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Rawson AM, Dempster AW, Humphreys CM, Minton NP. Pathogenicity and virulence of Clostridium botulinum. Virulence 2023; 14:2205251. [PMID: 37157163 PMCID: PMC10171130 DOI: 10.1080/21505594.2023.2205251] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Clostridium botulinum, a polyphyletic Gram-positive taxon of bacteria, is classified purely by their ability to produce botulinum neurotoxin (BoNT). BoNT is the primary virulence factor and the causative agent of botulism. A potentially fatal disease, botulism is classically characterized by a symmetrical descending flaccid paralysis, which is left untreated can lead to respiratory failure and death. Botulism cases are classified into three main forms dependent on the nature of intoxication; foodborne, wound and infant. The BoNT, regarded as the most potent biological substance known, is a zinc metalloprotease that specifically cleaves SNARE proteins at neuromuscular junctions, preventing exocytosis of neurotransmitters, leading to muscle paralysis. The BoNT is now used to treat numerous medical conditions caused by overactive or spastic muscles and is extensively used in the cosmetic industry due to its high specificity and the exceedingly small doses needed to exert long-lasting pharmacological effects. Additionally, the ability to form endospores is critical to the pathogenicity of the bacteria. Disease transmission is often facilitated via the metabolically dormant spores that are highly resistant to environment stresses, allowing persistence in the environment in unfavourable conditions. Infant and wound botulism infections are initiated upon germination of the spores into neurotoxin producing vegetative cells, whereas foodborne botulism is attributed to ingestion of preformed BoNT. C. botulinum is a saprophytic bacterium, thought to have evolved its potent neurotoxin to establish a source of nutrients by killing its host.
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Affiliation(s)
- Alexander M Rawson
- Clostridia Research Group, BBSRC/EPSRC Synthetic Biology Research Centre (SBRC), School of Life Sciences, The Biodiscovery Institute, The University of Nottingham, Nottingham, UK
| | - Andrew W Dempster
- Clostridia Research Group, BBSRC/EPSRC Synthetic Biology Research Centre (SBRC), School of Life Sciences, The Biodiscovery Institute, The University of Nottingham, Nottingham, UK
| | - Christopher M Humphreys
- Clostridia Research Group, BBSRC/EPSRC Synthetic Biology Research Centre (SBRC), School of Life Sciences, The Biodiscovery Institute, The University of Nottingham, Nottingham, UK
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2
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Dabritz HA, Payne JR, Khouri JM. Duration of Fecal Excretion of Clostridium Botulinum and Botulinum Neurotoxin in Patients Recovering from Infant Botulism. J Pediatr 2023; 258:113396. [PMID: 37004956 DOI: 10.1016/j.jpeds.2023.113396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/06/2023] [Accepted: 03/25/2023] [Indexed: 04/04/2023]
Abstract
This study sought to determine duration of fecal excretion of Clostridium botulinum organisms and neurotoxin after onset of infant botulism in 66 affected infants. Median excretion was longer for type A than type B patients (organisms: 5.9 vs 3.5 weeks, toxin: 4.8 vs 1.6 weeks, respectively). Toxin excretion always ceased before organism excretion. Antibiotic therapy did not affect duration of excretion.
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Affiliation(s)
- Haydee A Dabritz
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratories Division, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA
| | - Jessica R Payne
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratories Division, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA
| | - Jessica M Khouri
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratories Division, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA.
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Goldberg B, Danino D, Levinsky Y, Levy I, Straussberg R, Dabaja-Younis H, Guri A, Almagor Y, Tasher D, Elad D, Baider Z, Blum S, Scheuerman O. Infant Botulism, Israel, 2007-2021. Emerg Infect Dis 2023; 29:235-241. [PMID: 36692296 PMCID: PMC9881770 DOI: 10.3201/eid2902.220991] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Infant botulism (IB) is an intestinal toxemia that manifests as descending paralysis, constipation, and, in some cases, respiratory failure. Laboratory-confirmed IB cases are rare, and recent data in Israel are lacking. We conducted a national multicenter retrospective study of laboratory-confirmed IB cases reported in Israel during 2007-2021. A total of 8 cases were reported during the study period. During 2019-2021, incidence may have increased because of a cluster of 5 cases. Infant median age for diagnosis was 6.5 months, older than previously reported (3 months). Most cases occurred during March-July. Honey consumption was reported in 1 case, and possible environmental risk factors (living nearby rural or construction areas, dust exposure, and having a father who works as a farmer) were reported in 6 cases. Although IB is rare, its incidence in Israel may have increased over recent years, and its epidemiology and risk factors differ from cases reported previously in Israel.
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Vázquez-Frias R, Ladino L, Bagés-Mesa MC, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos MC, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez NE, Roda J, Sanabria MC, Sánchez-Valverde F, Santiago RJ, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2023; 88:57-70. [PMID: 36737343 DOI: 10.1016/j.rgmxen.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/17/2022] [Indexed: 02/04/2023]
Abstract
Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.
