Histamine release from intestinal mast cells induced by staphylococcal enterotoxin A (SEA) evokes vomiting reflex in common marmoset.

Staphylococcal enterotoxins (SEs) produced by Staphylococcus aureus are known as causative agents of emetic food poisoning. We previously demonstrated that SEA binds with submucosal mast cells and evokes mast cell degranulation in a small emetic house musk shrew model. Notably, primates have been recognized as the standard model for emetic assays and analysis of SE emetic activity. However, the mechanism involved in SEA-induced vomiting in primates has not yet been elucidated. In the present study, we established common marmosets as an emetic animal model. Common marmosets were administered classical SEs, including SEA, SEB and SEC, and exhibited multiple vomiting responses. However, a non-emetic staphylococcal superantigen, toxic shock syndrome toxin-1, did not induce emesis in these monkeys. These results indicated that the common marmoset is a useful animal model for assessing the emesis-inducing activity of SEs. Furthermore, histological analysis uncovered that SEA bound with submucosal mast cells and induced mast cell degranulation. Additionally, ex vivo and in vivo pharmacological results showed that SEA-induced histamine release plays a critical role in the vomiting response in common marmosets. The present results suggested that 5-hydroxytryptamine also plays an important role in the transmission of emetic stimulation on the afferent vagus nerve or central nervous system. We conclude that SEA induces histamine release from submucosal mast cells in the gastrointestinal tract and that histamine contributes to the SEA-induced vomiting reflex via the serotonergic nerve and/or other vagus nerve.

[Intoxications caused by Staphylococcal enterotoxin B]. / Zatrucia gronkowcowa enterotoksyna B.

Staphylococcal enterotoxin B (SEB) is one of exotoxins produced by Staphylococcus aureus. Depending on the type exposure SEB may cause a food or inhalant poisoning. The course of food poisoning is usually lighter and resolves spontaneously. The course of inhalant poisoning depends on the inhaled dose. It can be tough and demanding intensive treatment. Given the lack of specific therapy, led therapy is purely symptomatic.

Staphylococcal enterotoxin A has potent superantigenic and emetic activities but not diarrheagenic activity.

Staphylococcal enterotoxins (SEs) produced by Staphylococcus aureus are pyrogenic superantigenic toxins that are involved in human diseases including food poisoning and toxic shock syndrome. Although the superantigenic activity of SEs has been well characterized, its role and mechanism in clinical symptoms of food poisoning remain poorly understood. In this study, house musk shrews (Suncus murinus), a small emetic animal model, were used to study the role of SEs in clinical manifestations of food poisoning. Administration of SEA induced a potent emetic response in vivo and showed significant superantigenic activity in vitro in house musk shrews. However, SEA revealed no diarrheagenic activity. SEA directly injected into the intestinal loops of house musk shrews failed to induce fluid exudation and consequent dilation of the intestinal segments. Rabbit intestinal loop experiments were further carried out to confirm the results and also showed that SEA induced no fluid exudation and consequent dilation. Furthermore, the SEA-producing S. aureus also failed to induce fluid exudation in the administered loops of these animal models. These results indicate that SEA has potent superantigenic and emetic activities, but does not have a diarrheagenic activity.

Extended staphylococcal enterotoxin D expression in ham products.

Staphylococcal enterotoxin D (SED) is one of the most frequently recovered enterotoxins in staphylococcal food poisoning (SFP) outbreaks. The expression and production of SED were investigated in three ham products, i.e. boiled ham, smoked ham and dry-cured Serrano ham incubated at room temperature for seven days. Staphylococcus aureus was also, as a reference, grown in cultivation broth during optimal growth conditions for seven days. In boiled and smoked ham, continuous sed expression was observed throughout the incubation period with a second increase in sed expression found after five days of incubation. In smoked ham, nine times less SED per colony-forming unit of S. aureus was detected than in boiled ham. In boiled ham, the SED levels unpredictably decreased after three days of incubation. In the Serrano ham, SED was detected after five days of incubation although S. aureus growth was poor and sed expression was too low to determine. After five days of incubation, all three products contained enough SED to cause SFP. These results show that the specific production levels of SED vary in the different ham products, and that toxin production was in part uncoupled from bacterial growth.

Staphylococcus aureus Exotoxins and Their Detection in the Dairy Industry and Mastitis.

