Welder's Anthrax: A Tale of 2 Cases

Bacillus anthracis has traditionally been considered the etiologic agent of anthrax. However, anthrax-like illness has been documented in welders and other metal workers infected with Bacillus cereus group spp. harboring pXO1 virulence genes that produce anthrax toxins. We present 2 recent cases of severe pneumonia in welders with B. cereus group infections and discuss potential risk factors for infection and treatment options, including antitoxin.

cereus Group by Matrix-Assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry

ABSTRACT

Cereulide-producing Bacillus cereus, which causes foodborne illnesses with vomiting, and psychrotolerant B. cereus group strains such as Bacillus mycoides, which can grow at ≥7°C and cause spoilage of refrigerated foods, are significant concerns for the food industry. Rapid and simple methods to discriminate the cereulide-producing B. cereus and psychrotolerant B. cereus group strains from other B. cereus group strains are needed. We developed a novel, rapid, and simple method with matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) analysis for simultaneous discrimination of these two groups from other B. cereus group strains. A potassium adduct of cereulide was used to detect cereulide-producing B. cereus, and three ribosomal subunit proteins (L30, S16, and S20) were used to detect psychrotolerant B. cereus group. A total of 51 B. cereus group strains were analyzed by MALDI-TOF MS. The biomarkers allowed successful discrimination of 16 cereulide-producing B. cereus and 15 psychrotolerant B. cereus group strains from other B. cereus group strains. The results showed that this MALDI-TOF MS analysis allows simultaneous discrimination of cereulide-producing B. cereus and psychrotolerant B. cereus group strains from other B. cereus group strains. This efficient method has the potential to be a valuable tool for ensuring food safety.

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Effect of Hydrophobic or Hydrophilic Characteristics of B. cereus Spores on Their Resistance to Detergents

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Bacillus cereus spores have the ability to adhere to solid surfaces, including stainless steel, a material widely used in food industries. Adhesion of spores allows recontamination during food processing, and cleaning and disinfection are largely used by industries to control them. Hence, this study aims to assess the detachment capacity (or removing activity) of detergents based on sodium hydroxide, nitric acid, phosphoric acid, and chlorine against two adhered B. cereus spores (one hydrophobic and other hydrophilic) to stainless steel surfaces. Microorganism adhesion on the surfaces reached 5.5 log CFU/cm2 for the two strains studied. Two protocols composed of combinations of chemical compounds, concentration, temperature, and contact time were tested. The inactivation kinetics shapes were convex and modeled by the Weibull model. The effects of temperature and biocide concentration were quantified using a Bigelow-like model. The temperature applied during the cleaning-in-place treatment is an important factor acting on the speed of inactivation or detachment of B. cereus spores. However, this efficiency depends on the hydrophobic characteristics of B. cereus spores. The concentration of detergent and acid also affects the inactivation rate, whereas the characteristic of hydrophobicity does not intervene for the chlorine alkaline treatments.

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Evaluation of Ceftazidime as an Antibiotic Supplement in Mannitol-Yolk-Polymyxin B Agar Used for Enumeration of Bacillus cereus in Ready-to-Eat Vegetables

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The Bacillus cereus group of bacteria, which causes foodborne diseases, can be detected by culture on selective media. However, the presence of competing flora is the most common factor preventing the accurate enumeration of B. cereus on selective agars. In this study, we improved the selectivity of mannitol-yolk-polymyxin B agar (MYPA) and its modified version containing trimethoprim (mMYPA) developed in our previous study by supplementation with ceftazidime (16 μg/mL). Ceftazidime-supplemented MYPA (C-MYPA16) and mMYPA (C-mMYPA16) were evaluated for bacteria recovery and selectivity with three types of ready-to-eat vegetables. Four B. cereus and one Bacillus thuringiensis strains were mixed and artificially inoculated into vegetable salad, radish sprouts, and sprout mix and then recovered on MYPA, mMYPA, C-MYPA16, and C-mMYPA16. In all tested vegetables, mMYPA, C-MYPA16, and C-mMYPA16 culture resulted in similar recovery of B. cereus and B. thuringiensis (P > 0.05), whereas radish sprout and sprout mix colonies grown on MYPA were undistinguishable. C-mMYPA16 was the most selective medium because it eliminated most of the competing flora, especially that in sprouts, without negatively affecting the recovery of B. cereus and B. thuringiensis. Our results indicate that supplementation of mMYPA with ceftazidime may improve the selectivity of this medium for B. cereus and B. thuringiensis in food testing.