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Affiliation(s)
- R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN.
| | - L Ladino
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - M C Bagés-Mesa
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - V Hernández-Rosiles
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN
| | - E Ochoa-Ortiz
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Departamento de Nutrición, Mexico City, Mexico
| | - M Alomía
- Posgrado de Pediatría, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - R Bejarano
- Servicio de Gastroenterología y Nutrición, Hospital de Especialidades Pediátricas, Ciudad de Panamá, Panama
| | - C Boggio-Marzet
- Grupo de Trabajo en Gastroenterología y Nutrición Pediátrica, Hospital General de Agudos "Dr. I. Pirovano", Buenos Aires, Argentina
| | | | - E Colindres-Campos
- Departamento de Pediatría, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - G Fernández
- Departamento de Gastroenterología, Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - E García-Bacallao
- Sección de Pediatría, Instituto de Gastroenterología, Universidad de Ciencias Médicas, La Habana, Cuba
| | - I González-Cerda
- Servicio de Pediatría, Hospital Militar Escuela "Dr. Alejandro Dávila Bolaños", Managua, Nicaragua
| | - A Guisande
- Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - C Guzmán
- Hospital La Católica, San José, Costa Rica
| | - F Moraga-Mardones
- Unidad de Nutrición, Servicio de Pediatría, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - J Palacios-Rosales
- Facultad de Medicina, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - N E Ramírez-Rodríguez
- Facultad de Medicina, Departamento de Medicina y Salud Mental, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - J Roda
- Gastroenterología e Nutrição Pediátrica, Hospital Pediátrico - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M C Sanabria
- Cátedra y Servicio de Pediatría, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - F Sánchez-Valverde
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Universitario de Navarra, NAVARRA BIOMED, Pamplona, Navarra, Spain
| | - R J Santiago
- Departamento de Pediatría y Unidad de Gastroenterología, Hepatología y Nutrición, Hospital Universitario de Valera "Dr. Pedro Emilio Carrillo", Universidad de Los Andes, Valera, Venezuela
| | - N Sepúlveda-Valbuena
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - J Spolidoro
- Escuela de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - P Valdivieso-Falcón
- Departamento de Pediatría, Servicio subespecialidades pediátricas, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru
| | | | - B Koletzko
- Departamento de Pediatría, Medical Centre of LMU Munich, Ludwig Maximilian University of Munich, Dr. von Hauner Children's Hospital, München, Germany
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5
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Vázquez-Frias R, Ladino L, Bagés-Mesa M, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos M, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez N, Roda J, Sanabria M, Sánchez-Valverde F, Santiago R, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consenso de alimentación complementaria de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica: COCO 2023. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2023. [DOI: 10.1016/j.rgmx.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Peñuelas M, Guerrero-Vadillo M, Valdezate S, Zamora MJ, Leon-Gomez I, Flores-Cuéllar Á, Carrasco G, Díaz-García O, Varela C. Botulism in Spain: Epidemiology and Outcomes of Antitoxin Treatment, 1997-2019. Toxins (Basel) 2022; 15:2. [PMID: 36668823 PMCID: PMC9863742 DOI: 10.3390/toxins15010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Botulism is a low incidence but potentially fatal infectious disease caused by neurotoxins produced mainly by Clostridium botulinum. There are different routes of acquisition, food-borne and infant/intestinal being the most frequent presentation, and antitoxin is the treatment of choice in all cases. In Spain, botulism is under surveillance, and case reporting is mandatory. METHODS This retrospective study attempts to provide a more complete picture of the epidemiology of botulism in Spain from 1997 to 2019 and an assessment of the treatment, including the relationship between a delay in antitoxin administration and the length of hospitalization using the Cox proportional hazards test and Kruskal-Wallis test, and an approach to the frequency of adverse events, issues for which no previous national data have been published. RESULTS Eight of the 44 outbreaks were associated with contaminated commercial foods involving ≤7 cases/outbreak; preserved vegetables were the main source of infection, followed by fish products; early antitoxin administration significantly reduces the hospital stay, and adverse reactions to the antitoxin affect around 3% of treated cases.
