Intesar report on food micro

Bacterial Agents of Foodborne Illness
Intesar T. Aba-Conding
Bio 482 – Food Microbiology
Aeromonas hydrophi l a
Baci l l us cereus and other Baci l l us
species
Brucel l a
Campyl obact er

Aeromonas hydrophi l a
Scientific classification
Domain: Bacteria
Phylum: Proteobacteria
Class: Gammaproteobacteria
Order: Aeromonadales
Family: Aeromonadaceae
Genus: Aeromonas
Species: A. hydrophila
Binomial name
Aeromonas hydrophila
(Chester, 1901)
Stanier, 1943

Introduction
 Currently, Aeromonas has the status of a foodborne pathogen of emerging
importance.
 Like Listeria monocytogenes, Plesiomonas, and Yersinia enterocolitica, it
has attracted attention primarily because of its ability to grow at chill
temperatures, prompting the concern that any threat it might pose will
increase with the increasing use of chilled foods
 It was ﬁrst isolated from drinking water by Zimmerman in 1890 and the
following year from frog’s blood by Sanarelli.
 They called their isolates Bacillus punctata and Bacillus hydrophilus
respectively and it was not until the 1930s that the genus Aeromonas was
ﬁrst described.
 Although the taxonomy is still not settled, more recent studies have led to
the recognition of two major groups within the genus: the Salmonicida
group, which contains the non-motile Aeromonas salmonicida and the
Hydrophila–Punctata group containing a number of motile species, including
A. hydrophila A. sobria, and A. caviae.

Epidemiology
• Worldwide – Aeromonas spp. are inhabitants of aquatic ecosystems
and are found in most parts of the world.
• Although the role of Aeromonas hydrophila as a causative agent of
human disease is controversial, some estimated that they may
cause 13 % of gastroenteritis cases in United States. Some
jurisdictions may not identify these organisms as pathogens.
• Aeromonas spp. are commonly found in ground water; drinking
water at treatment plants, distribution systems, and reservoirs; and
in clean and polluted lakes and rivers.
• The bacteria are found in about 1% - 27 % of drinking water.
Aeromonas hydrophila can be found in fresh produce, meat, and
dairy products.
• The risk of infection from oral ingestion of Aeromonas spp. is
7.3/billion for low exposure.
• Aeromonas spp. can also be found in soil.

The Organism and its Characteristics

Host Range
• Human
• Animals
• Birds
• Fish
• Cold-blooded marine and freshwater
reptiles

Pathogenesis and Clinical Features
• Because of its structure, it is very toxic to many organisms.
• When it enters the body of its victim, it travels through the
bloodstream to the first available organ.
• It produces aerolysin cytotoxic enterotoxin that can cause tissue
damage.
• A. hydrophila, A. caviae, and A. sobria are all considered to be
opportunistic pathogens, meaning they rarely infect healthy
individuals.
• A. hydrophila is widely considered a major fish and amphibian
pathogen, and its pathogenicity in humans has been recognized for
decades.
• The genomic insights of aeromonads could be a stepping stone into
understanding of them.

Pathogenic mechanism
• The pathogenicity of Aeromonas species was believed to be mediated by a
number of extracellular proteins such as
– aerolysin, lipase, chitinase, amylase, gelatinase, hemolysins, and enterotoxins.
• Gastroenteritis associated with Aeromonas occurs most commonly in
children under ﬁve years old.
• It is normally mild and self-limiting mostly characterized by profuse watery
diarrh
• Aeromonas spp., particularly A. hydrophila and A. sobria, produce a range
of potential virulence factors including a number of distinct cytotoxic and
cytotonic enterotoxins.
• Most clinical strains of A. hydrophila and A. sobria produce aerolysin, a
heat-labile, b-haemolytic, cytotoxic enterotoxin with a molecular mass of 52
kDa.
• Three cytotonic enterotoxins have also been described which act like
cholera toxin, stimulating accumulation of high levels of cAMP within
epithelial cells.
• Only one of these shows any marked structural similarity to cholera toxin as
measured by cross reactivity with cholera toxin antibodies.

