Usefulness and Limitations of PFGE Diagnosis and Nucleotide Sequencing Method in the Analysis of Food Poisoning Pathogens Found in Cooking Employees.

In the case of a food poisoning outbreak, it is essential to understand the relationship between cooking workers and food poisoning. Many biological diagnostic methods have recently been developed to detect food poisoning pathogens. Among these diagnostic tools, this study presents PCR-based pulsed-field gel electrophoresis and nucleotide sequencing diagnostic analysis results for diagnosing food poisoning outbreaks associated with cooking employees in Chungcheongnam-do, Republic of Korea. Pulsed-field gel electrophoresis was useful in identifying the food poisoning outbreaks caused by Staphylococcus aureus and Enteropathogenic Escherichia coli. In the case of Norovirus, nucleotide sequencing was used to identify the relationship between cooking workers and the food poisoning outbreak. However, it is difficult to determine whether cooking employees directly caused the food poisoning outbreaks based on these molecular biological diagnostic results alone. A system is needed to integrate epidemiological and diagnostic information to identify a direct correlation between the food poisoning outbreak and cooking employees.

From Foodborne Disease Outbreak (FBDO) to Investigation: The Plant Toxin Trap, Brittany, France, 2018.

On 6 July 2018, the Center for Epidemiology and Public Health of the French Armed Forces was informed of an outbreak of acute gastroenteritis among customers of a dining facility at a military base in Brittany, France. A total of 200 patients were reported out of a population of 1700 (attack rate: 12%). The symptoms were mainly lower digestive tract disorders and occurred rapidly after lunch on 5 July (median incubation period: 3.3 h), suggesting a toxin-like pathogenic process. A case-control survey was carried out (92 cases and 113 controls). Statistical analysis pointed to the chili con carne served at lunch on 5 July as the very likely source of poisoning. Phytohaemagglutinin, a plant lectin, was found in the chili con carne at a concentration above the potentially toxic dose (400 HAU/gram). The raw kidney beans incorporated in the chili con carne presented a high haemagglutination activity (66,667 HAU/gram). They were undercooked, and the phytohaemagglutinin was not completely destroyed. FBDOs due to PHA are poorly documented. This study highlights the need to develop methods for routine testing of plant toxins in food matrices. Improved diagnostic capabilities would likely lead to better documentation, epidemiology, and prevention of food-borne illnesses caused by plant toxins.

Molecular detection and genotype analysis of Kudoa septempunctata from food poisoning outbreaks in Korea.

Concerns about foodborne illnesses caused by Kudoa septempunctata are steadily growing, but reports of K. septempunctata in clinical and food specimens related to food poisoning in Korea are limited. This study aimed to genetically identify K. septempunctata in patients with acute diarrhea and in clinical and food samples related to food poisoning caused by sashimi consumption. Both real-time and nested polymerase chain reaction assays were performed to detect K. septempunctata 18S and 28S rDNA genes in the stools of 348 patients with acute diarrhea, 11 samples (6 stool and 5 rectal swab samples) from patients with food poisoning, and 2 raw Paralichthys olivaceus samples collected from a restaurant where a food poisoning incident occurred. K. septempunctata was identified in 5 clinical specimens (4 stools and 1 rectal swab) and 1 P. olivaceus sashimi sample. All detected K. septempunctata were of genotype ST3. This is the first study to identify K. septempunctata in both patients and food samples with epidemiological relevance in Korea, providing evidence that it is a pathogen that causes food poisoning. Also, this is the first study to confirm the presence of K. septempunctata genes in rectal swabs. Despite continuing suspected occurrences of Kudoa foodborne outbreaks, the rate of identification of K. septempunctata is very low. One reason for this is the limitation in obtaining stool and vomit samples for the diagnosis of Kudoa infection. We strongly suggest the inclusion of rectal swabs among the diagnostic specimens for Kudoa food poisoning.

"Lock-and-key" recognizer-encoded lateral flow assays toward foodborne pathogen detection: An overview of their fundamentals and recent advances.