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Affiliation(s)
- Marina Peñuelas
- Escuela Internacional de Doctorado, Universidad Nacional de Educación a Distancia (UNED), Calle de Bravo Murillo, 38, 28015 Madrid, Spain
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, Pabellón 12, 28029 Madrid, Spain
| | - María Guerrero-Vadillo
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, Pabellón 12, 28029 Madrid, Spain
| | - Sylvia Valdezate
- Laboratorio de Referencia e Investigación en Taxonomía, Bacteriología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Carretera Pozuelo-Majadahonda Km 2.2, 28220 Madrid, Spain
| | - María Jesús Zamora
- Servicio de Microbiología Alimentaria, Centro Nacional de Alimentación, Agencia Española de Seguridad Alimentaria y Nutrición, Ctra. Pozuelo a Majadahonda Km 5.1, 28220 Madrid, Spain
| | - Inmaculada Leon-Gomez
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, Pabellón 12, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Ángeles Flores-Cuéllar
- Medicines for Human Use Department, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), C/Campezo 1, Edificio 8, 28022 Madrid, Spain
| | - Gema Carrasco
- Laboratorio de Referencia e Investigación en Taxonomía, Bacteriología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Carretera Pozuelo-Majadahonda Km 2.2, 28220 Madrid, Spain
| | - Oliva Díaz-García
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, Pabellón 12, 28029 Madrid, Spain
| | - Carmen Varela
- Department of Communicable Diseases, National Centre of Epidemiology, Instituto de Salud Carlos III, C/Monforte de Lemos 5, Pabellón 12, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Antonucci L, Locci C, Schettini L, Clemente MG, Antonucci R. Infant botulism: an underestimated threat. Infect Dis (Lond) 2021; 53:647-660. [PMID: 33966588 DOI: 10.1080/23744235.2021.1919753] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Infant botulism (IB) is defined as a potentially life-threatening neuroparalytic disorder affecting children younger than 12 months. It is caused by ingestion of food or dust contaminated by Clostridium botulinum spores, which germinate in the infant's large bowel and produce botulinum neurotoxin. Although the real impact of IB is likely underestimated worldwide, the USA has the highest number of cases. The limited reporting of IB in many countries is probably due to diagnostic difficulties and nonspecific presentation. The onset is usually heralded by constipation, followed by bulbar palsy, and then by a descending bilateral symmetric paralysis; ultimately, palsy can involve respiratory and diaphragmatic muscles, leading to respiratory failure. The treatment is based on supportive care and specific therapy with Human Botulism Immune Globulin Intravenous (BIG-IV), and should be started as early as possible. The search for new human-like antibody preparations that are both highly effective and well tolerated has led to the creation of a mixture of oligoclonal antibodies that are highly protective and can be produced in large quantities without the use of animals. Ongoing research for future treatment of IB involves the search for new molecular targets to produce a new generation of laboratory-produced antitoxins, and the development of new vaccines with safety and efficacy profiles that can be scaled up for clinical use. This narrative literature review aims to provide a readable synthesis of the best current literature on microbiological, epidemiological and clinical features of IB, and a practical guide for its treatment.
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Affiliation(s)
- Luca Antonucci
- Academic Department of Pediatrics, Children's Hospital Bambino Gesù, University of Rome 'Tor Vergata', Rome, Italy
| | - Cristian Locci
- Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Livia Schettini
- Academic Department of Pediatrics, Children's Hospital Bambino Gesù, University of Rome 'Tor Vergata', Rome, Italy
| | - Maria Grazia Clemente
- Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Roberto Antonucci
- Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Koike H, Kanda M, Hayashi H, Matsushima Y, Yoshikawa S, Ohba Y, Hayashi M, Nagano C, Sekimura K, Otsuka K, Kamiie J, Sasamoto T, Hashimoto T. Development of an alternative approach for detecting botulinum neurotoxin type A in honey: Analysis of non-toxic peptides with a reference labelled protein via liquid chromatography-tandem mass spectrometry. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2020; 37:1359-1373. [PMID: 32515305 DOI: 10.1080/19440049.2020.1766121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In this study, we developed a reference labelled protein containing the partial amino acid sequence of botulinum neurotoxin type A (BoNTA). We also applied it as an internal standard to detect specific and non-toxic peptides originated from BoNTA in honey with the use of liquid chromatography-tandem mass spectrometry (LC-MS/MS). Original proteins in the honey sample were collected through a two-step process that included solubilisation and trichloroacetic acid (TCA) precipitation. Solubilisation by adding water enabled processing of proteins in honey. TCA precipitation collected proteins without specific binding. The combination of protein alkylation and an appropriate enzyme-to-protein ratio ensured feasibility of tryptic digestion. A desalting process eliminated a large amount of salts and other tryptic peptides in the honey sample. The use of the reference labelled protein enabled compensation for tryptic digestion efficiency and electrospray ionisation efficiency based on LC-MS/MS measurement. After the peptide selection and protein BlastP analysis, five unique peptides were chosen. The non-toxic peptides originating from BoNTA were reliably detected using LC-MS/MS based on a multiple-reaction monitoring mode. Detection of several peptides ensured screening of BoNTA in honey samples. Based on the responses, the proteotypic peptide LYGIAINPNR was selected as the quantitative peptide. Due to maintaining the relative ion ratios, the selective transition completely identified the non-toxic peptides. The intensity of the transitions established a detection limit of BoNTA estimated to be 9.4 ng mL-1. Although extraction efficiency was not evaluated using the BoNTA standard, the results suggested this method may be used for quantification of BoNTA in honey. The method was applied to 19 honey samples purchased in Tokyo; none of them was found to contain the target toxin. Overall, the method is expected to accelerate BoNTA monitoring for food safety.