Isolation and Identification
• In some instances enrichment media such as alkaline peptone
water are used, but where high numbers are present direct plating is
usually su cient.ffi
• Species of the Hydrophila group grow on a wide range of enteric
media but may often be misidentified as ‘coliforms’ since many
strains can ferment lactose.
• Most cannot ferment xylose and this is a useful distinguishing
feature used in several media.
• As well as bile salts, ampicillin is used as a selective agent in media
such as starch ampicillin agar, blood ampicillin agar and some
commercial formulations.
• Colonies which give the characteristic appearance of Aeromonas on
the medium concerned and are oxidase-positive are then confirmed
with biochemical tests.

• INFECTIOUS DOSE:
– The infectious dose for humans and animals is greater than 10 10
organisms.
• MODE OF TRANSMISSION:
– Infection is spread via fecal-oral transmission during direct ingestion or drinking of
contaminated water or foods. Infection can also be transmitted by eating contaminated
meat, dairy, shrimp, or fish.
• INCUBATION PERIOD:
– The reported incubation period for Aeromonas-associated diarrhea is 1 to 2 days.
– Aeromonas’ infections contracted via recreational sporting activities, such as swimming
occur as early as 24h post exposure.
– Cellulitis is the most frequent soft tissue infection and is usually accompanied by systemic
signs developing within 8 to 48 h.
– The length of time from initial A. hydrophila infection to bacteremia ranges from 1 to 38
days.
• COMMUNICABILITY:
– It can be transferred from human-to-human by contact with infected wounds, feces or blood.
– The pathogen can also be transferred during sports; especially when played in muddy
environments involving transfer of infected soil.

Treatment
• A. hydrophila can be eliminated using a 1%
sodium hypochlorite solution or 2% calcium hypochlorite
solution.
• Brage et al., 1990 recommends fluoroquinolone
administration as a prophylactic treatment during
medicinal leech application.[8]
• Antibiotics such as chloramphenicol, florfenicol,
tetracycline, sulfonamide, nitrofuran derivatives, and
Pyridinecarboxylic acids are used to eliminate and
control the infection of A. hydrophila.
• Terramycin is placed in fish food during hatchery
operations as another chemotherapeutic agent in
preventing A. hydrophila.

Aeromonas in Blood AgarAeromonas in Blood Agar
Ref: http://www.microbiologyatlas.kvl.dkRef: http://www.microbiologyatlas.kvl.dk
Medium sized to large, smooth
colonies, which are white, or
especially in older cultures, buff in
colour. The colonies have an entire
margin.
The same Blood Agar plate examined
with transmitted light. The colonies
are surrounded by a wide haemolysis
zone.

Association with Foods
• A. hydrophila infections occur most often during
environmental changes, stressors, changes in
temperature, in contaminated environments, and
when an organism is already infected with a
virus or another bacterium.
• It can also be ingested through food products
contaminated with the bacterium, such as
seafood, meats, and even certain vegetables
such as sprouts. It can also be transmitted by
leeches.

Baci l l us cereus
and other
Baci l l us species

Baci l l us cereus and other Baci l l us
species
Domain: Bacteria
Phylum: Firmicutes
Class: Bacilli
Order: Bacillales
Family: Bacillaceae
Genus: Bacillus
Species: B. cereus
Binomial name
Bacillus cereus
Frankland & Frankland 1887

Introduction
• An early report associating food poisoning with Bacillus spp. was
made in 1906 when Lubenau described an outbreak in a sanatorium
where 300 inmates and sta developed symptoms of profuseﬀ
diarrhoea, stomach cramps and vomiting.
• A spore forming bacillus was isolated from meatballs from the
incriminated meal.
• Although Lubenau named the organism Bacillus peptoniﬁcans, the
properties he described resemble those of B. cereus.
• Subsequently, aerobic spore formers were implicated in a number of
outbreaks in Europe and between 1936 and 1943 they were
suspected of causing 117 of 367 cases investigated by the
Stockholm Board of Health.

