Phenotypic characterization and prevalence of enterotoxin genes in Staphylococcus aureus isolates from outbreaks of illness in Chengdu City

Coordination of prophage and global regulator leads to high enterotoxin production in staphylococcal food poisoning-associated lineage

Staphylococcus species in food produce Staphylococcal enterotoxins (SEs) that cause Staphylococcal food poisoning (SFP). More than 20 SE types have been reported, among which Staphylococcal enterotoxin A (SEA) has been recognized as one of the most important SEs associated with SFP. However, the regulatory mechanisms underlying its production remain unclear. Previously, we identified a major SFP clone in Japan, CC81 subtype-1, which exhibits high SEA production. In this study, we attempted to identify the factors contributing to this phenomenon. Thus, we demonstrated that the attenuation of the activity of endogenous regulator, Staphylococcal accessory regulator S (SarS), and the lysogenization of a high SEA-producing phage contributed to this phenomenon in CC81 subtype-1. Furthermore, our results indicated that SarS could directly bind to the promoter upstream of the sea gene and suppress SEA expression; this low SarS repression activity was identified as one of the reasons for the high SEA production observed. Therefore, we revealed that both exogenous and endogenous factors may probably contribute to the high SEA production. Our results confirmed that SE production is a fundamental and critical factor in SFP and clarified the associated production mechanism while enhancing our understanding as to why a specific clone frequently causes SFP.

IMPORTANCE

The importance of this study lies in its unveiling of a molecular regulatory mechanism associated with the most important food poisoning toxin and the evolution of Staphylococcal food poisoning (SFP)-associated clone. SFP is primarily caused by Staphylococcus aureus, with Staphylococcal enterotoxin A (SEA) being commonly involved in many cases. Thus, SEA has been recognized as a major toxin type. However, despite almost a century since its discovery, the complete mechanism of SEA production is as yet unknown. In this study, we analyzed an SEA-producing SFP clone isolated in East Asia and discovered that this strain, besides acquiring the high SEA-producing phage, exhibits remarkably high SEA production due to the low activity of SarS, an intrinsic regulatory factor. This is the first report documenting the evolution of the SFP clone through the coordinated action of exogenous mobile genetic factors and endogenous regulators on this notorious toxin.

Occurrence and Patterns of Enterotoxin Genes, spa Types and Antimicrobial Resistance Patterns in Staphylococcus aureus in Food and Food Contact Surfaces in Singapore

Staphylococcus aureus contamination of food and food contact surfaces is a public health concern given its virulent and antimicrobial-resistant properties worldwide. In this study, a total of 181 MSSA isolates were analyzed for SE genes, antimicrobial resistance patterns, and spa types. Overall, 24.9% of isolates were positive for SE gene detection, with sea being the most prevalent classical SE (18.8%). The most predominant sample sources for SE gene contamination were hand swabs for sea (6/48), meat dishes for seb (3/14) and seafood dishes for sec (2/24). Antimicrobial resistance was also observed at relatively high frequencies for the clinically important antibiotics penicillin G and ampicillin (both 54.7%), followed by tetracycline (14.9%) and azithromycin (8.8%). In addition, characterization of spa types revealed spa type t5078 to be the most predominant (40.3%), with significant associations between spa types t127 and t5521 and the sea gene. This study offers insights into the enterotoxin gene and antimicrobial resistance profiles of S. aureus in cooked or ready-to-eat food to inform future surveillance and epidemiological studies.

Antibiotics Resistance and Virulence of Staphylococcus aureus Isolates Isolated from Raw Milk from Handmade Dairy Retail Stores in Hefei City, China

Handmade dairy products, which retain the nutrients in milk to the greatest extent, have become popular in China recently. However, no investigation regarding the characteristics of Staphylococcus aureus (S. aureus) in raw milk of handmade dairy retail stores has been reported. Here, we investigated the antimicrobial susceptibility, virulence, biofilm formation, and genetic diversity of S. aureus in raw milk from handmade dairy retail stores in Hefei, China. After 10 months of long-term monitoring, 50 S. aureus strains were isolated from 69 different raw milk samples, of which 6 were positive for methicillin-resistant S. aureus (MRSA). The resistance rates of these isolates to ampicillin, erythromycin, kanamycin, tetracycline, sulfamethoxazole-trimethoprim, gentamicin, ofloxacin, oxacillin, chloramphenicol, and doxycycline were 56, 54, 40, 24, 22, 22, 18, 14, 8 and 6%, respectively. All 50 isolates were susceptible to vancomycin and 29 strains (58%) showed multidrug resistance phenotype. For enterotoxins genes, selp (14%) was detected the most frequently, followed by sea (6%), sec (4%), sei (4%), ser (4%), selj (4%), and seh (2%). By microplate assay, 32 and 68% of the strains showed moderate and strong biofilm formation ability, respectively. Fifty isolates were discriminated into nine spa types, and the most common spa typing was t034 (42%). The results of this study indicate that S. aureus from raw milk may constitute a risk concerning food poisoning, and more attention must be given to awareness and hygienic measures in the food industry.