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cereus Isolates at Changing Temperatures

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In this study, Bacillus cereus was isolated from soft soybean curds, and a dynamic model was developed to describe the kinetic behavior of these isolates during transfer and storage. B. cereus isolates recovered from soft soybean curds were inoculated into soft soybean curd, and the levels were determined during storage at 10 to 30°C. The B. cereus counts were fitted to the Baranyi model to calculate maximum growth rate (μmax) and lag-phase duration (LPD). These kinetic parameters were then analyzed with a polynomial equation to evaluate the effects of temperature on the kinetic parameters. The developed model was validated with observed values, and the differences between predicted and observed values were determined by calculating the root mean square error (RMSE). A dynamic model was then developed with a combination of primary and secondary models to describe B. cereus growth under changing temperature conditions. B. cereus was detected in two soft soybean curd samples (5.1%) at 0.7 log CFU/g. The μmax was -0.04 to 0.47 log CFU/g/h, and the ln(LPD) was 3.94 to 0.04 h, depending on the storage temperature. The model performance was appropriate with a 0.216 RMSE and accurately described the kinetic behavior of B. cereus in soft soybean curd samples. These results suggest that B. cereus can contaminate soft soybean curds and that the models developed with the B. cereus isolates are useful for describing the kinetic behavior of B. cereus in soft soybean curd.

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Microbiological Contamination of Ready-to-Eat Algae and Evaluation of Bacillus cereus Behavior by Microbiological Challenge Test

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Consumption of seaweeds (forms of algae), often categorized as a superfood, is becoming popular in western countries. Algae can be marketed fresh, but are usually sold dehydrated to ensure longer shelf life. Their consumption, often as ready-to-eat, opens up possible risks for public health because of foodborne pathogens that can contaminate the raw material during harvesting or manipulation. In this study, 14 ready-to-eat foods based on dehydrated algae, representative of the most consumed species, were considered. The microbial content, with a focus on Listeria monocytogenes and Bacillus cereus, was investigated by plate counts, and B. cereus strains were isolated and identified by 16S rRNA gene sequencing. The microbiological quality was heterogeneous among the samples and, in particular, marine bacteria, Listeria spp., B. cereus, and coliforms were detected. To contribute to related risk assessment, the ability of B. cereus to grow during refrigerated storage was evaluated, to our knowledge for the first time, by a microbiological challenge test on two ready-to-eat foods based on Undaria pinnatifida and Palmaria palmata. Despite this study demonstrating the inability of B. cereus to proliferate in seaweed-based food, its presence in dehydrated foodstuffs cannot rule out replication after rehydration before consumption, making it necessary to elucidate the possible risks for consumers.

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High Risk of Potential Diarrheagenic Bacillus cereus in Diverse Food Products in Egypt

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Bacillus cereus is one of the important foodborne pathogens that can be found in various foodstuffs, causes diarrheal and/or emetic syndromes, and can cause severe systemic diseases that may lead to death. This study was conducted to evaluate the prevalence, antimicrobial susceptibility profile, pathogenic potential, and genotypic diversity of B. cereus isolates recovered from diverse food products collected from markets in Cairo, Egypt. Of 165 food samples investigated in this study, 39 (24%) were positive for B. cereus, with contamination levels of 2 to 6 log CFU/g or mL and a higher prevalence of levels >3 log CFU. Antimicrobial susceptibility testing revealed that the B. cereus isolates were fully sensitive to all tested antimicrobial agents except β-lactams. The pathogenic potential of the 39 B. cereus isolates was assessed by detecting and profiling genes encoding virulence factors or toxins: the chromosomal genes hblA, bceT, plc, sph, nheA, entFM, and cytK associated with the diarrheal syndrome and the plasmid ces gene associated with the emetic syndrome. The most frequently detected genes were hblA, nheA, and entFM. All isolates harbored more than one of the diarrheal enterotoxin genes, and the genetic profile hblA-bceT-nheA-entFM-cytK-plc-sph was the most prevalent (20 of 39 isolates). The emetic toxin gene ces was not detected in any isolate. Enterobacterial repetitive intergenic consensus analysis of the 20 B. cereus isolates harboring the most prevalent genetic profile revealed that these isolates were genetically distinct, with a Simpson index of diversity value of 0.989. These findings provide useful information for public health management and serve as a warning of the potential risk of diarrheagenic B. cereus in diverse food products. Therefore, extensive study of the epidemiology of this food pathogen in Egypt is warranted. Strict procedures should be developed to monitor, protect, and safely handle food products, particularly ready-to-eat foodstuffs that are usually consumed without heat treatment.