Staphylococcus aureus constitutes a major food-borne pathogen, as well as one of the main causative agents of mastitis in dairy ruminants. This pathogen can produce a variety of extracellular toxins; these include the shock syndrome toxin 1 (TSST-1), exfoliative toxins, staphylococcal enterotoxins (SE), hemolysins, and leukocidins. S. aureus expresses many virulence proteins, involved in evading the host defenses, hence facilitating microbial colonization of the mammary glands of the animals. In addition, S. aureus exotoxins play a role in the development of both skin infections and mastitis. Indeed, if these toxins remain in dairy products for human consumption, they can cause staphylococcal food poisoning (SFP) outbreaks. As a result, there is a need for procedures to identify the presence of exotoxins in human food, and the methods used must be fast, sensitive, reliable, and accurate. It is also essential to determine the best medical therapy for human patients suffering from S. aureus infections, as well as establishing the relevant veterinary treatment for infected ruminants, to avoid economic losses in the dairy industry. This review summarizes the role of S. aureus toxins in the development of mastitis in ruminants, their negative effects in the food and dairy industries, and the different methods used for the identification of these toxins in food destined for human consumption.

[Raw milk-associated Staphylococcus aureus intoxication in children]. / Rohmilch-assoziierte Staphylococcus aureus Intoxikation bei Kindern.

Four hours after the consumption of raw goat milk, three Swiss children came down with emesis and diarrhea in July 2008. First investigations showed that the milk originated from a goat suffering from clinical mastitis (Staphylococcus aureus). In the milk sample from the untreated left udder, Staphylococcus aureus counts reached 5.0 x 10(7) CFU ml(-1). By PCR, the gene for the staphylococcal enterotoxin D was found in isolated strains. The consumption of raw milk is rarely associated with Staphylococcus aureus intoxications. Due to the flora naturally present in raw milk, Staphylococcus aureus normally cannot multiply sufficiently. However, in the present case, high Staphylococcus aureus counts were already present in the milk due to the mastitis of the goat. This amount sufficed to cause a Staphylococcus aureus intoxication in the children.

Effects of Lactic Acid and Salt on Enterotoxin A Production and Growth of Staphylococcus aureus.

Food poisoning caused by Staphylococcus aureus is responsible for staphylococcal enterotoxin (SE) produced in foods. Staphylococcal food poisoning is mostly caused by staphylococcal enterotoxin type A (SEA) among SEs. Growth/no growth for S. aureus under various environmental conditions was well studied with a logistic regression model so far. Recently we successfully described the boundaries of SEA production and growth of S. aureus in broth at various temperatures and salt concentrations with the model. In this study, the effects of lactic acid and salt on SEA production and growth of S. aureus was quantitatively studied. Consequently the boundaries of SEA production and growth of S. aureus cocktail in broth at various combinations of salt concentrations and pH values that were adjusted with lactic acid were successfully described with a logistic regression model. Here the cocktail was incubated in stationary culture at 30 °C and 10 °C. The maximum toxin production and cell growth of the cocktail were observed both at 5% salt in the pH range from 4.5 to 7.0. Also, the characteristics of individual strains of the cocktail in SEA production and growth at 30 °C and 10 °C were found to be specific to the strains. The present study revealed the effect of lactic acid and salt on SEA production and growth of S. aureus as well as the variety of SEA production and growth of S. aureus strains. These results would become useful information in food industry to prevent staphylococcal food poisoning. PRACTICAL APPLICATION: Boundaries of enterotoxin A production/no production and growth/no growth of staphylococcal cocktail at various combinations of pHs adjusted with lactic acid and salt concentrations were well described with a logistic regression model. The maximum toxin production and cell growth were observed both at 5% salt in the pH range from 4.5 to 7.0. A variety of the toxin production and cell growth were observed in terms of pH and salt concentration among individual strains of the cocktail.

Diversity in Staphylococcus aureus enterotoxins.

The molecular mechanism of Staphylococcus aureus phathogenicity is complex and involves several toxins, including the famous staphylococcal enterotoxin (SE) and toxic shock syndrome toxin-1 (TSST-1). Although these toxins were discovered in specific clinical contexts of food poisoning and menstrual toxic shock syndrome, they share common biochemical and biological properties. As superantigens they are able to massively activate mononuclear cells and T cells regardless of the antigenic specificity of the T cells. To date, 19 different enterotoxins and related toxins have been described in S. aureus with some differences in structure and biological activity. It has been clearly demonstrated that most human S. aureus isolates harbor at least one gene encoding for these toxins. It is suspected that S. aureus produces SEs and TSST-1 in humans from colonization to infection, whatever the clinical situation. It is proposed that the production of SEs plays a role not only in classical staphylococcal infections but also in noninfectious diseases. This review will focus on recent findings related to staphylococcal superantigens and their impact on human diseases.