Prevalence and Diversity of Staphylococcus aureus and Staphylococcal Enterotoxins in Raw Milk From Northern Portugal

Staphylococcus aureus and staphylococcal enterotoxins are a serious public health concern associated with hospital and community-acquired illnesses. Dairy animals frequently shed S. aureus into the milk supply which can lead to food poisoning in humans. This study aims to investigate the prevalence and genetic diversity of S. aureus and staphylococcal enterotoxins in raw milk from the main dairy region of mainland Portugal. S. aureus was found in 53.0% (95% CI: 40.6-65.4%) of 100 raw cow's milk samples collected from bulk cooling tanks. The highest contamination level was 3.4 log10 CFU.mL^-1, and in some samples more than one S. aureus strain was identified. Staphylococcal enterotoxins (SEA-SEE) were detected in one sample. Spa typing revealed 62 distinct S. aureus isolates, being t529 (17.7%, 95% CI: 8.2-27.3%) and t1403 (16.1%, 95% CI: 7.0-25.3%) the predominant types, commonly associated with livestock infection or carriage. The antimicrobial susceptibility test showed that 35.5% of the S. aureus isolates were resistant to at least one antimicrobial agent, with resistance to penicillin being the highest (32.3%, 95% CI: 20.6-43.9%) followed by tetracycline (24.2%, 95% CI: 13.5-34.9%), ciprofloxacin (16.1%, 95% CI: 7.0-25.3%) and chloramphenicol (16.1%, 95% CI: 7.0-25.3%). Moreover, five isolates (8.1%, 95% CI: 1.3-14.8%) were identified as methicillin-resistant S. aureus (MRSA, cefoxitin resistant). Regarding virulence/resistance genes, 46,8% (95% CI: 34.4-59.2%) isolates harbored at least one enterotoxin-encoding gene, and the seg gene was the most frequently detected (41.9%, 95% CI: 29.7-54.2%) followed by the sei (40.3%, 95% CI: 28.1-52.5%), sec (6.5%, 95% CI: 0.3-12.6%), seh (4.8%, 95% CI: 0.0-10.2%), and sea (1.6%, 95% CI: 0.0-4.7%) genes. Five (8.1%, 95% CI: 1.3-14.8%) non-enterotoxigenic isolates carried the mecA gene (corresponding to isolates phenotypically classified as MRSA), and 4.8% (95% CI: 0.0-10.2%) enterotoxigenic strains also had the tsst-1 gene. Our study confirm that raw milk can be a zoonotic source of S. aureus, including enterotoxigenic and MRSA strains. Furthermore, the majority of enterotoxigenic isolates were found to contain genes encoding SEs (SEG, SEH and SEI) not routinely screened. This shows the need for a broader SE screening in food safety control, as well as the relevance of risk mitigation measures to control S. aureus transmission along the food chain in Portugal.

Prevalence, Antimicrobial Resistance, and Molecular Characterization of Staphylococcus aureus Isolated from Animals, Meats, and Market Environments in Xinjiang, China