In light of severe health risks of foodborne pathogenic bacterial diseases, the potential utility of point-of-care (POC) sensors is recognized for pathogens detection. In this regard, lateral flow assay (LFA) is a promising and user-friendly option for such application among various technological approaches. This article presents a comprehensive review of "lock-and-key" recognizer-encoded LFAs with respect to their working principles and detection performance against foodborne pathogenic bacteria. For this purpose, we describe various strategies for bacteria recognition including the antibody-based antigen-antibody interactions, nucleic acid aptamer-based recognition, and phage-mediated targeting of bacterial cells. In addition, we also outline the technological challenges along with the prospects for the future development of LFA in food analysis. The LFA devices built based upon many recognition strategies are found to have great potential for rapid, convenient, and effective POC detection of pathogens in complex food matrixes. Future developments in this field should emphasize the development of high-quality bio-probes, multiplex sensors, and intelligent portable readers.

Scombroid Poisoning: An Overview for the Emergency Nurse Practitioner.

Scombroid poisoning is a common fish-borne disease in clinical settings. Fish that has not been adequately stored after catching can allow bacteria to proliferate, which causes the conversion of histidine to histamine. Once histamine has formed, freezing or cooking the fish will not remove the histamine content. Once the fish is consumed, histamine is released, causing toxicity to the patient with symptoms including cutaneous, gastrointestinal, and anaphylactoid. Emergency nurse practitioners should identify, appropriately diagnose, and treat individuals with scombroid poisoning and avoid misdiagnosing it as fish allergy.

Molecular Mechanisms of Scombroid Food Poisoning.

Scombroid food poisoning (SFP) is a foodborne disease that develops after consumption of fresh fish and, rarely, seafood that has fine organoleptic characteristics but contains a large amount of exogenous histamine. SFP, like other food pseudo-allergic reactions (FPA), is a disorder that is clinically identical to allergic reactions type I, but there are many differences in their pathogenesis. To date, SFP has been widespread throughout the world and is an urgent problem, although exact epidemiological data on incidence varies greatly. The need to distinguish SFP from true IgE-associated allergy to fish and seafood is one of the most difficult examples of the differential diagnosis of allergic conditions. The most important difference is the absence of an IgE response in SFP. The pathogenesis of SFP includes a complex system of interactions between the body and chemical triggers such as exogenous histamine, other biogenic amines, cis-urocanic acid, salicylates, and other histamine liberators. Because of the wide range of molecular pathways involved in this process, it is critical to understand their differences. This may help predict and prevent poor outcomes in patients and contribute to the development of adequate hygienic rules and regulations for seafood product safety. Despite the vast and lengthy history of research on SFP mechanisms, there are still many blank spots in our understanding of this condition. The goals of this review are to differentiate various molecular mechanisms of SFP and describe methods of hygienic regulation of some biogenic amines that influence the concentration of histamine in the human body and play an important role in the mechanism of SFP.

One-step immunoassay based on filtration for detection of food poisoning-related bacteria.

A one-step immunoassay based on filtration was presented, which used microbeads for target analyte detection and filters with appropriate pore sizes to distinguish the complexity of target analyte and microbeads. For effective bacterial detection, the microbead size and the filter's pore size must be optimized. The optimal concentrations of the enzyme (urease) and antibody were determined at the maximum absorbance change, that is, the maximum pH change. The pH change was measured using a field-effect transistor (FET). The correlation between pH change and threshold voltage was estimated to be 21.7 mV/pH, and the correlation between pH change and the source-drain current was estimated to be -379 nA/pH. For the one-step immunoassay, antibodies against target bacteria were isolated from horse serum by filtration, and these antibodies were estimated to have a sufficiently high specificity to overcome cross-reactivity among five types of food poisoning-related bacteria: Escherichia coli O157, Salmonella typhimurium, Listeria monocytogenes, Bacillus cereus, and Staphylococcus aureus. Finally, the FET-based one-step immunoassay was demonstrated for five types of food poisoning-related bacteria in human serum.

An allergist's approach to food poisoning.