Risk evaluation for staphylococcal food poisoning in processed milk produced with skim milk powder.

The growth of S. aureus and the production of staphylococcal enterotoxin A (SEA) in skim milk concentrates stored at inappropriate temperatures in a recovery milk tank (tank for excess concentrated skim milk) used in the manufacture of skimmed milk powder were investigated. Also, it was estimated if a possible outbreak of food poisoning would occur if the contaminated skimmed milk powder was used in the manufacture of processed milk. Skim milk concentrates with milk solid content of 15, 25, and 35% were inoculated with S. aureus at 1-2 log CFU/ml and incubated at 15, 25, or 35 degrees C for 0 to 24 h with or without shaking. Bacterial growth and the level of SEA production were measured. At 35 degrees C with shaking, there was a significant difference (p<0.05) in one way layout analysis of variance, and it was demonstrated that the growth of S. aureus and SEA production could be milk solid content-dependent. Shaking accelerated the growth of S. aureus and SEA production at 35 degrees C. Generally, skim milk powder is produced by mixing a set percentage of skim milk concentrates (recovery milk) from the recovery milk tank into raw milk. If recovery milk contaminated with S. aureus at levels of 1-2 log CFU/ml is kept at 15 to 35 degrees C due to a power failure, it was estimated that processed milk consumption of 670-1200 ml, 420-1500 ml and 18-83 ml would trigger the onset of food poisoning symptoms when skim milk concentrates (recovery milk) are stored at 25 degrees C for 24 h, 35 degrees C for 10 h, and 35 degrees C for 24 h, respectively, during the production of the skim milk powder. Based on these consumption levels, it was concluded that, if recovery milk cannot be refrigerated and is stored at room temperature (25 to 35 degrees C), it must be used within 8 h and preferably within 6 h.

Assessment of Enterotoxin Production and Cross-Contamination of Staphylococcus aureus between Food Processing Materials and Ready-To-Eat Cooked Fish Paste.

This study evaluated Staphylococcus aureus growth and subsequent staphylococcal enterotoxin A production in tryptone soy broth and on ready-to-eat cooked fish paste at 12 to 37 °C, as well as cross-contamination between stainless steel, polyethylene, and latex glove at room temperature. A model was developed using Barany and Roberts's growth model, which satisfactorily described the suitable growth of S. aureus with R(2)-adj from 0.94 to 0.99. Except at 12 °C, S. aureus cells in TSB presented a lag time lower (14.64 to 1.65 h), grew faster (0.08 to 0.31 log CFU/h) and produced SEA at lower cell density levels (5.65 to 6.44 log CFU/mL) compare to those inoculated on cooked fish paste with data of 16.920 to 1.985 h, 0.02 to 0.23 log CFU/h, and 6.19 to 7.11 log CFU/g, respectively. Staphylococcal enterotoxin type A (SEA) visual immunoassay test showed that primary SEA detection varied considerably among different storage temperature degrees and media. For example, it occurred only during exponential phase at 30 and 37 °C in TSB, but in cooked fish paste it took place at late exponential phase of S. aureus growth at 20 and 25 °C. The SEA detection test was negative on presence of S. aureus on cooked fish paste stored at 12 and 15 °C, although cell density reached level of 6.12 log CFU/g at 15 °C. Cross-contamination expressed as transfer rate of S. aureus from polyethylene surface to cooked fish paste surface was slower than that observed with steel surface to cooked fish paste under same conditions. These results provide helpful information for controlling S. aureus growth, SEA production and cross-contamination during processing of cooked fish paste.

Investigating an outbreak of staphylococcal food poisoning among travellers across two Australian states.