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Affiliation(s)
- Hiroshi Koike
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Maki Kanda
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Hairoshi Hayashi
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Yoko Matsushima
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Souichi Yoshikawa
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Yumi Ohba
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Momoka Hayashi
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Chieko Nagano
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Kotaro Sekimura
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Kenji Otsuka
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Junichi Kamiie
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Azabu University , Sagamihara, Japan
| | - Takeo Sasamoto
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
| | - Tsuneo Hashimoto
- Department of Food Safety, Tokyo Metropolitan Institute of Public Health , Tokyo, Japan
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Clostridium botulinum and Clostridium perfringens Occurrence in Kazakh Honey Samples. Toxins (Basel) 2019; 11:toxins11080472. [PMID: 31412583 PMCID: PMC6723067 DOI: 10.3390/toxins11080472] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to assess occurrence of Clostridium botulinum and Clostridium perfringens in honey samples from Kazakhstan. Analyses were carried out using a set of PCR methods for identification of anaerobic bacteria, and detection of toxin genes of C. botulinum and C. perfringens. Among 197 samples, C. botulinum was noticed in only one (0.5%). The isolated strain of this pathogen showed the presence of the bont/A and ntnh genes. C. perfringens strains were isolated from 18 (9%) samples, and mPCR (multiplex PCR) analysis led to them all being classified as toxin type A with the ability to produce α toxin. Sequence analysis of 16S rDNA genes showed occurrence in 4 samples of other anaerobes related to C. botulinum, which were C. sporogenes and C. beijerinckii strains. C. botulinum prevalence in honey samples from Kazakhstan in comparison to the prevalence in samples collected from the other regions seems to be less. The highest prevalence of Clostridium sp. was noticed in the East Kazakhstan province. Our study is the first survey on BoNT-producing clostridia and C. perfringens prevalence in Kazakh honey.
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Lianou A, Panagou EZ, Nychas GJE. Meat Safety—I Foodborne Pathogens and Other Biological Issues. LAWRIE´S MEAT SCIENCE 2017. [PMCID: PMC7152306 DOI: 10.1016/b978-0-08-100694-8.00017-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This chapter presents information pertinent to foodborne pathogens (bacteria and bacterial toxins, viruses, parasites) and other biological issues (prions) with importance to the safety of meat and meat products. Aspects covered refer mainly to the characteristics of the most important pathogenic organisms, their distribution in the environment, their transmission routes to humans, as well as their epidemiology and association with sporadic or epidemic foodborne illness. Current and emerging challenges to meat safety management also are discussed.
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11
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Mazuet C, Legeay C, Sautereau J, Ma L, Bouchier C, Bouvet P, Popoff MR. Diversity of Group I and II Clostridium botulinum Strains from France Including Recently Identified Subtypes. Genome Biol Evol 2016; 8:1643-60. [PMID: 27189984 PMCID: PMC4943176 DOI: 10.1093/gbe/evw101] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2016] [Indexed: 01/31/2023] Open
Abstract
In France, human botulism is mainly food-borne intoxication, whereas infant botulism is rare. A total of 99 group I and II Clostridium botulinum strains including 59 type A (12 historical isolates [1947-1961], 43 from France [1986-2013], 3 from other countries, and 1 collection strain), 31 type B (3 historical, 23 recent isolates, 4 from other countries, and 1 collection strain), and 9 type E (5 historical, 3 isolates, and 1 collection strain) were investigated by botulinum locus gene sequencing and multilocus sequence typing analysis. Historical C. botulinum A strains mainly belonged to subtype A1 and sequence type (ST) 1, whereas recent strains exhibited a wide genetic diversity: subtype A1 in orfX or ha locus, A1(B), A1(F), A2, A2b2, A5(B2') A5(B3'), as well as the recently identified A7 and A8 subtypes, and were distributed into 25 STs. Clostridium botulinum A1(B) was the most frequent subtype from food-borne botulism and food. Group I C. botulinum type B in France were mainly subtype B2 (14 out of 20 historical and recent strains) and were divided into 19 STs. Food-borne botulism resulting from ham consumption during the recent period was due to group II C. botulinum B4. Type E botulism is rare in France, 5 historical and 1 recent strains were subtype E3. A subtype E12 was recently identified from an unusual ham contamination. Clostridium botulinum strains from human botulism in France showed a wide genetic diversity and seems to result not from a single evolutionary lineage but from multiple and independent genetic rearrangements.
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Affiliation(s)
| | - Christine Legeay
- Bactéries Anaérobies et Toxines, Institut Pasteur, Paris, France
| | - Jean Sautereau
- Bactéries Anaérobies et Toxines, Institut Pasteur, Paris, France
| | - Laurence Ma
- Plateforme Genomique-Pôle Biomics, Institut Pasteur, Paris, France
| | | | - Philippe Bouvet
- Bactéries Anaérobies et Toxines, Institut Pasteur, Paris, France
| | - Michel R Popoff
- Bactéries Anaérobies et Toxines, Institut Pasteur, Paris, France
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Kobayashi T, Haginoya K, Morimoto T, Hatakeyama T, Tsuchiya S. A case of infant botulism infection due to consumption of untreated well-water. J Pediatr 2014; 164:931-3. [PMID: 24461790 DOI: 10.1016/j.jpeds.2013.11.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 09/25/2013] [Accepted: 11/19/2013] [Indexed: 10/25/2022]
Abstract
A 7-week-old boy with flaccid paralysis was diagnosed with infant botulism caused by Clostridium botulinum toxin type A. In this case of infant botulism, untreated well-water was identified as a potential source of this infection.