Foodborne illnesses represent a significant global health concern. These preventable diseases lead to substantial mortality and morbidity worldwide. Substantial overlap with food allergy exists with similar clinical presentations and symptom onset. Knowledge of the typically implicated microorganisms and toxins can help properly identify these diseases. A thorough history is essential to differentiate between these 2 disorders. The types of food implicated may be similar including milk, egg, fish, and shellfish. The timing of symptom onset may overlap and lead to misdiagnosis of disorders such as food protein-induced enterocolitis syndrome. Classically, histamine-related food poisoning is also typically confused with true food allergy and may be seen as related to fish and cheese. Knowledge of epidemiology, patterns, and etiology of allergic conditions and foodborne illness may help the allergist differentiate among these common diseases.

Botulismo alimentar: relato de caso de uma doença rara, grave e de relevância para a saúde pública / Foodborne botulism: case report of a rare, serious disease of public health relevance

Este resumo apresenta o relato de um caso de Botulismo ocorrido em maio de 2021 no Hospital do Servidor Público Municipal (HSPM) em São Paulo. O objetivo principal é sensibilizar os profissionais de saúde para considerar o Botulismo como uma possível causa de síndrome neuroparalítica aguda, apesar de sua raridade. Destaca-se a importância do diagnóstico precoce e do tratamento com antitoxina, juntamente com cuidados intensivos, para reduzir a mortalidade. O estudo é observacional e descritivo, relatando o caso de uma paciente hospitalizada com Botulismo de origem alimentar entre maio e agosto de 2021. Diante de uma síndrome neuroparalítica aguda, a suspeita de Botulismo e uma revisão da epidemiologia da doença são cruciais. Destaca-se a importância da antitoxina e dos cuidados intensivos no tratamento para reduzir a mortalidade. Complicações pós-infecção, como sequelas motoras, são comuns em pacientes de Botulismo, tornando essencial uma abordagem multidisciplinar de reabilitação física para uma recuperação eficaz. A Vigilância Epidemiológica e Sanitária desempenham um papel vital na prevenção e controle do Botulismo, incluindo a coleta e transporte oportunos de amostras, busca ativa de casos suspeitos e orientação à população sobre medidas preventivas. A qualidade dos dados notificados é fundamental para a eficácia dessas ações. Em vista da alta letalidade do Botulismo, destaca-se a importância de alertar os profissionais de saúde para identificar casos suspeitos, bem como treiná-los na integração com as unidades de Vigilância Sanitária e Epidemiológica. Isso permite uma identificação precoce e tratamento oportuno de casos suspeitos, contribuindo para a saúde pública. Palavras-chave: Botulismo. Neurotoxina botulínica. Intoxicação alimentar.

[Color Reaction Identification of Omphalotus guepiniformis Causing Food Poisoning].

Simple identification using a color reaction was applied to investigate poisoning, putatively caused by Omphalotus guepiniformis. Some leftover uncooked mushrooms had turned turquoise green when a beam reagent (5 w/v% potassium hydroxide ethanolic solution) was dripped onto the mushroom pileus. Furthermore, ethanol extract of the mushrooms exhibited the same color reaction. Then, illudin S, a toxic compound contained in O. guepiniformis, was detected in uncooked leftover mushrooms using LC-MS/MS analysis. Therefore, this case was inferred as caused by O. guepiniformis. These results indicate the identification method described above as useful for screening tests for investigating food poisoning caused by O. guepiniformis.

Molecular Methods for Identification and Quantification of Foodborne Pathogens.

Foodborne pathogens that enter the human food chain are a significant threat worldwide to human health. Timely and cost-effective detection of them became challenging for many countries that want to improve their detection and control of foodborne illness. We summarize simple, rapid, specific, and highly effective molecular technology that is used to detect and identify foodborne pathogens, including polymerase chain reaction, isothermal amplification, loop-mediated isothermal amplification, nucleic acid sequence-based amplification, as well as gene chip and gene probe technology. The principles of their operation, the research supporting their application, and the advantages and disadvantages of each technology are summarized.

