Two Cases of Type E Infant Botulism Caused by Neurotoxigenic Clostridium butyricum in Italy

Aureli, Paolo; Fenicia, Lucia; Pasolini, Beatrice; Gianfranceschi, Monica Virginia; McCroskey, L M; Hatheway, Charles L.

doi:10.1093/infdis/154.2.207

Cited by 234 publications

(123 citation statements)

References 18 publications

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“…Infectious botulism is related mainly to group I C. botulinum, as its temperature optimum for growth and subsequent toxin production is close to the body temperature, while the growth of group II organisms at the same temperature is limited (197). For infant botulism (150,172), in addition to group I C. botulinum types A and B (92,93), Bf (21), and F (99), cases due to type E and F toxins produced by Clostridium butyricum (18,92,144) and Clostridium baratii (22,88,119), respectively, have been reported. Infant botulism typically affects babies under 1 year of age, with the youngest reported patient being only 54 h old (22,119).…”

Section: Infant Botulismmentioning

confidence: 99%

Laboratory Diagnostics of Botulism

2006

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SUMMARY Botulism is a potentially lethal paralytic disease caused by botulinum neurotoxin. Human pathogenic neurotoxins of types A, B, E, and F are produced by a diverse group of anaerobic spore-forming bacteria, including Clostridium botulinum groups I and II, Clostridium butyricum, and Clostridium baratii. The routine laboratory diagnostics of botulism is based on the detection of botulinum neurotoxin in the patient. Detection of toxin-producing clostridia in the patient and/or the vehicle confirms the diagnosis. The neurotoxin detection is based on the mouse lethality assay. Sensitive and rapid in vitro assays have been developed, but they have not yet been appropriately validated on clinical and food matrices. Culture methods for C. botulinum are poorly developed, and efficient isolation and identification tools are lacking. Molecular techniques targeted to the neurotoxin genes are ideal for the detection and identification of C. botulinum, but they do not detect biologically active neurotoxin and should not be used alone. Apart from rapid diagnosis, the laboratory diagnostics of botulism should aim at increasing our understanding of the epidemiology and prevention of the disease. Therefore, the toxin-producing organisms should be routinely isolated from the patient and the vehicle. The physiological group and genetic traits of the isolates should be determined.

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Section: Infant Botulismmentioning

confidence: 99%

Laboratory Diagnostics of Botulism

2006

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“…[6][7][8] IB is the most common form of botulism, with about 80 to 100 cases reported annually in the USA. 9 Almost all cases of IB are caused by proteolytic C. botulinum group I strains that produce either type A or B (or Bf) neurotoxin. However, type E and F neurotoxins have been recovered from infants with botulism due to Clostridium butyricum 8,10 and Clostridium barati, [9][10][11][12] respectively.…”

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confidence: 99%

Infant botulism

Brook

2007

J Perinatol

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Infant botulism results from the absorption of heat-labile neurotoxin produced in situ by ingested Clostridium botulinum. Honey and environmental exposure are the main sources of acquisition of the organism. Clinical manifestations are owing to progressive neuromuscular blockade, initially of muscles innervated by cranial nerves and later of the trunk, extremities and diaphragm. Presynaptic autonomic nerves are also affected. The diagnosis is made on clinical grounds and is confirmed by recovery of the organism or by detection of toxin in the stool. Management includes meticulous supportive intensive care that may include mechanical ventilation and administration of human botulinum immunoglobulin in severe cases.

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“…In the order of their discovery, they have been named types A to G. However, the capability to produce BoNTs is not limited to C. botulinum only. Some strains of Clostridium baratii (8) and Clostridium butyricum (3,21) are toxigenic as well.…”

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Sensitive Detection of Botulinum Neurotoxin Types C and D with an Immunoaffinity Chromatographic Column Test

Gessler¹,

Hampe²,

Böhnel³

2005

Appl Environ Microbiol

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A sensitive and specific immunoassay for the simultaneous detection of Clostridium botulinum type C (BoNT/C) and type D neurotoxin was developed. Goat anti-mouse immunoglobulin G was bound to polyethylene disks in a small disposable column used for this assay. The sample was preincubated together with monoclonal antibodies specific for the heavy chain of BoNT/C and D and affinity-purified, biotinylated polyclonal antibodies against these neurotoxins. This complex was captured on the assay disk. Streptavidinpoly-horseradish peroxidase was used as a conjugate, and a precipitating substrate allowed the direct semiquantitative readout of the assay, if necessary. For a more accurate quantitative detection, the substrate can be eluted and measured in a photometer. Depending on the preincubation time, a sensitivity of 1 mouse lethal dose ml ؊1 was achieved in culture supernatants.Clostridium botulinum is a gram-positive, anaerobic, and spore-forming soil bacterium that can be found in the guts of domestic animals (9, 10). The fact that it produces the most toxic metabolite known to humans brought it to the attention of medical microbiologists in the early days of this field (27). Nowadays, seven distinct botulinum neurotoxins (BoNTs) are known. In the order of their discovery, they have been named types A to G. However, the capability to produce BoNTs is not limited to C. botulinum only. Some strains of Clostridium baratii (8) and Clostridium butyricum (3, 21) are toxigenic as well.The prevalence of C. botulinum in the soil might explain where the bacterium enters the food chain (20), leading to the best-known form of the disease in the worst case, food-borne botulism (25). The bacterium multiplies in food or feed under favorable conditions and produces the toxin, which is orally taken up by the host. The typical signs of flaccid paralysis develop, which are caused by the inhibition of acetylcholine release at the synapses (19).In animal husbandry and for wildlife, types C and D botulism are predominant. Throughout the world, millions of waterfowl have reportedly died from botulism caused by BoNT type C (BoNT/C) (24). BoNT/C and D are pathogenic for our domestic animals, with sometimes dramatic losses in the affected farms (6, 15). The losses of cattle reported from Brazil amount to five million animals over the past 10 years (18).However, the disease may present as a toxico infection as well. With the shaker foal syndrome in horses, it was shown that the bacteria colonize the gut and produce the toxin in the host animal (23). Visceral botulism in cattle (5) and equine grass sickness (7) might have a toxico infectious botulinum etiology as well.The recent concerns for the use of botulinum neurotoxins by bioterrorists (2) again highlighted the fact that only a limited number of tools are available to detect BoNTs. The mouse bioassay, still the most common method, needs to be replaced for obvious reasons. Recently, alternative in vitro tests (13, 17) have become commercially available. However, these assays are limited t...

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Two Cases of Type E Infant Botulism Caused by Neurotoxigenic Clostridium butyricum in Italy

Cited by 234 publications

References 18 publications

Laboratory Diagnostics of Botulism

Laboratory Diagnostics of Botulism

Infant botulism

Sensitive Detection of Botulinum Neurotoxin Types C and D with an Immunoaffinity Chromatographic Column Test

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