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Evidence for Bacillus cereus Spores as the Target Pathogen in Thermally Processed Extended Shelf Life Refrigerated Foods

The microbial safety concern associated with thermally processed extended shelf life (ESL) refrigerated foods is based on adequate elimination of spore-forming pathogens such as nonproteolytic Clostridium botulinum types B, E, and F. These pathogens are traditionally regarded as targets for validation of thermally processed ESL foods. However, their use for research is restricted due to their designation as select agents. In this study, the thermal resistances of spores of 10 nonproteolytic C. botulinum types B and F and seven psychrotrophic Bacillus cereus strains were evaluated in ACES (N-(2-acetamido)-2-aminoethanesulfonic acid) buffer (0.05 M, pH 7.00) and compared to determine whether any of the B. cereus strains could serve as a nonselect agent for establishing thermal processes for ESL refrigerated foods. Thermal decimal reduction times (DT-values) of both nonproteolytic C. botulinum types B and F and psychrotrophic B. cereus strains decreased as process temperature increased from 80 to 91°C, and the highest values were obtained at 80°C. All psychrotrophic B. cereus strains tested were more thermally resistant than nonproteolytic C. botulinum types B and F. DT-values of nonproteolytic C. botulinum types B and F decreased to <1.0 min at 87°C, whereas all psychrotrophic B. cereus strains had higher DT-values (i.e., 52.35 to 133.69 min) at the same temperature. Among all psychrotrophic B. cereus strains tested, BC-6A16 had the highest DT-values at any given temperature. The DT-values indicated that the psychrotrophic B. cereus strains were more thermally resistant than the nonproteolytic C. botulinum strains and therefore may be potential target pathogens for thermal process validation of ESL refrigerated foods. However, further comparative challenge studies are needed with a model food system or an ESL refrigerated food to confirm these results.

Optimization of the Antimicrobial Effects of Surfactin against Bacillus cereus Spores

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The purpose of this study was to establish a three-variable bactericidal model of temperature, time, and concentration to determine the optimal conditions for Bacillus cereus spore inactivation by surfactin. To obtain the binary regression equation of the inactivated spore model, a total of 17 simulations were performed using response surface methodology. The experimental results showed that the three factors each had a discernible but nonequal impact on the inactivation response value. Multiple regression analysis of experimental results using Design-Expert software yielded the following equation: Y = 1.47 + 0.39ξ1(temperature) + 0.38ξ2(time) + 0.39ξ3(concentration) - 0.20ξ1ξ2 + 0.22ξ1ξ2 - 0.12ξ2ξ3 - 0.23ξ12 - 0.11ξ22 - 0.40ξ32. Optimal inactivation of spores was achieved by treatment with surfactin at a concentration of 4 mg/mL for 40 h at 53°C, with the response value reaching 1.8. The spores were treated with surfactin under these conditions; the microstructural changes of spores were observed by use of scanning electron microscopy. We found that the structures of the outer wall of the spores were damaged, whereas the spores in the control sample showed no visible damage.