Staphylococcus aureus has been recognized as an important foodborne pathogen. However, knowledge about the epidemiology and genetic characteristics of S. aureus in the meat production chain from farm to market is limited. The aim of this study was to investigate the genetic characteristics of S. aureus in animal samples isolated from Xinjiang province farms and farmer' markets, by determining staphylococcal protein A (spa) repeat region and virulence factor typing, and by assessment of antimicrobial resistance. Out of 1324 samples, 128 (9.7%) were positive for S. aureus, 26 (2.0%) of them were identified as methicillin-resistant S. aureus (MRSA) and 88 (6.6%) of them were identified as vancomycin-resistant S. aureus (VRSA). Antimicrobial resistance was determined using the disk diffusion method. S. aureus isolates showed resistance to penicillin G (98.4%), clarithromycin (69.5%), erythromycin (69.5%), vancomycin (68.8%), and tetracycline (67.2%). A total of 80.4% of isolates showed resistance to three or more antimicrobial classes. PCR was used to detect ten virulence genes such as the enterotoxin (sea, seb, and sec), hemolysin (hla and hlb), clumping factor (clfA), and fibronectin-binding proteins A and B (fnbA and fnbB). Our study showed that isolates harbored two or seven virulence genes. All strains encode hla and clfA, and half of them encode hlb and enterotoxin genes. The spa typing results showed that the 128 isolates were grouped into 32 spa types. The main spa types were t127 (22.7%), t2592 (12.5%), t437 (10.9%), and t2616 (10.9%). Notably, isolates of t437 type accounted for 46.2% of the MRSA. Our data indicate that meats in the slaughterhouse and farmers' markets were contaminated with S. aureus. S. aureus virulence genes and spa types were diverse, and its antibiotic resistance was serious. The presence of MRSA and VRSA represents potential public health risks and warrants further investigation regarding the driving factors of such resistance and their transmission to humans.

Methicillin-resistant Staphylococcus aureus from infected skin lesions present several virulence genes and are associated with the CC30 in Brazilian children with atopic dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease and colonization by Staphylococcus aureus may affect up to 100% of these patients. Virulent and resistant isolates can worsen AD patient clinical condition and jeopardize the treatment. We aimed to detect virulence genes and to evaluate the biofilm production of S. aureus isolates from infected skin lesions of children with AD. Methicillin resistance was detected by phenotypic and molecular tests and the virulence genes were detected by PCR. Biofilm formation was assessed by bacterial growing on microtiter plates and later stained with safranin. Genotyping was performed by Pulsed-Field Gel Electrophoresis and Multilocus Sequence Typing. Among 106 AD patients, 55 (51.8%) had developed S. aureus cutaneous infections and 23 (41.6%) were methicillin-resistant (MRSA). All 55 isolates carried the fnbA, hla, icaA, sasG, and seu genes, and more than 70% presented cna, eap, ebpS, hlg, and pvl genes. Clonal complex (CC) 30 was the main lineage found (34.5%), especially among MRSA isolates (52.2%). The egc cluster and the bbp gene were significantly the most frequent in MRSA isolates and in USA1100/ST30/CC30 lineage. Most of the isolates (74.5%) were non-biofilm producers and many of them only started to produce it in the presence of fibrinogen. There was no significant association between S. aureus isolates features and the AD severity. This study demonstrated a high frequency of CC30 MRSA isolates presenting several virulence genes in infected skin lesions of AD children in Brazil, that may influence the severity of the disease and the treatments required.

Short communication: Enterotoxigenic potential of coagulase-negative staphylococci isolated from bovine milk in Poland

Our objective was to assess the enterotoxigenic potential of coagulase-negative staphylococci (CNS) isolated from bovine milk in Poland. We analyzed CNS isolates collected from 133 bovine milk batches from dairy farms in the Western Pomerania district during 2 milking seasons. A total of 163 isolates were screened by multiplex/duplex PCR for the presence of 18 of 25 enterotoxin genes identified so far in Staphylococcus aureus. The CNS strains presumed to be potentially enterotoxigenic were identified at the species level based on MALDI-TOF mass spectrometry analysis. Based on the presence of an amplicon matching D, G, or O enterotoxin genes, we initially identified 32 of the 163 CNS isolates tested as potentially enterotoxigenic. However, only 8 of these strains were confirmed as such. All 8 of these CNS strains, identified as Staphylococcus haemolyticus, harbored the seg genes, a prerequisite for enterotoxin G production, but so far not connected with staphylococcal foodborne poisoning cases. None of the CNS bovine milk isolates tested was a potential producer of classical A to E staphylococcal enterotoxins. Results of our surveys revealed a low prevalence of enterotoxigenic CNS among the milk isolates from dairy farms in the Western Pomerania district, Poland, suggesting that they pose only a mild health risk in milk. In our opinion, confirmed formation of nonspecific amplicons leading to false-positive results excludes multiplex/duplex PCR as the sole method for assessing the enterotoxigenic potential of CNS.

Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in bulk tank milk, livestock and dairy-farm personnel in north-central and north-eastern Greece: Prevalence, characterization and genetic relatedness

Recently, there has been an increased tendency towards raw-milk consumption, which may pose a consumer risk, due to the possible presence of human pathogenic microorganisms, such as Staphylococcus aureus and even methicillin-resistant S. aureus (MRSA). The prevalence of S. aureus and methicillin-resistant S. aureus (MRSA) was investigated in 40 dairy (cattle, sheep and goat) farms in northern Greece. S. aureus and MRSA were detected in 47.8% and 4.1% of the 387 samples (raw milk, farmers and animal samples) tested, respectively. Most (81.3%) of the MRSA isolates harbored the mecA gene, whereas the mecC or Panton-Valentine Leucocidin (PVL) genes were not detected. Seven spa types were identified, with t127 being the most prevalent. Spa type t034 (CC398) was isolated for the first time from livestock in Greece. Staphylococcal enterotoxin genes were detected in 93.8% of the MRSA isolates. The MRSA isolates were genetically diverse and were all capable of biofilm production. Our results confirm the lurking threat of MRSA in raw milk and dairy farms and suggest the need for surveillance programs starting at the farm level.

Genotypes, Enterotoxin Gene Profiles, and Antimicrobial Resistance of Staphylococcus aureus Associated with Foodborne Outbreaks in Hangzhou, China

Staphylococcal food poisoning is an illness caused by the consumption of food that contains sufficient amounts of one or more enterotoxins. In the present study, a total of 37 S. aureus isolates were recovered from leftover food, swabs from a kitchen environment, and patient feces associated with four foodborne outbreaks that occurred in Hangzhou, southeast China, and were characterized by multilocus sequence typing (MLST), spa typing, pulse-field gel electrophoresis (PFGE), and antimicrobial susceptibility. Classical enterotoxin and enterotoxin-like genes were profiled by PCR analysis. ST6-t304 was the most common clone (40.54%), followed by ST2315-t11687 (32.43%). Six clusters (A to F) were divided based on PFGE patterns, and Clusters A and C were the most common types, constituting 86.49% of all isolates. Moreover, sea was the most frequently identified enterotoxin gene (81.08%), followed by the combination of seg-sei-selm-seln-sleo-selu and sec-sell (each 48.65%). Five isolates also harbored the exotoxin cluster sed-selj-ser. In addition, resistance to penicillin (97.30%), erythromycin (37.85), tetracycline (32.43%), clindamycin, gentamicin, and sulfamethoxazole (each 10.81%) was observed. Our research demonstrated the link between leftover foods and patients by molecular typing and detecting the profiles of enterotoxin or enterotoxin-like genes in human and food isolates. S. aureus maintains an extensive repertoire of enterotoxins and drug resistance genes that could cause potential health threats to consumers.

Comparative Effects of Food Preservatives on the Production of Staphylococcal Enterotoxin I from Staphylococcus aureus Isolate

Staphylococcal enterotoxin I (SEI) is associated with staphylococcal food poisoning, but little is known about different food preservatives on the production of SEI. In this study, the effect of different food preservatives (sodium nitrite, polylysine, chitosan, and tea catechin) on the bacteria growth, sei gene expression, and extracellular SEI production of Staphylococcus aureus isolate H4 was detected in tryptone soya broth (TSB) culture. Our results showed that all of these preservatives depressed S. aureus H4 growth and the order of inhibitory effect was 0.8 g/L tea catechin > 6 g/L chitosan > 0.25 g/L polylysine > 0.4 g/L tea catechin > 0.15 g/L sodium nitrite. Furthermore, 0.25 g/L polylysine or 0.15 g/L sodium nitrite did not significantly alter sei gene transcription, while 6 g/L chitosan obviously increased the relative mRNA level of sei gene expression. 0.4 g/L tea catechin remarkably inhibited sei gene transcription. In addition, 0.15 g/L sodium nitrite and 6 g/L chitosan significantly enhanced SEI secretion. 0.25 g/L polylysine, especially 0.4 g/L tea catechin, sharply inhibited the level of SEI secretion. The results indicated that tea catechin not only suppressed Staphylococcus aureus growth, but also inhibited SEI production and secretion, suggesting that tea catechin may be better than sodium nitrite, polylysine, or chitosan for keeping the food from the contamination of SEI. These investigations would be useful for food industry to provide safer food products due to S. aureus enterotoxins-related control strategy.