Bacteriophage-Based Biosensors: A Platform for Detection of Foodborne Bacterial Pathogens from Food and Environment.

Foodborne microorganisms are an important cause of human illness worldwide. Two-thirds of human foodborne diseases are caused by bacterial pathogens throughout the globe, especially in developing nations. Despite enormous developments in conventional foodborne pathogen detection methods, progress is limited by the assay complexity and a prolonged time-to-result. The specificity and sensitivity of assays for live pathogen detection may also depend on the nature of the samples being analyzed and the immunological or molecular reagents used. Bacteriophage-based biosensors offer several benefits, including specificity to their host organism, the detection of only live pathogens, and resistance to extreme environmental factors such as organic solvents, high temperatures, and a wide pH range. Phage-based biosensors are receiving increasing attention owing to their high degree of accuracy, specificity, and reduced assay times. These characteristics, coupled with their abundant supply, make phages a novel bio-recognition molecule in assay development, including biosensors for the detection of foodborne bacterial pathogens to ensure food safety. This review provides comprehensive information about the different types of phage-based biosensor platforms, such as magnetoelastic sensors, quartz crystal microbalance, and electrochemical and surface plasmon resonance for the detection of several foodborne bacterial pathogens from various representative food matrices and environmental samples.

Giant Magnetoresistance Biosensors for Food Safety Applications.

Nowadays, the increasing number of foodborne disease outbreaks around the globe has aroused the wide attention of the food industry and regulators. During food production, processing, storage, and transportation, microorganisms may grow and secrete toxins as well as other harmful substances. These kinds of food contamination from microbiological and chemical sources can seriously endanger human health. The traditional detection methods such as cell culture and colony counting cannot meet the requirements of rapid detection due to some intrinsic shortcomings, such as being time-consuming, laborious, and requiring expensive instrumentation or a central laboratory. In the past decade, efforts have been made to develop rapid, sensitive, and easy-to-use detection platforms for on-site food safety regulation. Herein, we review one type of promising biosensing platform that may revolutionize the current food surveillance approaches, the giant magnetoresistance (GMR) biosensors. Benefiting from the advances of nanotechnology, hundreds to thousands of GMR biosensors can be integrated into a fingernail-sized area, allowing the higher throughput screening of food samples at a lower cost. In addition, combined with on-chip microfluidic channels and filtration function, this type of GMR biosensing system can be fully automatic, and less operator training is required. Furthermore, the compact-sized GMR biosensor platforms could be further extended to related food contamination and the field screening of other pathogen targets.

Detection of Bacillus cereus as a causative agent of emetic food poisoning by an unconventional culture procedure.

Bacillus cereus is known to cause two types of food poisoning: emetic and diarrhoeal. Both diseases are usually self-limiting; however, severe cases have been reported, presenting with acute liver failure and encephalopathy, including rarely fatal cases of vomiting. Clinical laboratories do not routinely test for B. cereus in patients with gastrointestinal disease. Therefore, B. cereus causing food poisoning goes undetected. We report a successful isolation of emetic B. cereus from a patient with food poisoning who presented with severe vomiting, fulminant hepatic failure, and acute encephalopathy, by a non-conventional method. Initially, stool specimens from the patients were routinely cultured to identify the causative organisms of food poisoning. No foodborne pathogens were detected in this study. In contrast, additional clinical and epidemiological information strongly suggested food poisoning by emetic B. cereus. Consequently, we allowed Drigalski agar medium smeared with patient stool specimens to stand at room temperature (approximately 25 °C) for 9 days. After 9 days, mixed bacteria grown on the medium were inoculated onto mannitol egg yolk polymyxin (MYP) agar plates, a selective medium for B. cereus. Typical colonies of B. cereus developed on MYP agar plates. The isolated B. cereus had a cereulide-producing genetic locus (ces) gene encoding the emetic toxin cereulide. The method used in this case study was unique. This method is easy to apply after obtaining an additional clinical and epidemiological information, and this method will improve the diagnostic rate of severe B. cereus food poisoning. This will contribute to the advancement of therapeutics in the future.