INTRODUCTION: Staphylococcus aureus is a common cause of staphylococcal food poisoning in Australia with several outbreaks associated with foods prepared by commercial caterers. Laboratory testing on cases of gastrointestinal illness caused by enterotoxin-producing S. aureus is not routinely done as this condition is self-limiting. Hence outbreaks of such illness may go undetected. METHODS: A retrospective cohort study was conducted among a group of tourists who were hospitalized in Sydney shortly after flying from Queensland. The group had consumed food prepared by a restaurant on the Gold Coast before transit. Laboratory analyses on stool specimens were conducted in Sydney. An environmental assessment of the restaurant in the Gold Coast was conducted, and environmental specimens were assessed for contamination. RESULTS: Epidemiological investigations linked the outbreak to a restaurant in the Gold Coast where the suspected food was produced. Stool samples from two of the hospitalized cases were confirmed to have enterotoxin-producing S. aureus, and several environmental samples were found to be contaminated with S. aureus as well. Investigations suggested that absence of hand washing and other unhygienic food handling at the implicated restaurant was the likely cause of this outbreak. CONCLUSION: Food poisoning due to toxin-mediated S. aureus is frequently undetected and underreported. Public health units should consider toxin-producing pathogens such as S. aureus when investigating outbreaks where vomiting is the predominant symptom and occurs rapidly after consuming food.

Outbreak of staphylococcal food poisoning associated with precooked ham--Florida, 1997.

On September 27, 1997, a community hospital in northeastern Florida notified the St. Johns County Health Department about several persons who were treated in the emergency department because of gastrointestinal illnesses suspected of being associated with a common meal. This report summarizes the investigation of the outbreak by the Florida Department of Health; the findings implicated staphylococcal intoxication as the cause of illness among some persons who attended a retirement party on September 26, 1997.

Milkborne gastroenteritis due to Staphylococcus aureus enterotoxin B from a goat with mastitis.

Three children developed Staphylococcus aureus food poisoning due to enterotoxin type B following ingestion of milk from a goat with overt mastitis.

Production of staphylococcal enterotoxin A in cream-filled cake.

Cakes were baked with normal ingredients and filled with cream, inoculated with different size enterotoxigenic-staphylococcal inocula. Samples of the cakes were incubated at room temperature and put in the refrigerator. Samples of cake and filling were taken at different times and analyzed for staphylococcal count and presence of enterotoxin. The smaller the inoculum, the longer the time required for sufficient growth (10(6)) to occur for production of detectable enterotoxin. Enterotoxin added to the cake dough before baking (210 degrees C, 45 min) did not survive the baking. The presence of enterotoxin in the contaminated cream filling indicated this as the cause of staphylococcal food poisoning from cream-filled cakes. Refrigeration of the cakes prevented the growth of the staphylococci.

Production of staphylococcal enterotoxin D in foods by low-enterotoxin-producing staphylococci.

The goal of this investigation was to determine whether staphylococcal strains producing enterotoxins at nanogram levels per milliliter in laboratory medium, not detectable by gel diffusion methods, could produce sufficient enterotoxin in foods to result in food poisoning. Three low-enterotoxin D (SED)-producing strains were selected for this research because this enterotoxin is produced in smaller amounts than the other enterotoxins. The foods used were cream pie and cooked ham, divided into two portions, sterile and non-sterile. Each portion was inoculated with known concentrations of the staphylococcal strains under study and incubated for 48 h at 25, 30, and 37 degrees C. Samples were taken after 24 and 48 h. Enterotoxin was detectable in both sterilized and unsterilized cream and ham after 24 h at 37 degrees C with an inoculum of 10(3)/g. Some strains produced detectable amounts of enterotoxin in the sterilized foods after 24 h at 30 degrees C and some produced detectable amounts of enterotoxin in the sterilized foods after 24 h at 25 degrees C with inocula of 10(4)/g. It can be concluded that staphylococcal strains producing enterotoxin at ng/ml levels in laboratory medium, not detectable by gel diffusion methods, can produce sufficient enterotoxin (ng/g) in foods to cause food poisoning.

Influence of holding temperature on the growth and survival of Salmonella spp. and Staphylococcus aureus and the production of staphylococcal enterotoxin in egg products.

In this study, growth and survival of Salmonella spp. and Staphylococcus aureus in steamed egg and scrambled egg held at 5, 18, 22, 37, 55 and 60 degrees C are investigated. The production of staphylococcal enterotoxin in steamed egg is also examined. Results reveal that Salmonella spp. and Staph. aureus in the egg products multiply best at 37 degrees C, followed closely by 22 and 18 degrees C. Neither pathogen showed growth in the egg products held at 5 degrees C. Initial inoculation dose, holding temperature and holding time affected the population of both organisms found in the egg products. Staphylococcal enterotoxin A (SEA) and B (SEB) are detected only in the egg products held at 37 or 22 degrees C. After holding at 37 degrees C for 36 h, scrambled egg inoculated with ca. 5.0 log cfu/g Staph. aureus contains the highest levels of SEA (> 64 ng/g) and SEB (> 64 ng/g). Although Salmonella spp. and Staph. aureus grow better in steamed eggs than in scrambled eggs, production of staphylococcal enterotoxin, in general, was higher in scrambled eggs than in steamed eggs. On the other hand, a repaid destruction of the test organisms in steamed eggs held at 60 degrees C was observed. Holding the steamed eggs at 60 degrees C, Salmonella spp. and Staph. aureus with an initial population of ca. 5.9 and 5.6 log cfu/g, respectively, reduced to a non-detectable level in 1 h.