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Evaluating the Behavior of Staphylococcus aureus and Bacillus cereus in Dairy- and Non-Dairy-Based Aqueous Slurries during Manufacturing of Table Spreads

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High-moisture slurries used in the production of table spreads may permit growth of Staphylococcus aureus and Bacillus cereus and subsequent production of heat-stable enterotoxins. Compliance with the Food Safety Modernization Act (FSMA), specifically 21 CFR Part 117, subpart B and section 117.80 (c)(2) and (c)(3), requires a hazard analysis to determine whether preventive controls are needed. This study estimates the risk of potential growth of S. aureus and B. cereus in eight different dairy- and non-dairy-based slurries during extended storage and use. Mathematical models were used to screen which slurries might support the growth of S. aureus and B. cereus. Samples were individually inoculated with multiple strains of S. aureus and B. cereus to achieve a target level of 102 to 103 CFU/g. Inoculated and uninoculated slurry samples were incubated at typical holding temperatures of 35°C (95°F), 46.1°C (115°F), and 54.4°C (130°F). Samples were removed and tested following inoculation (time zero), after 4 and 12 h, and after 1, 2, 3, 4, 5, 6, 7, and 10 days of incubation at the target temperatures. All experiments were repeated in triplicate. Samples were analyzed for S. aureus and B. cereus using Baird-Parker agar and mannitol yolk polymyxin agar, respectively. Neither S. aureus nor B. cereus exceeded (P < 0.05) proposed food safety limits (105 CFU/g) at the evaluated experimental conditions. The study highlights the role of multiple hurdles (e.g., pH, potassium sorbate and sodium benzoate, salt, and other ingredients) in assuring microbiological safety of in-process dairy- and non-dairy-based slurries used in the production of table spreads. This study also found that mathematical models representative of product composition, intrinsic parameters, and experimental conditions can help risk managers make informed decisions during product development. Finally, the study findings indicate no significant risk of growth of the target pathogens associated with the dairy- and non-dairy-based aqueous slurries used in the routine manufacturing of table spreads.

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Outbreaks, Germination, and Inactivation of Bacillus cereus in Food Products: A Review

ABSTRACT

Bacillus cereus has been reported as a foodborne pathogen worldwide. Although food processing technologies to inactivate the pathogen have been developed for decades, foodborne outbreaks related to B. cereus have occurred. In the present review, foodborne outbreaks, germination, inactivation, and detection of B. cereus are discussed, along with inactivation mechanisms. B. cereus outbreaks from 2003 to 2016 are reported based on food commodity, number of cases, and consequent illnesses. Germination before sporicidal treatments is highlighted as an effective way to inactivate B. cereus, because the resistance of the pathogen increases significantly following sporulation. Several germinants used for B. cereus are listed, and their efficacies are compared. Finally, recently used interventions with sporicidal mechanisms are identified, and rapid detection methods that have been developed are discussed. Combining two or more interventions, known as the hurdle technology concept, is suggested to maximize the sporicidal effect. Further study is needed to ensure food safety and to understand germination mechanisms and sporicidal resistance of B. cereus.

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Influence of Cooling Rate on Growth of Bacillus cereus from Spore Inocula in Cooked Rice, Beans, Pasta, and Combination Products Containing Meat or Poultry

The objective of this study was to assess the ability of Bacillus cereus spores to germinate and grow in order to determine a safe cooling rate for cooked rice, beans, and pasta, rice-chicken (4:1), rice-chicken-vegetables (3:1:1), rice-beef (4:1), and rice-beef-vegetables (3:1:1). Samples were inoculated with a cocktail of four strains of heat-shocked (80°C for 10 min) B. cereus spores (NCTC 11143, 935A/74, Brad 1, and Mac 1) to obtain a final spore concentration of approximately 2 log CFU/g. Thereafter, samples were exponentially cooled through the temperature range of 54.5 to 7.2°C in 6, 9, 12, 15, 18, and 21 h. At the end of the cooling period, samples were removed and plated on mannitol egg yolk polymyxin agar. The plates were incubated at 30°C for 24 h. The net B. cereus growth from spores in beans was <1 log after 9 h of cooling, but the pathogen grew faster in rice and pasta. In combination products, the net growth was as follows: 3.05, 3.89, and 4.91 log CFU/g in rice-chicken; 3.49, 4.28, and 4.96 log CFU/g in rice-beef; 3.50, 4.20, and 5.32 CFU/g in rice-chicken-mixed vegetables; and 3.68, 4.44, and 5.25 CFU/g in rice-beef-mixed vegetables after 15, 18, and 21 h of cooling, respectively. This study suggests safe cooling rates for cooling cooked rice, beans, pasta, rice-chicken, rice-chicken-vegetables, rice-beef, and rice-beef-vegetables to guard against the hazards associated with B. cereus.