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A hospital food-borne outbreak of diarrhea caused by Bacillus cereus: clinical, epidemiologic, and microbiologic
Abstract:
An outbreak of diarrhea involving 28 patients occurred in two wards of a chronic disease hospital. The illness was characterized by abdominal cramps and watery diarrhea without vomiting or fever. An epidemiologic investigation suggested food-borne intoxication and incriminated turkey loaf served at the preceding evening meal as the source of the outbreak. Bacillus cereus was isolated both from the stool of all 14 symptomatic patients who were cultured and from turkey loaf. No other enteropathogens were found. The isolate of B. cereus was shown to elaborate an enterotoxin that caused fluid secretion in assays in the rabbit ileal loop and suckling mice and that also caused a positive response in the Y-1 adrenal cell assay. B. cereus is an enteropathogen that should be sought in outbreaks of food-related gastroenteritis. This organism affects the gastrointestinal tract probably by the elaboration of enterotoxins.
Insights
A foodborne illness outbreak caused by Bacillus cereus affected 28 patients in a hospital. The bacteria, found in turkey loaf, produced toxins leading to diarrhea and abdominal cramps.
Area of Science:
- Microbiology
- Food Safety
- Epidemiology
Background:
- Diarrheal outbreaks in healthcare settings pose significant public health risks.
- Foodborne illnesses are a common cause of gastroenteritis, necessitating identification of causative agents.
Purpose of the Study:
- To investigate an outbreak of diarrhea in a chronic disease hospital.
- To identify the causative agent and source of the foodborne illness.
Main Methods:
- Epidemiological investigation including patient interviews and food source tracing.
- Microbiological analysis of patient stool samples and implicated food.
- Laboratory assays to detect enterotoxin production by isolated bacteria.
Main Results:
- Twenty-eight patients experienced symptoms of watery diarrhea and abdominal cramps.
- Bacillus cereus was identified in stool samples from symptomatic patients and the suspect food (turkey loaf).
- The isolated B. cereus produced enterotoxins confirmed through rabbit ileal loop, suckling mouse, and Y-1 adrenal cell assays.
Conclusions:
- Bacillus cereus was identified as the causative agent of the foodborne outbreak.
- Enterotoxin production by B. cereus is the likely mechanism for the observed gastrointestinal symptoms.
- B. cereus should be considered in the investigation of food-related gastroenteritis outbreaks.