined to be a chimeric toxin gene composed of bont/F1 and bont/F2. The serotype G strain CDC 2741 remained unfinished in 20 contigs with the bont/G located within a 1.15 Mb contig, indicating a possible chromosomal location for this toxin gene. Within the genome of C. baratii Sullivan strain, direct repeats of IS1182 insertion sequence (IS) elements were identified flanking the bont/F7 toxin complex that may be the mechanism of bont insertion into C. baratii. Highlights of the six strains are described and release of their genomic sequences will allow further study of unusual neurotoxin-producing clostridial strains. Copyright © 2014. Published by Elsevier B.V.
    Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases 03/2015; 30:102-113. DOI:10.1016/j.meegid.2014.12.002 · 3.26 Impact Factor
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    • "However, some strains have acquired the type E botulinal neurotoxin gene (BoNT/E) and have caused both infant and classical foodborne botulism. The first recorded incident of C. butyricum type E botulism was a case of infant botulism in Italy [16]. Further cases of intestinal colonization by toxigenic C. butyricum strains were recorded in Italy but in older patients [17]. "
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    ABSTRACT: Some rare strains of Clostridium butyricum carry the gene encoding the botulinal type E neurotoxin and must be considered as possible hazards in certain types of food. The limiting growth conditions for C. butyricum were determined in peptone yeast glucose starch (PYGS) broth incubated anaerobically at 30°C for up to 42 days. The minimum pH values permitting growth depended on the acidulant and strain. Organic acids were more effective at inhibiting growth than HCl as expected. The lowest pH values at which growth of toxigenic and nontoxigenic strains of C. butyricum was observed in broth acidified with HCl were 4.1 and 4.2, respectively. In organic acids, however, the minimum pH varied between 4.4 and 5.1 depending on acid type and concentration. The minimum water activity for growth of toxigenic strains of C. butyricum was 0.96. The minimum growth temperatures of the toxigenic strains of C. butyricum (ca 10-11°C) were somewhat higher than for non-toxigenic ones (8°C). It was concluded that control of toxigenic C. butyricum in the food industry needs to allow for the greater pH tolerance of this species compared with proteolytic C. botulinum.
    09/2013; 2013:731430. DOI:10.1155/2013/731430
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    • "Clostridium butyricum was considered a non-pathogen clostridium until 1986, when the first two cases of botulism linked with C. butyricum were reported in Italy (Aureli et al., 1986). Neurotoxigenic C. butyricum type E has been implicated in infectious botulism (Aureli et al., 1986; Fenicia et al., 1999a) and has lately been shown to be an evolving foodborne pathogen (Aureli et al., 1986; Meng et al., 1997; Meng et al., 1999; Pourshaban et al., 2002). Neurotoxigenic C. butyricum was also isolated from food implicated in an outbreak of clinically diagnosed type E botulism in China (Meng et al., 1997). "
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    ABSTRACT: Clostridia such as Clostridium tyrobutyricum, C. pasteurianum and C. butyricum may cause spoilage problems in certain types of food, but they are not normally regarded as dangerous. However some strains of C. butyricum have acquired the type E botulinum neurotoxin gene and have caused both infant and classical botulism in Italy (1986), China (1994) and India (1996). This study was carried out to examine a range of samples from fresh vegetables to food and environmental samples in the UK and test their ability to produce type E botulinal neurotoxin (BoNT) by probing for the presence of the toxin gene. Samples were enriched in modified Bhat and Barker (MBB) broth which is a minimal medium with lactate and acetate as a source of carbon and energy. In addition selective antibiotics are present in the medium to favour the growth of C. butyricum. This was followed by plating out onto iron sulphite agar (ISA) for isolation of C. butyricum from food and environmental samples. A total of 978 samples were tested and 302 (31%) yielded presumptive C. butyricum isolates. The highest percentage of positives came from soil, potato skins, Swede skin, yoghurt and cream. No positive isolates were obtained from pate, garlic or spring greens. A sub-sample of isolates was examined for the presence of gene encoding the type E botulinum neurotoxin using PCR. Only one of the many existing PCR methods was successful and therefore used for screening C. butyricum isolates for the presence of the type E toxin gene. None of the 93 tested isolates were found to be toxigenic (type E botulinal neurotoxin).
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