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Affiliation(s)
- Tomoko Kobayashi
- Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan.
| | - Kazuhiro Haginoya
- Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan
| | - Tetsuji Morimoto
- Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan
| | - Takashi Hatakeyama
- Department of Microbiology, Miyagi Prefectural Institute of Public Health and Environment, Sendai, Japan
| | - Shigeru Tsuchiya
- Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan
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13
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Gücükoğlu A, Terzi G, Çadirci Ö, Alişarli M, Kevenk O, Uyanik T. Detection of C. botulinum types in honey by mPCR. J Food Sci 2014; 79:M600-3. [PMID: 24621137 DOI: 10.1111/1750-3841.12402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 01/19/2014] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine the prevalence of Clostridium botulinum in honey samples using conventional methods and multiplex PCR (mPCR). A total number of 150 honey samples were randomly collected from apiaries, retail shops, weekly open bazaars, and supermarkets in Samsun, Turkey. Of 150 honey samples, 4 (2.6%) were positive for the botulinum neurotoxin gene by mPCR analysis. A total of 4 C. botulinum isolates were obtained from the mPCR positive samples, of which 3 were type A and 1 was type B. No samples were positive regarding the type E and type F neurotoxin genes. This is the first report of type A and type B spores of C. botulinum being detected and isolated in Turkey. This study revealed that some honey samples may present a potential hazard for food borne and infant botulism.
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Affiliation(s)
- Ali Gücükoğlu
- Dept. of Food Hygiene and Technology, Faculty of Veterinary Medicine, Ondokuz Mayıs Univ, Kurupelit/Samsun, Turkey
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14
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Radšel A, Andlovic A, Neubauer D, Osredkar D. Infant botulism: first two confirmed cases in Slovenia and literature review. Eur J Paediatr Neurol 2013; 17:651-6. [PMID: 23707631 DOI: 10.1016/j.ejpn.2013.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 04/10/2013] [Accepted: 04/28/2013] [Indexed: 12/26/2022]
Abstract
In Europe, infant botulism is a rare but probably under-diagnosed disease. With the intent to spread the awareness of this potentially life-threatening disease, we present a review of the literature with the emphasis on European epidemiology and a practical approach to diagnosis. We also report the first two confirmed cases of infant botulism in Slovenia and describe our way to the final diagnosis in a clinical setting where all appropriate diagnostic tests and treatment options are not readily available. The second case is particularly interesting, presenting with profound diarrhea following initial constipation, an unlikely symptom for an infant with botulism and possibly caused by Bacteroides fragilis.
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Affiliation(s)
- Anja Radšel
- Department of Pediatric Infectious Diseases, University Medical Centre Ljubljana, Slovenia
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15
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Yaghoobi R, Kazerouni A, Kazerouni O. Evidence for Clinical Use of Honey in Wound Healing as an Anti-bacterial, Anti-inflammatory Anti-oxidant and Anti-viral Agent: A Review. Jundishapur J Nat Pharm Prod 2013; 8:100-4. [PMID: 24624197 PMCID: PMC3941901 DOI: 10.17795/jjnpp-9487] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 03/11/2013] [Accepted: 04/22/2013] [Indexed: 01/22/2023] Open
Abstract
Context To provide an updated review of published literature on the anti-oxidant, anti-bacterial and anti-inflammatory properties of honey. Evidence Acquisition CINAHL, BioMed Central, Cochrane Library, Medline and Embase data bases and reference lists were used to find randomized controlled trials and review articles. Randomized controlled trials using honey with a comparator were reviewed, along with published review articles to determine the relative benefits of tropical honey. These methods were undertaken by three reviewers. Results Honey has anti-oxidant, anti-bacterial and anti-inflammatory properties. It can be used as a wound dressing to promote rapid and improved healing. These effects are due to honey’s anti-bacterial action, secondary to its high acidity, osmotic effect, anti-oxidant content and hydrogen peroxide content. The use of honey leads to improved wound healing in acute cases, pain relief in burn patients and decreased inflammatory response in such patients. However, it has proven to be ineffective in chronic leg ulcers. Overall, studies have been done in favor of the use of honey in medicine. Conclusions Honey has almost equal or slightly superior effects when compared with conventional treatments for acute wounds and superficial partial thickness burns. More randomized controlled trials with significant statistical power comparing different kinds of honey, are required in order to create a strong body of evidence towards definite recommendations for medical use. There is biological plausibility.
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Affiliation(s)
- Reza Yaghoobi
- Department of Dermatology, Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Afshin Kazerouni
- Department of Dermatology, Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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16
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Abstract
Microbial food safety remains a major economic and public health concern in Arab countries. Over the past several years, many of these countries have attempted to revise and upgrade food quality control and surveillance programs; however, these systems vary in scope and effectiveness. This review addresses the major reported foodborne outbreaks and multidrug resistance of pathogenic microorganisms isolated from food products. Major foodborne pathogens of concern included Brucella spp., Clostridium botulinum, fecal coliforms, Escherichia coli O157:H7, Listeria monocytogenes, Salmonella, and Staphylococcus aureus. Measures for managing microbial food hazards based on a comprehensive risk analysis also are proposed.
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Affiliation(s)
- Rabih Kamleh
- Environmental Health Department, American University of Beirut, Lebanon, Beirut, Lebanon.
