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Kim, Lim, Jang, Park, Lee, Park, Choi, and Lee: A Case of Emetic Toxin Producing Bacillus cereus Strains Isolated from Outbreak
Original Article

Korean J Clin Microbiol 2009;12(1):48-52.

Published online: 22 March 2009

DOI: https://doi.org/10.5145/KJCM.2009.12.1.48

A Case of Emetic Toxin Producing Bacillus cereus Strains Isolated from Outbreak

Jong Hyun Kim1, Eun Gyoung Lim2, Hyun Chul Jang1, Ju Young Park2, Sun Jin Lee1, Mi Sun Park1, Gil Bae Choi2, Bok Kwon Lee1

1Division of Enteric Bacterial Infections, Center for Infectious Diseases, National Institute of Health, Seoul, Korea

2Microbe Division, Ulsan Institute of Health and Environment, Ulsan, Korea

Correspondence: Bok Kwon Lee, Division of Enteric Bacterial Infections, Center for Infectious Diseases, National Institute of Health, 194, Tongil-ro, Eunpyeong-gu, Seoul 122-701, Korea. (Tel) 82-2-380-2981, (Fax) 82-2-352-4767, (E-mail) bokrates@nih.go.kr

Received 10 August 200810 February 2009       Accepted 25 February 2009

Copyright © 2009 Korean Journal of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bacillus cereus causes two types of gastrointestinal diseases: emesis and diarrhea. It produces one emetic toxin and nine different enterotoxins. In March 2008, eight of a family became sick after eating slices of raw fish. We isolated emetic toxin producing B. cereus from the stools of 6 patients and 2 sub-clincal humans. In this study, the presence of enterotoxin genes, such as those of haemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe), B. cereus enterotoxin T (BceT), enterotoxin FM (EntFM), cytotoxin K (cytK) and cereulide were assayed by polymerase chain reaction (PCR) methods. Their enterotoxin activities were assayed using the BCET- RPLA, Tecra ELISA kit and Hep-2 vacuole activity. Bacterial isolates were subtyped by pulsed-field gel electrophoresis (PFGE). This study demonstrates the emetic toxin-producing stains of B. cereus in clinical specimens, for the first time in the Republic of Korea.

Keywords: Emetic toxin, Cereulide, B. cereus

REFERENCES

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Fig. 1.
Vacuolation responses in Hep-2 cells after treatment with isolated B. cereus supernatant. (A) Hep-2 cell treated with B. cereus (case 1) culture supernatant at 1/64 dilution, 8 h after treatment. Arrow indicate vacuolation of cell (200× magnification). (B) B. cereus (case 2). (C) B. cereus (case 3). (D) B. cereus (case 4). (E) B. cereus (case 5). (F) B. cereus (case 6). (G) B. cereus (case 7). (H) B. cereus (case 8). (I) Hep-2 cells control with no vacuolation present, 8 h after treatment (200× magnification).
kjcm-12-48f1.tif
Fig. 2.
PFGE patterns of emetic toxin producing B. cereus isolated from patients of the outbreak. Control 1 and control 2 strain isolates from human and food in 2007, respectively.
kjcm-12-48f2.tif
Table 1.
Toxin gene profiles and toxin titer of B. cereus isolates obtained from outbreak case
No. case hbl gene nhe gene Enterotoxin gene NRPS gene bceT RPLA Tecra ELISA Vacuolation titer
hblA hblC hblD nheA nheB nheC cytK entFM bceT ces
1 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
2 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
3 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
4 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
5 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
6 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
7 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
8 − − − ＋ ＋ ＋ − ＋ − ＋ − − 128
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