First Report Worldwide of an Infant Botulism Case Due to
            <i>Clostridium botulinum</i>
            Type E

Lúquez, Carolina; Dykes, Janet K.; Yu, Patricia; Raphael, Brian; Maslanka, Susan E.

doi:10.1128/jcm.01420-09

Cited by 31 publications

(8 citation statements)

References 14 publications

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“…For example, the vast majority of colonization botulism cases are a result of group I C. botulinum, C. baratii, and C. butyricum strains, presumably because they prefer a higher incubation temperature to group II C. botulinum strains [29]. Yet, recently a case of infant colonization botulism was reported as caused by a group II C. botulinum, type E, which have an optimal growth temperature of 25 • C [81]. Considering that adult intestinal toxemia botulism is difficult to diagnose and exceptionally rare, a concerted effort by healthcare professionals should be taken to identify and characterize this form of botulism.…”

Section: Recognition Of Casesmentioning

confidence: 99%

Adult Intestinal Toxemia Botulism

Harris

Anniballi

Austin

2020

Toxins

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Intoxication with botulinum neurotoxin can occur through various routes. Foodborne botulism results after consumption of food in which botulinum neurotoxin-producing clostridia (i.e., Clostridium botulinum or strains of Clostridium butyricum type E or Clostridium baratii type F) have replicated and produced botulinum neurotoxin. Infection of a wound with C. botulinum and in situ production of botulinum neurotoxin leads to wound botulism. Colonization of the intestine by neurotoxigenic clostridia, with consequent production of botulinum toxin in the intestine, leads to intestinal toxemia botulism. When this occurs in an infant, it is referred to as infant botulism, whereas in adults or children over 1 year of age, it is intestinal colonization botulism. Predisposing factors for intestinal colonization in children or adults include previous bowel or gastric surgery, anatomical bowel abnormalities, Crohn's disease, inflammatory bowel disease, antimicrobial therapy, or foodborne botulism. Intestinal colonization botulism is confirmed by detection of botulinum toxin in serum and/or stool, or isolation of neurotoxigenic clostridia from the stool, without finding a toxic food. Shedding of neurotoxigenic clostridia in the stool may occur for a period of several weeks. Adult intestinal botulism occurs as isolated cases, and may go undiagnosed, contributing to the low reported incidence of this rare disease.

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Section: Recognition Of Casesmentioning

confidence: 99%

Adult Intestinal Toxemia Botulism

Harris

Anniballi

Austin

2020

Toxins

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“…A recent outbreak of botulism in birds and fish in the Great Lakes region was attributed to genetically distinct strains of C. botulinum type E and the organism was also found in lake sediment [6]. A case of infant botulism occurred in Illinois in 2007 although the source of spores in this case could not be determined [7]. …”

Section: Introductionmentioning

confidence: 99%

Analysis of a unique Clostridium botulinum strain from the Southern hemisphere producing a novel type E botulinum neurotoxin subtype

et al. 2012

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BackgroundClostridium botulinum strains that produce botulinum neurotoxin type E (BoNT/E) are most commonly isolated from botulism cases, marine environments, and animals in regions of high latitude in the Northern hemisphere. A strain of C. botulinum type E (CDC66177) was isolated from soil in Chubut, Argentina. Previous studies showed that the amino acid sequences of BoNT/E produced by various strains differ by < 6% and that the type E neurotoxin gene cluster inserts into the rarA operon.ResultsGenetic and mass spectral analysis demonstrated that the BoNT/E produced by CDC66177 is a novel toxin subtype (E9). Toxin gene sequencing indicated that BoNT/E9 differed by nearly 11% at the amino acid level compared to BoNT/E1. Mass spectrometric analysis of BoNT/E9 revealed that its endopeptidase substrate cleavage site was identical to other BoNT/E subtypes. Further analysis of this strain demonstrated that its 16S rRNA sequence clustered with other Group II C. botulinum (producing BoNT types B, E, and F) strains. Genomic DNA isolated from strain CDC66177 hybridized with fewer probes using a Group II C. botulinum subtyping microarray compared to other type E strains examined. Whole genome shotgun sequencing of strain CDC66177 revealed that while the toxin gene cluster inserted into the rarA operon similar to other type E strains, its overall genome content shared greater similarity with a Group II C. botulinum type B strain (17B).ConclusionsThese results expand our understanding of the global distribution of C. botulinum type E strains and suggest that the type E toxin gene cluster may be able to insert into C. botulinum strains with a more diverse genetic background than previously recognized.

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“…BabyBIG } is available for treatment of infant botulism type A and type B, and the titers of antibodies in BabyBIG } against type A and B botulinum toxin are at least 3,000 and 540 LD 50 /mg antibody, respectively. Although the level of antibody against type E has not been measured, L áuquez et al reported that a patient rapidly recovered from type E infant botulism owing to treatment with BabyBIG } (27). We suggest that EC94 possesses high neutralizing activity against type E comparable to that of BabyBIG } , given estimates from the antibody titers against types A and B.…”

Section: Resultsmentioning

confidence: 99%

Production of a Neutralizing Mouse-Human Chimeric Antibody against Botulinum Neurotoxin Serotype E

et al. 2013

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SUMMARY: A mouse-human chimeric antibody that can neutralize botulinum neurotoxin serotype E (BoNT/E) was developed. Variable regions of heavy and light chains obtained using a mouse hybridoma clone (E9-4) cDNA, which was selected on the basis of neutralizing activity against BoNT/E, were fused with the upstream regions of the constant counterparts of human kappa light and gamma 1 heavy chain genes, respectively. CHO-DG44 cells were transfected with these plasmids and a mouse-human chimeric antibody (EC94) was purified to examine binding and neutralizing activity against BoNT/E. EC94 exhibited the same levels of binding activities against BoNT/E as those of a parent mouse monoclonal antibody and neutralized more than 4,000 LD 50 /mg antibody. This chimeric antibody seems to be a useful candidate for infant botulism in which the use of passive immunotherapy is not planned so as to avoid serious events such as anaphylactic shock. We designed shuffling chimeric antibodies with replacement of V H or V L of EC94 with that of a chimeric antibody (AC24) that possessed neutralizing activity against BoNT/A. These shuffling antibodies did not exhibit neutralizing activity against either BoNT/E or BoNT/A.

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First Report Worldwide of an Infant Botulism Case Due to Clostridium botulinum Type E

Abstract: Clostridium botulinum type E has been associated with botulism in adults but never in infants. Infant botulism type E cases have been associated with neurotoxigenic strains of C. butyricum . We report the first infant botulism case due to C. botulinum type E worldwide.

Cited by 31 publications

References 14 publications

Adult Intestinal Toxemia Botulism

Adult Intestinal Toxemia Botulism

Analysis of a unique Clostridium botulinum strain from the Southern hemisphere producing a novel type E botulinum neurotoxin subtype

Production of a Neutralizing Mouse-Human Chimeric Antibody against Botulinum Neurotoxin Serotype E

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