Enterotoxin Gene Profile and Molecular Characterization of Staphylococcus aureus Isolates from Bovine Bulk Milk and Milk Products of Tigray Region, Northern Ethiopia

Staphylococcal food poisoning (SFP) is an important foodborne disease worldwide, and milk and milk products are commonly associated with SFP outbreaks. The objectives of this study were to investigate the distribution of staphylococcal enterotoxin (se) genes in Staphylococcus aureus from raw cow's milk and milk products and to assess their genetic background with the spa typing method. Of the 549 samples (297 bulk milk and 162 milk product samples) collected from Tigray region, Northern Ethiopia, 160 (29.1%) were positive for S. aureus, of which 82 (51%) were found to harbor se genes by a modified multiplex PCR. Nine se genes were identified: sea (n = 12), seb (n = 3), sec (n = 3), sed(n = 4), seg (n = 49), seh (n = 2), sei (n = 40), sej (n = 1), and tsst-1 (n = 24). The classical type of genes accounted for 27%. Of the 82 enterotoxigenic isolates, 41.5 and 12.4% harbored two or more se genes, respectively. The highest gene association was observed between sei and seg, whereas sea and seb were always found together with the new types of se genes. Altogether, 18 genotypes of toxin genes were identified, and 33% of the samples contained > 5 log CFU ml(-1) S. aureus. spa typing identified 22 spa types and three novel spa sequences, which showed the high genetic diversity of the isolates. No apparent relationship was observed between spa type and se genes. Of the 25 spa types, 13 (52%) were from raw milk, 3 (12%) from milk products, and 9 (36%) from both types of sample. Types t314 (20.7%,n = 17), t458 (18.3%, n = 15), and t6218 (9.8%, n= 8) were the most common spa types identified and were widely distributed in three of the eight studied localities. This is the first study from the Tigray region to report the high distribution of enterotoxigenic S. aureus with a diversified genetic background from dairy food. The study may provide valuable data for microbial food safety risk assessment, molecular epidemiology, and phylogenetic studies of S. aureus in Ethiopia.

High Prevalence and Properties of Enterotoxin-Producing Staphylococcus aureus ST5 Strains of Food Sources in China

Staphylococcus aureus with the ability of staphylococcal enterotoxins (SEs) production is one of the most common causes of bacterial foodborne outbreaks worldwide. In our study, 336 S. aureus isolates were recovered from 3476 food samples during 2010-2014. A total of 86 S. aureus isolates were proved to be enterotoxin-producing strains with PCR and enzyme-linked immunosorbent assay. In the 86 isolates, 20 STs were identified using multilocus sequence typing (MLST) and 20 isolates were typed as sequence type 5 (ST5), which was the most prevalent ST using MLST. There were six SE profiles and high carrier rates of sec (50%) and sed (75%) genes in the 20 S. aureus ST5 isolates. Additionally, 8 antibiotic resistance patterns were observed, and 10 multidrug-resistant isolates (50%) and 4 methicillin-resistant S. aureus isolates were identified. Our findings illustrate high prevalence of S. aureus ST5 isolates from food sources and diversity in SE profiles and antibiotic resistance patterns. These results indicate that great difference in the ability of obtaining SE production and antimicrobial resistance may exist between different genetic lineages of S. aureus strains.

Prevalence of Staphylococcus aureus in Imported Fish and Correlations between Antibiotic Resistance and Enterotoxigenicity

A total of 156 Staphylococcus aureus isolates were obtained from 330 imported fresh fish samples from three countries. Selective media were used for the isolation of S. aureus, and the isolates were confirmed by PCR. The isolates were tested for mecA gene, antibiotic resistance, and enterotoxin genes (sea, seb, sec, sed, see, seg, seh, and sei). Most isolates carried sea, seg, and sei genes, and seg-sei was the most frequent enterotoxin profile. About 88.5% of the S. aureus exhibited resistance to at least one antibiotic. High resistance to penicillin and ampicillin; low resistance to tetracycline, erythromycin, rifampin, and clindamycin; and very low resistance to cefotaxime, amoxicillin-clavulanic acid, gentamicin, and ciprofloxacin were exhibited by S. aureus from the three countries. In addition, some antibiotic resistance exhibited a strong correlation (P ≤ 0.01) with enterotoxigenicity in S. aureus. The study concluded that the large amount of globally traded fish increases the possibility of intercontinental transmission of enterotoxigenic and multidrug-resistant S. aureus through fish and highlights the potential influence of local fish handling and processing on consumer health worldwide. The introduction of periodic training in food safety and hygiene is essential to increase fish handlers' awareness of good hygienic practices in handling fish. These findings also enrich the ongoing debate about the risk of methicillin- and multidrug-resistant S. aureus as a foodborne pathogen compared with drug-susceptible S. aureus.