Staphylococcal enterotoxins.

Staphylococcus aureus is a major human pathogen that produces a wide array of toxins, thus causing various types of disease symptoms. Staphylococcal enterotoxins (SEs), a family of nine major serological types of heat stable enterotoxins, are a leading cause of gastroenteritis resulting from consumption of contaminated food. In addition, SEs are powerful superantigens that stimulate non-specific T-cell proliferation. SEs share close phylogenetic relationships, with similar structures and activities. Here we review the structure and function of each known enterotoxin.

Superantigens: interaction of staphylococcal enterotoxins with MHC class II molecules.

We have shown that the staphylococcal enterotoxins and TSST specifically bind to MHC class II molecules. This binding to class II molecules is a prerequisite for the function of these bacterial exotoxins as T cell mitogens in vitro. While SEA bound all class II molecules tested with respect to isotype and allotype, the other enterotoxins were limited in binding by the class II isotype. In contrast to conventional antigen, the nature of enterotoxin interactions with MHC enables them to stimulate class I-restricted CD8+ T cells, most likely due to the ability of SEs to engage the T cell receptor based solely on V beta usage. Finally, in addition to activating adjacent T cells, the enterotoxins and TSST can evoke responses from the class II-bearing cells to which they bind. Enterotoxin/TSST effects on cells that bear class II molecule "receptors", in addition to their induction of T cell hormones such as interleukin-2 and interferon-gamma, provide possible explanations for some of the symptomatology seen with these bacterial exotoxins and also implicate MHC class II molecules as signal-transducing receptors.

Staphylococcus aureus growth and enterotoxin A production in an anaerobic environment.

The effects of strict anaerobic conditions on the growth of Staphylococcus aureus and the production of staphylococcal enterotoxin A (SEA) were studied. The growth of S. aureus, a facultative anaerobic bacterium, is slower anaerobically than aerobically. When grown on brain heart infusion broth at 37 degrees C, the anaerobic generation time at mid-log phase was 80 min, compared with 35 min for the aerobic control. In contrast to previous studies demonstrating that staphylococcal cell density was 9- to 17-fold greater in aerobic than in anaerobic cultures, data for a staphylococcal strain implicated in food poisoning showed that the cell density was only two to three times as great in aerobic cultures. Production of SEA was monitored by Western immunoblotting and shown to be growth dependent. With slower anaerobic growth, relatively less toxin was produced than under aerobic conditions. but in both cases SEA was detected after 120 min of incubation. The combined effects of temperature and aeration on S. aureus were also studied. Growth and toxin production of aerobic and anaerobic cultures at temperatures ranging from 14 to 37 degrees C were analyzed. Growth was still observed at low temperatures in both environments. A linear model for S. aureus aerobic or anaerobic growth as a function of incubation temperature was developed from these studies. The model was tested from 17 to 35.5 degrees C, and the results suggest that the model can accurately predict the S. aureus growth rate in this temperature range. The data suggest that anaerobic conditions are not an effective barrier against S. aureus growth.

Performance of response surface and Davey model for prediction of Staphylococcus aureus growth parameters under different experimental conditions.

The combined effect of different temperatures (7 to 19 degrees C), pH levels (4.5 to 8.5), sodium chloride levels (0 to 8%), and sodium nitrite levels (0 to 200 ppm) on the predicted growth rate and lag time of Staphylococcus aureus under aerobic and anaerobic conditions was studied. The two predictive models developed, response surface (RS) and the Davey model, provided reliable estimates of the two kinetic parameters studied. The RS provided better predictions of maximum specific growth rate, with bias factors of 1.06 and 1.31 and accuracy factors of 1.17 and 1.37, respectively, in aerobic and anaerobic conditions. The Davey model performed more accurately for lag time, with a bias factor of 1.12 and an accuracy factor of 1.49, for both aerobic and anaerobic conditions. Predictive growth models are a valuable tool, enabling swift determination of Staphylococcus aureus growth rate and lag time. These data are essential for ensuring staphylococcus-related quality and safety of food products.