FulminantBacillus cereusfood poisoning with fatal multi-organ failure

Abstract

This case represents a rare fulminant course of fried-rice associated food poisoning in an immunocompetent person due to pre-formed exotoxin produced by Bacillus cereus, with severe manifestations of sepsis, including multi-organ (hepatic, renal, cardiac, respiratory and neurological) failure, shock, metabolic acidosis, rhabdomyolysis and coagulopathy. Despite maximal supportive measures (continuous renal replacement therapy, plasmapheresis, N-acetylcysteine infusion and blood products, and broad-spectrum antimicrobials) and input from a multidisciplinary team (consisting of infectious diseases, intensive care, gastroenterology, surgery, toxicology, immunology and haematology), mortality resulted. This case is the first to use whole genome sequencing techniques to confirm the toxigenic potential of B. cereus. It has important implications for food preparation and storage, particularly given its occurrence in home isolation during the COVID-19 pandemic.

Comparative Analysis of Bacillus cereus Group Isolates' Resistance Using Disk Diffusion and Broth Microdilution and the Correlation between Antimicrobial Resistance Phenotypes and Genotypes

“…These antibiotics are widely used clinically due to the high prevalence of β-lactamases found among Bacillus cereus group isolates ( 22 – 24 ), although specific β-lactams (e.g., carbapenems) are also used in combination for the treatment of clinical cases ( 18 , 25 ). Notably, there are reports of poor patient outcomes due to carbapenem resistance ( 12 , 26 ). Recent studies have shown a high prevalence of resistance against penicillin, early cephalosporins, and 3rd and 4th generation cephalosporins among environmental isolates ( 2 , 27 – 29 ).…”

Survival of community-acquired Bacillus cereus sepsis with venous sinus thrombosis in an immunocompetent adult man – a case report and literature review

“…Our patient presented with elevated liver enzymes and bilirubin after onset, and abdominal ultrasound and CT revealed diffuse abnormalities in the liver. Emetic toxin of B. cereus can cross the blood-brain barrier to attack the central nervous system in immunocompetent people [20,25], causing subarachnoid hemorrhage, parenchymal hemorrhage, brain abscess, cerebral edema, and disturbance of consciousness [15,17]. Patients with hematological diseases combined with central nervous system involvement have a very poor prognosis for B. cereus infection [26].…”

Prevalence, distribution, enterotoxin profiles, antimicrobial resistance, and genetic diversity of Bacillus cereus group isolates from lettuce farms in Korea

“…These B. cereus group strains differ remarkably in their importance to medicine, public health and food safety (Mandic-Mulec et al, 2015). For example, some isolates of B. cereus and B. cytotoxicus strains cause foodborne illness (Naranjo et al, 2011;Guinebretière et al, 2013;Colaco et al, 2021). B. anthracis may cause different forms of anthrax diseases (cutaneous, gastrointestinal, and inhalational anthrax) to both animals and humans (Okinaka et al, 1999;Marston et al, 2005;Cote et al, 2015).…”