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17
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The safety of pasteurised in-pack chilled meat products with respect to the foodborne botulism hazard. Meat Sci 2012; 70:461-75. [PMID: 22063745 DOI: 10.1016/j.meatsci.2004.07.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2004] [Revised: 06/30/2004] [Accepted: 07/15/2004] [Indexed: 11/22/2022]
Abstract
There has been a substantial increase in sales of pasteurised in-pack chilled products over the last decade. It is anticipated that this trend will continue. These foods address consumer demand in being of high quality and requiring little preparation time. The microbiological safety of these foods commonly depends on a combination of a minimal heat treatment, refrigerated storage and a restricted shelf-life. The principal microbiological safety hazard for pasteurised in-pack meat products is foodborne botulism, as presented by non-proteolytic Clostridium botulinum. This review provides a summary of research that has contributed to the safe development of these foods without incidence of botulism.
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18
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Two cases of type A infant botulism in Grenoble, France: no honey for infants. Eur J Pediatr 2012; 171:589-91. [PMID: 22159905 DOI: 10.1007/s00431-011-1649-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 11/30/2011] [Indexed: 10/14/2022]
Abstract
We report two severe cases of infant botulism diagnosed at Grenoble University Hospital, France, respectively in 2006 and 2009. Both cases were characterized by a delay in diagnosis, severe neurological manifestations and extended period of hospitalization in intensive care unit, but a complete recovery. Infant botulism is a rare but life-threatening disease. It primarily affects infants, and the main risk factor is honey ingestion. Diagnosis should be systematically evoked by pediatricians in infants suffering from constipation, fatigue, muscle weakness, difficult feeding and altered cry, but before the onset of generalized flaccid paralysis, so as to administer specific treatment (BabyBIG®, a human derived botulinum antitoxin) at an early stage of the disease when it is most effective. In conclusion, parents should be aware of the role of honey as a source of spores of Clostridium botulinum and therefore infant botulism in the first year of life.
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Kumar R, Lorenc A, Robinson N, Blair M. Parents' and primary healthcare practitioners' perspectives on the safety of honey and other traditional paediatric healthcare approaches. Child Care Health Dev 2011; 37:734-43. [PMID: 21143272 DOI: 10.1111/j.1365-2214.2010.01186.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Traditional and complementary healthcare approaches (TCA) are widely used for children, often because of perceived safety. Honey is a traditional remedy for upper respiratory tract symptoms in infants. Health officials currently advise limiting honey use because of the risk of botulism. OBJECTIVE This paper discusses honey as a traditional healthcare approach for children in a multi-ethnic community, and parents' and primary healthcare practitioners' (PHPs) perceptions of its safety. DESIGN As part of a larger study exploring beliefs about TCA, this paper focuses on perceived safety and use of honey, using data extracted for detailed analysis. Eleven parent focus groups (n= 92) and 30 interviews with PHPs were conducted. Qualitative data analysis used the Framework approach. SETTING London Boroughs of Brent and Harrow RESULTS TCA, particularly home remedies, dietary and religious approaches were popular for children. Honey was a particularly common TCA, reportedly used by 27 (29%) parents for their children. Honey was believed to be traditional, acceptable, accessible, natural and safe. It was most commonly used for respiratory tract symptoms and administered with hot water and lemon juice. PHPs were more concerned about the safety of TCA than parents. Almost half (40%) of PHPs mentioned the use of honey for children, few perceived it as a 'treatment' or were concerned about botulism. Others were aware of the risks and some reported challenges in communicating risk to parents. CONCLUSION TCA are commonly used for children, honey in particular for respiratory tract symptoms. Parents and some PHPs appear unaware of the risk of botulism from honey use in infants. Healthcare practitioners should ask routinely about the use of honey and other TCA, and consider different parental belief systems in ethnically diverse populations. Further research is required on the use and efficacy of honey for infants, to raise awareness of its benefits and risks.
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Affiliation(s)
- Raekha Kumar
- River Island Paediatric and Child Health Academic Centre, Imperial College Northwick Park Hospital Campus, Harrow, UK
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20
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King LA, Popoff MR, Mazuet C, Espié E, Vaillant V, de Valk H. Le botulisme infantile en France, 1991–2009. Arch Pediatr 2010; 17:1288-92. [DOI: 10.1016/j.arcped.2010.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 06/03/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
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Barash JR, Hsia JK, Arnon SS. Presence of soil-dwelling clostridia in commercial powdered infant formulas. J Pediatr 2010; 156:402-8. [PMID: 20004414 DOI: 10.1016/j.jpeds.2009.09.072] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 08/25/2009] [Accepted: 09/30/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Because Clostridium botulinum was isolated from powdered infant formula (PIF) fed to an infant in the United Kingdom who subsequently developed infant botulism and from unopened PIF from the same manufacturer, we tested PIF manufactured in the United States for the presence of clostridial spores. STUDY DESIGN Thirty PIF ingested by 19 California infants with botulism within 4 weeks of onset of illness (48% of all patients fed PIF during study) in 2006-2007 were cultured anaerobically to isolate clostridia. All isolated clostridia were identified to the species level and enumerated with standard microbiologic and molecular methods. RESULTS Five of 30 (17%) PIF samples ingested by patients contained clostridial spores. Spores were also found in 7 of 9 (78%) market-purchased PIF samples. Clostridium sporogenes was isolated most frequently, followed by Clostridium butyricum and at least 10 other soil-dwelling clostridial species. No neurotoxigenic clostridia were isolated. The most probable number of clostridial spores in PIF ranged between 1.1 to >23 per 100 g. CONCLUSIONS With the notable exception of production of botulinum neurotoxin, C sporogenes is physiologically comparable with proteolytic strains of C botulinum, and both share the same natural reservoir (soils and dust worldwide). The isolation of C sporogenes and potentially pathogenic clostridia from U.S.-manufactured PIF suggests that neurotoxigenic clostridial spores have the potential to be present in these products.