Further evidence for staphylococcal food poisoning outbreaks caused by egc-encoded enterotoxins

Staphylococcal food poisoning represents the most prevalent foodborne intoxication worldwide. It is caused by oral intake of enterotoxins preformed by Staphylococcus aureus in food. The relevance of newly described enterotoxins in outbreaks of staphylococcal food poisoning is controversially discussed. Although the staphylococcal enterotoxins SEG, SEI, SEM, SEN, and SEO elicit emesis in a monkey feeding assay, there has been no conclusive proof of their emetic activity in humans. In this study, we provide further evidence suggesting that one of these enterotoxins or a combination of SEG, SEI, SEM, SEN, and SEO cause staphylococcal food poisoning. We investigated two outbreaks registered with the Swiss Federal Office of Public Health, in which only Staphylococcus aureus strains harboring the egc cluster, including seg, sei, sem, sen, and seo linked to typical signs of staphylococcal food poisoning were isolated. The outbreaks were caused by consumption of raw goat cheese and semi-hard goat cheese, and were linked to strains assigned to CC45 (agr type I) and CC9 (agr type II), respectively. These outbreaks provide further evidence that newly-described staphylococcal enterotoxins are likely to cause staphylococcal food poisoning in humans.

Virulence and resistance gene profiles of staphylococcus aureus strains isolated from ready-to-eat foods

Staphylococcal food poisoning represents the most prevalent foodborne intoxication worldwide. Oral intake of staphylococcal enterotoxins from food can result in emesis and diarrhea and can be fatal in children and the elderly. Few data have been available on the characteristics and sources of Staphylococcus aureus strains isolated from ready-to-eat (RTE) foods. In this study, we used a DNA microarray to determine virulence and antimicrobial resistance gene profiles of S. aureus from RTE foods. A total of 267 S. aureus strains isolated from 244 RTE foods were investigated. The isolates originated from precooked foods (41% of isolates), meat and fish products (17%), cheese (13%), delicatessen salads (8%), sandwiches and canapés (8%), confectionery and bakery products (6%), and various other RTE foods (7%). Eleven samples (5%), of which 9 were raw milk cheeses, contained > 10(5) CFU/g, which is considered a health risk. Four S. aureus strains were associated with intoxications; three cases were linked to consumption of cheese and one case was linked to consumption of potato salad. DNA microarray results revealed that one-third of the tested strains had at least one major enterotoxin gene (sea through see). We also detected the toxic shock syndrome gene (18% of isolates) and various genes conferring antimicrobial resistance, including genes involved in resistance to beta-lactams (blaZ, 72% of isolates), methicillin (mecA, 1% of isolates), and vancomycin (vanB, 1% of isolates). S. aureus strains were most frequently assigned to clonal complex (CC) 30 (17% of isolates), CC8 (12%), CC15 (11%), and CC45 (10%), which are commonly detected in humans colonized or infected with S. aureus. Although a large proportion of the tested food items contained milk, we did not detect CC705, the most prevalent clonal complex among S. aureus isolates from bovine mastitis milk. Our results suggest that S. aureus isolates from RTE foods do not commonly originate from animals but more likely come from food handlers who contaminate foods.

Prevalence of enterotoxins and toxin gene profiles of Staphylococcus aureus isolates recovered from a bakery involved in a second staphylococcal food poisoning occurrence

AIMS

The study objective was to characterize and analyse the distribution of enterotoxins and genes encoding enterotoxins in Staphylococcus aureus strains recovered from the 601 environment and ingredient samples obtained during multiple inspections of a bakery implicated in two separate staphylococcal food poisoning incidents.

METHODS AND RESULTS

Staphylococcus aureus isolates were evaluated using serological assays for identification of classical staphylococcal enterotoxins (SEs) SEA-SEE and polymerase chain reaction for the detection of newly described SE and SE-like enterotoxin genes seg-seu. Pulsed field gel electrophoresis identified thirteen pattern types. During these investigations, a total of 585 environmental swabs and 16 raw ingredient samples were collected by investigators, 85 of which were confirmed to contain Staph. aureus; of those isolates, 95·3% (81/85) harboured enterotoxin genes and 4·7% (4/85) carried newly described SE and SE-like enterotoxin genes in the absence of classical enterotoxins.

CONCLUSIONS

Our research demonstrates the prevalence and diversity of classical SEs and the probable underestimated impact of nonclassical SE and SE-like enterotoxins role in domestic staphylococcal food poisoning outbreaks.

SIGNIFICANCE AND IMPACT OF THE STUDY

Given the abundance of SEs and SE-like toxins, these findings illustrate the utilization of PCR for enterotoxin gene identification and its significance in outbreak investigations.