Relationship between the incidence of infant botulism and the presence of botulinum-toxin producing clostridia in the soil of Argentina from 1982–2005

Lúquez, Carolina; Bianco, María I.; Sagua, María D.; Barzola, Cristian P.; Jong, Laura I. T. de; Degarbo, Stella Maris; Fernández, Rafael

doi:10.1055/s-0035-1557408

Cited by 12 publications

(8 citation statements)

References 36 publications

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“…Environmental studies report the presence of BoNT F in soil samples in Argentina, although BoNT A is the most common type and the only one detected in infant botulism cases in Argentina between 1982 and 2005 [16]. Studies on 294 honey and honey-comb samples from Denmark, Norway and Sweden using a multiplex-PCR method detected BoNT presence in 83 samples, of which two were positive for type F [17].…”

Section: Scientific Advice Background and Epidemiologymentioning

confidence: 99%

Cluster of two cases of botulism due to Clostridium baratii type F in France, November 2014

Castor¹,

Mazuet

Saint-Leger³

et al. 2015

Eurosurveillance

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The first two cases in France of botulism due to Clostridium baratii type F were identified in November 2014, in the same family. Both cases required prolonged respiratory assistance. One of the cases had extremely high toxin serum levels and remained paralysed for two weeks. Investigations strongly supported the hypothesis of a common exposure during a family meal with high level contamination of the source. However, all analyses of leftover food remained negative.

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Section: Scientific Advice Background and Epidemiologymentioning

confidence: 99%

Cluster of two cases of botulism due to Clostridium baratii type F in France, November 2014

Castor¹,

Mazuet

Saint-Leger³

et al. 2015

Eurosurveillance

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“…22 No cases of infant botulism have ever been reported in Africa, and the only case of infant botulism reported in Africa was confirmed to be not caused by honey. 23,24 No cases of infant botulism or flaccid paralysis have been reported (botulism is a reportable disease in Egypt), 25,26 while the average annual incidence of infant botulism in Argentina is 2.2 per 100,000 live births 27 and that in the United States is 2.1 per 100,000 live births. 28 We advise strict analysis for botulinum spores in honey prior to its use in infants with cholestasis.…”

Section: Discussionmentioning

confidence: 99%

Medical-grade Spore-free Natural Honey is an Effective Choleretic in Neonatal Cholestasis: A Pilot Single-center Trial

Kotb¹,

Satar²,

Badr³

et al. 2023

Gene Expr

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Background and objectives: Liver damage in cholestasis is multifactorial, yet bile acid-mediated hepatotoxicity is pivotal. Honey consumption has many physiological effects; it influences detoxification process (phase I, II and III), has antioxidant, anti-inflammatory, immune-stimulant, anti-ulcer, wound/burn healing effects and others. The bile acid ursodeoxycholic acid (UDCA) is currently used off-label to treat neonatal cholestasis. This study aimed to assess the effectiveness of spore-free natural honey to treat neonatal nonobstructive cholestasis.Methods: Thirty infants with cholestasis received spore-free natural honey. Their progression was compared to a control group with cholestasis (28 infants) and a historical group (31 infants) on UDCA. Results:The mean ± standard deviation (SD) follow-up duration was 29.68 ± 18.68 months. At presentation, the total bilirubin concentrations were 9.5 ± 5.9 mg/dL, 10.9 ± 7 mg/dL and 14 ± 9 mg/dL in the honey, control and UDCA groups, respectively (p = 0.064), and their direct bilirubin concentrations were 6 ± 4 mg/dL, 6.7 ± 4 mg/dL and 8.4 ± 6.9 mg/dL, respectively (p = 0.169). The final total bilirubin concentrations were 1.2 ± 1.7 mg/dL, 4.6 ± 8.2 mg/dL and 7.3 ± 8.9 mg/dL, (p = 0.006), and their final direct bilirubin concentrations were 0.8 ± 1 mg/dL, 2.77 ± 5.2 mg/dL and 5.1 ± 7.2 mg/dL (p = 0.008), with cure achievement in 25, 16 and 16 (p = 0.023), improvement in 3, 5 and 3 (p = 0.565), failure in 2, 3 and 10 (p = 0.016), and death in 0, 4 and 2, respectively (p = 0.095). None suffered from botulism or flaccid paralysis.Conclusions: Spore-free honey is effective in clearing cholestasis in neonates and infants. UDCA use in cholestasis in pediatric age should be abandoned as it is less effective and is associated with a worse outcome.

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“…Type A toxin has been the prevalent toxin found in soils and was detected in all cases of IB. 4,5 Some foods likely to be contaminated, such as honey, milk formulas, and some herbs (chamomile), have been reported as potential sources of spores responsible for IB cases in several publications. [6][7][8] Laboratory criteria for the diagnosis of IB include the detection of toxins in stools or serum or the isolation of C. botulinum from stools.…”

Section: Introductionmentioning

confidence: 99%

Infant botulism: a descriptive study in a pediatric intensive care unit

et al. 2023

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Introduction.Infant botulism (IB) is the most common form of human botulism in Argentina. Our objective was to describe the main aspects of diagnosis and management of patients with IB admitted to the pediatric intensive care unit (PICU).Methods. Observational, descriptive, and retrospective study. The PICU database with IB diagnosis in 2005-2020 period was used. Demographic variables, diagnostic methods, days of conventional mechanical ventilation (CMV), non-invasive ventilation (NIV), length of stay in the PICU and mortality upon hospital discharge were recorded.Results. In total, 21 patients with IB were recorded; 14 were male, their median age was 5 months (IQR: 2-6 m). Diagnosis was made by bioassay, and the toxin was identified in the serum of 12 patients. Only 1 patient did not require CMV; 1 patient had a tracheostomy; 18 patients received antibiotics; 5 received NIV. No patient was administered antitoxin and no patient died. The median length of stay in the hospital was 66 days (IQR: 42-76); in the PICU, 48 days (IQR: 29-78); and the median use of CMV, 37 days (IQR: 26-64). The delay until diagnostic confirmation was 15.8 ± 4.8 days. Conclusions.All patients were diagnosed using the bioassay technique, which resulted in a diagnostic delay that exceeds the recommended period for the administration of a specific treatment. No patient received a specific treatment. IB was related to a low mortality, but also to prolonged use of MV and length of hospital stay, which were associated with cross infections and frequent antibiotic use.

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Relationship between the incidence of infant botulism and the presence of botulinum-toxin producing clostridia in the soil of Argentina from 1982–2005

Cited by 12 publications

References 36 publications

Cluster of two cases of botulism due to Clostridium baratii type F in France, November 2014

Cluster of two cases of botulism due to Clostridium baratii type F in France, November 2014

Medical-grade Spore-free Natural Honey is an Effective Choleretic in Neonatal Cholestasis: A Pilot Single-center Trial

Infant botulism: a descriptive study in a pediatric intensive care unit

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