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Affiliation(s)
- Jason R Barash
- Infant Botulism Treatment and Prevention Program, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, CA 94804, USA
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22
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Kuehnelt-Leddihn M, Trabi T, Dunitz-Scheer M, Burmucic K, Scheer P. Infantiler Botulismus. Monatsschr Kinderheilkd 2009. [DOI: 10.1007/s00112-009-2000-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Simon A, Traynor K, Santos K, Blaser G, Bode U, Molan P. Medical honey for wound care--still the 'latest resort'? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2009; 6:165-73. [PMID: 18955301 PMCID: PMC2686636 DOI: 10.1093/ecam/nem175] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Accepted: 11/05/2007] [Indexed: 01/14/2023]
Abstract
While the ancient Egyptians and Greeks used honey for wound care, and a broad spectrum of wounds are treated all over the world with natural unprocessed honeys from different sources, Medihoney has been one of the first medically certified honeys licensed as a medical product for professional wound care in Europe and Australia. Our experience with medical honey in wound care refers only to this product. In this review, we put our clinical experience into a broader perspective to comment on the use of medical honey in wound care. More prospective randomized studies on a wider range of types of wounds are needed to confirm the safety and efficacy of medical honey in wound care. Nonetheless, the current evidence confirming the antibacterial properties and additional beneficial effects of medical honey on wound healing should encourage other wound care professionals to use CE-certified honey dressings with standardized antibacterial activity, such as Medihoney products, as an alternative treatment approach in wounds of different natures.
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Affiliation(s)
- Arne Simon
- Paediatric Haematology and Oncology, Children's Hospital Medical Centre, University of Bonn, Adenauerallee 119, 53113 Bonn, Germany.
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24
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Affiliation(s)
- Michael W Peck
- Institute of Food Research, Norwich Research Park, Colney, Norwich, UK
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25
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Fathalla WM, Mohammed KA, Ahmed E. Infant botulism type Ba: first culture-confirmed case in the United Arab Emirates. Pediatr Neurol 2008; 39:204-6. [PMID: 18725068 DOI: 10.1016/j.pediatrneurol.2008.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2008] [Revised: 05/08/2008] [Accepted: 05/14/2008] [Indexed: 11/15/2022]
Abstract
We report on a 3-month-old girl with culture-confirmed infant botulism caused by a rare double toxin-producing Clostridium botulinum type Ba. This case was not related to honey-feeding. The clinical course was prolonged, with minimal spontaneous improvement at onset, and a period of fluctuating motor weakness and nasogastric feeding dependence afterward. Neurophysiologic studies produced normal results. Human botulism immune globulin was administered empirically on day 23 of presentation, with rapid full recovery. This case highlights the importance of pursuing diagnoses of infant botulism despite normal results of neurophysiologic testing and no history of honey-feeding. Our case also demonstrates a favorable response to human botulism immune globulin, despite the relatively late treatment.
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Affiliation(s)
- Waseem M Fathalla
- Division of Child Neurology, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
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26
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Abstract
OBJECTIVE To summarize the worldwide occurrence of reported infant (intestinal toxemia) botulism cases since first recognition of the disease in 1976. PATIENTS AND METHODS We collected information on infant botulism cases by active and passive surveillance, by provision of therapeutic Human Botulism Immune Globulin to suspected cases, and by searching the medical literature. We defined a case as laboratory-confirmed botulism that occurred in an infant <or=12 months of age that was not caused by the ingestion of botulinum toxin in food. RESULTS Twenty-six countries representing 5 continents reported the occurrence of at least 1 case of infant botulism among their residents. The United States, Argentina, Australia, Canada, Italy, and Japan, in this order, reported the largest number of cases. A history of honey exposure was significantly more common among case subjects hospitalized outside of the United States than among those who were recently hospitalized in California. CONCLUSIONS Most countries have not yet reported cases of infant botulism. This limited reporting of the disease to date contrasts with the known global occurrence of Clostridium botulinum spores in soils and dust and suggests that infant botulism may be under-recognized, underreported, or both. When bulbar palsies, hypotonia, and weakness are present, physicians should consider the possibility of infant botulism even if the patient has not been fed honey. Publication of additional case reports and surveillance summaries will enhance understanding of the occurrence and extent of this under-recognized disease.
