Food Poisoning Caused by Gram Positive Spore forming Bacteria

At least three gram-positive spore forming rods are known to cause bacterial food poisoning:
Clostridium perfringens (welchii), C. botulinum, and Bacillus cereus. The incidence of food
poisoning caused by each of these organisms is related to certain specific foods.  The foods most
commonly known to cause botulism food poisoning are smoked or raw fish, cured pork and ham,
honey or corn syrup, and home-canned vegetables. The disease has also occurred from oil
infused with garlic and baked potatoes. In infants, the most common causes are exposure to
contaminated soil and eating contaminated honey.

Clostridium Botulinum:
Clostridium botulinum is an obligate anaerobic, gram positive, endospore-forming, rod-shaped
bacterium that can cause a very deadly form of food poisoning. Let's break that down a little bit.
C. botulinum is an obligate anaerobe, meaning it cannot survive in the presence of oxygen, and
can only grow by fermentation in anoxic environments. The bacterium is gram positive,
meaning it has a thick peptidoglycan cell wall. It also forms very resistant endospores that are
able to survive unfavorable environmental conditions. These endospores are everywhere. If you
brush your hand across the desk in front of you and examined the dust you stirred up, it would
contain C. botulinum endospores. These endospores will only become active, growing bacteria if
they land in an anoxic, protein-rich environment.
On the basis of the serological specificity of their toxins, seven types are recognized: A, B, C, D,
E, F, and G. Types A, B, E, F, and G cause disease in humans. Types A, B, E, F, and G cause
disease in humans; type C causes botulism in fowls, cattle, mink, and other animals; and type D
is associated with forage poisoning of cattle, especially in South Africa. The types are also
differentiated on the basis of their proteolytic activity. Types A and G are proteolytic, as are
some types B and F strains. Type E is nonproteolytic, as are some B and F strains. The
proteolytic activity of type G is slower than that for type A, and its toxin requires trypsin
potentiation.

Distribution of C. Botulinum:
This organism is indigenous to soils and waters. All toxin-producing strains have been placed
into one of four groups—I, II, III, or IV

 Group I contains the proteolytics (types A and G; some B and F )

 Group II the nonproteolytics (types E; some B and F)
 Group III consists of types C and D.
 Group IV serological type G.

Growth of C. botulinum Strains:

The proteolytic strains, unlike the nonproteolytics, digest casein and produce H₂S. The latter, on
the other hand, ferment mannose, whereas the proteolytics do not. The proteolytics and
nonproteolytics have been shown to form single groups relative to somatic antigens as evaluated
by agglutination. The absorption of antiserum by any one of a group removes antibodies from all
three of that group.
The nutritional requirements of these organisms are complex, with amino acids, B vitamins,
and minerals being required. Synthetic media have been devised that support growth and toxin
production of most types. The proteolytic strains tend not to be favored in their growth by
carbohydrates, whereas the nonproteolytics are. At the same time, the nonproteolytics tend to be
more fermentative than the proteolytic types.
The proteolytics generally do not grow below 12.5°C, although a few reports exist in which
growth was detected at 100C. The upper range for types A and proteolytic B, and presumably for
the other proteolytic types, is about 500C. On the other hand, the nonproteolytic strains can grow
as low as 3.3°C with the maximum about 5° below that for proteolytics. Minimum and maximum
temperatures of growth of these organisms are dependent on the state of other growth
parameters, and the minima and maxima noted may be presumed to be at totally optimal
conditions relative to pH. In a study of the minimum temperature for growth and toxin
production by nonproteolytic types B and F in broth and crabmeat, both grew and produced toxin
at 4°C in broth, but in crabmeat, growth and toxin production occurred only at 26°C and not at
12°C or lower. A type G strain grew and produced toxin in broth and crabmeat at 12°Cbut not at
80C. The minimum pH that permits growth and toxin production of C. botulinum strains has
been the subject of many studies. It is generally recognized that growth does not occur at or
below pH 4.5, and it is this fact that determines the degree of heat treatment given to foods with
pH values below this level. Because of the existence of botulinal toxins in some high acid, home-
canned foods, this area has been the subject of recent studies.
The minimum water activity that permits growth and toxin production is 0.94 - 0.97. Proteolytic
strains are much more heat resistant than nonproteolytics.

Ecology of C. botulinum Growth:

This organism cannot grow and produce its toxins in competition with large numbers of other
microorganisms. In the presence of yeasts, however, C. botulinum has been reported to grow
and produce toxin at a pH as low as 4.0. Yeasts are presumed to produce growth factors needed
by the clostridia to grow at low pH.

Nature of the Botulinal Neurotoxins:

The neurotoxins are formed within the organism and released upon autolysis (the self-digestion
that occurs in tissues or cells by enzymes in the cells themselves). They are produced by cells
growing under optimal conditions, although resting cells have been reported to form toxin as
well. The botulinal neurotoxins (BoNT) are the most toxic substances known. The minimum
lethal dose for mice has been reported also to be 0.4-2.5 ng/kg by intravenous or intraperitioneal
injection, and a 50% human lethal dose of about 1 ng/kg of body weight has been reported.
The genes for BoNT A, B, E, and F are chromosomal, whereas type G is plasmid borne.
Symptoms of botulism can be produced by either parenteral or oral administration of the toxins.
They may be absorbed into the blood stream through the respiratory mucous membranes, as well
as through the walls of the stomach and intestines.
Unlike the staphylococcal enterotoxins and heat-stable toxins of other foodborne pathogens, the
botulinal toxins are heat sensitive and may be destroyed by heating at 80˚C (176˚F) for 10
minutes, or boiling temperatures for a few minutes.

The Adult Botulism Syndrome: Incidence and Vehicle Foods

Symptoms of botulism may develop anywhere between 12 and 72 hours after the ingestion of
toxin-containing foods. Symptoms consist of nausea, vomiting, fatigue dizziness, and headache;
dryness of skin, mouth, and throat; constipation, lack of fever, paralysis of muscles, double
vision, and, finally, respiratory failure and death. Treatment consists of administering specific
antisera as early as possible. Heat suspect foods to boiling temperatures for a few minutes, which
is sufficient to destroy the neurotoxins.
The risk factors for botulism food poisoning
The greatest hazards of botulism come from home-prepared and home-canned foods that are
improperly handled or given insufficient heat treatments to destroy botulinal spores. Such foods
are often consumed without heating. The best preventive measure is the heating of suspect foods
to boiling temperatures for a few minutes, which is sufficient to destroy the neurotoxins..
Reducing your risk of botulism food poisoning
You can lower your risk of botulism food poisoning by:
 Discarding bulging cans of food, any bad-smelling food, and expired preserved foods.
 Refraining from giving honey to infants.
 Refrigerating foil-wrapped baked potatoes instead of leaving them out at room
temperature.
 Sterilizing home-canned foods by pressure cooking them for 30 minutes at 250⁰ F.

Infant Botulism:
In the adult form of botulism, preformed toxins are ingested. In infant botulism, viable botulinal
spores are ingested, and upon germination in the intestinal tract, toxin is then synthesized.
Although it is possible that in some adults under special conditions botulinal endospores may
germinate and produce small quantities of toxin, the colonized intestinal tract does not favor
spore germination. Infants over 1 year of age tend not to be affected by this syndrome because of
the establishment of a more normal intestinal biota. Infants get viable spores from infant foods
and possibly from their environment. Vehicle foods are those that do not undergo heat
processing to destroy endospores; the two most common products are syrup and honey.