Current Scenario of Pathogen Detection Techniques in Agro-Food Sector.

Over the past-decade, agricultural products (such as vegetables and fruits) have been reported as the major vehicles for foodborne diseases, which are limiting food resources. The spread of infectious diseases due to foodborne pathogens poses a global threat to human health and the economy. The accurate and timely detection of infectious disease and of causative pathogens is crucial in the prevention and treatment of disease. Negligence in the detection of pathogenic substances can be catastrophic and lead to a pandemic. Despite the revolution in health diagnostics, much attention has been paid to the agro-food sector regarding the detection of food contaminants (such as pathogens). The conventional analytical techniques for pathogen detection are reliable and still in operation. However, laborious procedures and time-consuming detection via these approaches emphasize the need for simple, easy-to-use, and affordable detection techniques. The rapid detection of pathogens from food is essential to avoid the morbidity and mortality originating from the suboptimal nature of empiric pathogen treatment. This review critically discusses both the conventional and emerging bio-molecular approaches for pathogen detection in agro-food.

Problemas diagnósticos de la intoxicación por cianuro derivada de la ingesta de almendras amargas / Difficulties in the diagnosis of cyanide poisoning following consumption of bitter almonds

Los casos de intoxicación por ingesta de cianuro en niños son raros. La almendra amarga contiene amigdalina y se descompone tras su ingesta, produciendo ácido cianhídrico que bloquea el uso celular del oxígeno, lo que ocasiona afectación de órganos diana. Presentamos un caso de sospecha de intoxicación por cianuro en un niño de 3 años tras ingesta de almendras amargas. El diagnóstico de sospecha se estableció con base en la clínica gastrointestinal y neurológica y en el hallazgo gasométrico de acidosis metabólica con hiperlactacidemia y anión GAP aumentado, lo cual es muy específico de esta entidad. No se pudieron determinar los niveles de cianuro en ningún laboratorio habitual de España, tampoco en el Instituto Toxicológico Nacional y Ciencias Forenses sin disponer de orden judicial. Ante la clínica inespecífica y las dificultades para determinar la concentración de cianuro en sangre, debe ofrecerse tratamiento precoz y antídoto específico ante la sospecha de intoxicación por cianuro (AU)

Cyanide poisoning in children is rare. Bitter almonds contain amygdalin, and hydrolysis of this compound following ingestion yields hydrocyanic acid, which inhibits cellular oxygen use and therefore causes target organ damage. We present a case of suspected cyanide poisoning in a child aged 3 years after the ingestion of bitter almonds. The diagnosis was based on the gastrointestinal and neurological symptoms and the detection of metabolic acidosis with hyperlacticaemia and a high anion gap, which are highly specific for this type of poisoning. Blood cyanide levels could not be measured in any clinical laboratory in Spain, and it was also not possible to do it in the National Institute of Toxicology and Forensic Sciences without a court order. Given the non-specific symptoms and the difficulty of measuring the concentration of cyanide in blood, treatment should be initiated early with administration of specific antidote if cyanide poisoning is suspected. (AU)

Cutaneous infection due to Bacillus cereus: a case report.

BACKGROUND: Bacillus cereus is a Gram-positive bacterium that can be found in various natural and human-made environments. It is often involved in gastrointestinal infections and food poisoning; yet, it can rarely cause serious non-gastrointestinal tract infections. CASE PRESENTATION: Here we describe a case of B. cereus cutaneous infection of a wound on the hand of a young woman from a rural area in Iran. On admission, she had no systemic symptoms other than a cutaneous lesion. The identification of the causative agent was performed using sequencing of the 16S rRNA gene of the bacteria isolated from the wound. The isolated microorganism was identified as B. cereus. Targeted antibiotic therapy with ciprofloxacin was successful. DISCUSSION AND CONCLUSION: Although non-intestinal infections caused by B. cereus are rare, it should be taken into consideration that this organism might also cause infections in other parts of the body.