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Affiliation(s)
- Ruth Koepke
- California Department of Public Health, 850 Marina Bay Pkwy, Room E-361, Richmond, CA 94804, USA
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Mikkelsen A, Rinné-Ljungqvist L, Borres MP, van Odijk J. Do parents follow breastfeeding and weaning recommendations given by pediatric nurses? A study with emphasis on introduction of cow's milk protein in allergy risk families. J Pediatr Health Care 2007; 21:238-44. [PMID: 17606160 DOI: 10.1016/j.pedhc.2006.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2006] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The aim of this study was to retrospectively examine weaning practices during the first year of life in a representative sample of Swedish children and how parents with a history of atopy introduced milk protein in their infant's diet. METHODS Data were derived from 467 infants visiting Child Health Centers in three different counties in Sweden for a health check up at 12 months of age. RESULTS The children were breastfed for an average of 7 months (range, 0.2-15 months), and 18% were still breastfed at the age of 12 months. Few infants had received solid food before the age of 4 months (6%) or after the age of 6 months (12%). Cow's milk protein was introduced in disagreement with the current recommendation for children at risk of developing atopy. CONCLUSION Breastfeeding and weaning recommendations seem to be followed by most families. The creation of routines for the distribution of information concerning weaning foods should be encouraged in order to reach families with special needs; otherwise, implementation of current recommendations and preventive strategies will be less useful.
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Fenicia L, Anniballi F, Aureli P. Intestinal toxemia botulism in Italy, 1984–2005. Eur J Clin Microbiol Infect Dis 2007; 26:385-94. [PMID: 17516104 DOI: 10.1007/s10096-007-0301-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Botulism in humans is caused by botulinum neurotoxins, produced in most cases by Clostridium botulinum, although other Clostridia species are implicated as well. Of the five forms of botulism in humans, three are referred to as "infective": wound botulism, infant botulism, and adult intestinal botulism; the latter two forms are also referred to as "intestinal toxemia botulism" because the organism colonizes the lumen of the intestinal tract and produces botulinum neurotoxin in vivo. Twenty-three cases of infant botulism and three cases of adult intestinal botulism occurred in Italy between 1984 and 2005. Microbiological analyses of clinical, environmental, and food samples and analysis of clinical and epidemiological data revealed two main characteristics of intestinal toxemia botulism in Italy that are not common in cases in other countries: the isolation of a strain of C. butyricum that produced botulinum neurotoxin type E in 6 of 26 cases, including two cases of adult intestinal toxemia botulism, and the onset of botulism in these cases with concomitant severe gastrointestinal symptomatology. This report summarizes the microbiological, clinical, and epidemiological data of all cases of intestinal toxemia botulism that have occurred in Italy in the period 1984-2005.
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Affiliation(s)
- L Fenicia
- National Reference Center for Botulism, National Center for Food Quality and Risk Assessment, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy.
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29
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Affiliation(s)
- Sarah S Long
- St. Christopher's Hospital for Children, Drexel University College of Medicine Philadelphia, PA, USA
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30
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Abstract
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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Affiliation(s)
- Miia Lindström
- Department of Food and Environmental Hygiene, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland.
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31
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van der Vorst MMJ, Jamal W, Rotimi VO, Moosa A. Infant botulism due to consumption of contaminated commercially prepared honey. First report from the Arabian Gulf States. Med Princ Pract 2006; 15:456-8. [PMID: 17047355 DOI: 10.1159/000095494] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2005] [Accepted: 12/05/2005] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To report the first case of infant botulism in Arabian Gulf States. CLINICAL PRESENTATION AND INTERVENTION A 6-week-old infant, presenting with signs of sepsis, was intubated and ventilated due to progressive weakness. Infant botulism was suspected with acute flaccid paralysis and a history of honey consumption. An electromyogram showed decreased amplitude of compound muscle action potential in all motor nerves, preserved sensory responses; the motor terminal latencies and motor conduction velocities were normal. Blood, stool and honey samples were sent for culture. Stool and honey cultures showed two identical strains of Clostridium botulinum. CONCLUSION This case shows that the infant botulism occurred from the ingested contaminated honey. Hence vigilance should be maintained when a baby is fed honey and shows signs of progressive weakness because the disease can quickly progress to respiratory failure.
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32
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Abstract
Since infant botulism was first identified three decades ago, our understanding of botulinum toxins and the organisms that produce them has grown. A newer classification system now recognizes Clostridium baratii and Clostridium butyricum along with Clostridium botulinum as causative agents. Recently, increasing therapeutic use of botulinum toxins has sparked substantial new research into their mechanisms of action. This research, and some case reports from infants sickened by unusual botulinum toxins suggest that disease caused by different toxin types may result in varying clinical presentations. Perhaps most significantly for pediatricians and child neurologists, a specific treatment for infant botulism has just been approved. This article reviews the clinical presentation, diagnosis, and treatment of infant botulism, including human botulism immune globulin, and discusses the various organisms and toxins that cause this disease.
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Affiliation(s)
- Christine K Fox
- Division of Child Neurology, UCSF School of Medicine, University of California-San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143-0136, USA
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33
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Fagan M, Khine H. Pediatric neurologic potpourri: cases to remember. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2003. [DOI: 10.1016/s1522-8401(03)00062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nafissi S, Pourmand R. Current concepts in botulism: clinical and electrophysiological aspects. J Clin Neuromuscul Dis 2003; 4:139-149. [PMID: 19078706 DOI: 10.1097/00131402-200303000-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Shahriar Nafissi
- Salt Lake City, UT From the *Department of Neurology, Tehran University of Medical Sciences, Tehran; and the daggerDepartment of Neurology, State University of New York, Stony Brook, New York
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