• Bacillus cereus was not conclusively established as a cause of food
poisoning until 1950, after the taxonomy of the genus had been
clarified.
• Hauge described four outbreaks in Norway involving 600 people.
• The food vehicle was a vanilla sauce which had been prepared a
day in advance and stored at room temperature before serving.
• This classic report and many of the early ones from Europe
described an illness in which diarrhoea was the predominant
symptom.
• It is now known that B. cereus is responsible for two distinct types of
foodborne illness: a relatively late-onset, ‘diarrheal syndrome’ and a
rapid-onset, ‘emetic syndrome’, first described in 1971 in the UK.
• It accounted for 33% of total bacterial food poisoning cases in
Norway between 1988 and 1993, 47% in Iceland (1985–1992), 22%
in Finland (1992) and 8.5% in the Netherlands (1991).
• In Denmark, England and Wales, Japan, the USA and Canada the
figure ranges between 0.7 and 5.0%.

• Symptoms of the diarrhoeal syndrome resemble those of
Clostridium perfringens food poisoning.
• The onset of illness is about 8–16h after consumption of
the food, lasts for between 12 and 24h, and is
characterized by abdominal pain, profuse watery
diarrhoea and rectal tenesmus.
• Nausea and vomiting are less frequent.
• The emetic syndrome resembles the illness caused by
Staphylococcus aureus.
• It has a shorter incubation period than the diarrhoeal
syndrome, typically 0.5–5h, and nausea and vomiting,
lasting between 6 and 24h, are the dominant feature.

Colonies on a plate of blood agar of
Bacillus anthracis (right) and Bacillus cereus (left)

• The ability of spores to resist desiccation allows their survival on
dried products such as cereals and ﬂours.
• Dried herbs and spices used in food preparation can be an
important source of B. cereus causing food poisoning
• Meat pies and pasties are common vehicles for the other
foodpoisoning bacilli along with a range of processed meats and
meat and rice dishes.
• Baked goods such as bread and crumpets have been involved in a
number of B. subtilis outbreaks.
– Although B. subtilis is responsible for the defect known as ropey bread where spores surviving baking
degrade the loaf ’s internal structure and produce a sticky slime, this does not always prevent people from
eating it.
– In 1988, a bakery in the Isle of Man omitted propionate from their bread in order to claim for it the virtue of
being free from artiﬁcial preservatives and thereby more healthy.
– As a result, nine people developed nausea, vomiting, diarrhoea, headache and chills 10min after
consuming ropey bread

Brucel l a
Domain: Bacteria
Class: Alphaproteobacteria
Order: Rhizobiales
Family: Brucellaceae
Genus: Brucella
Species
B. abortus
B. canis
B. ceti
B. inopinata
B. melitensis
B. microti
B. neotomae
B. ovis
B. pinnipedialis
B. suis[1]

The species of Brucella and other principal hosts

Introduction
• The genus Brucella is named after Sir David Bruce who in 1887
recognized it as the causative organism of undulant fever
(brucellosis, Malta fever, Mediterranean fever).
• Each of the four species that are human pathogens is associated
with a particular animal host, B. abortus (cattle), B. melitensis
(sheep and goats), B. suis (pigs), and B. canis (dogs) (Table 7.3).
• Brucellosis is principally contracted from close association with
infected animals and is an occupational disease of farmers,
herdsmen, veterinarians and slaughterhouse workers.
• It can also be contracted by consumption of milk or milk products
from an infected animal, although the risk is lower.
• The illness has been e ectively eliminated from the United States,ﬀ
Scandinavia, the UK and other countries by campaigns to eradicate
the organism in the national dairy herds through a programme of
testing, immunization of young calves and compulsory slaughter of
infected cattle.

• Brucellosis is a protracted and debilitating illness characterized by
an incubation period of from one to six weeks followed by a chronic,
relapsing fever with accompanying lassitude, sweats, headache,
constipation, anorexia, pains in the limbs and back, and weight loss.
• After the temperature has returned to normal for a few days, another
bout of fever may ensue and such episodes recur a number of times
over several months.
• Treatment is commonly with a mixture of tetracycline and
streptomycin.
• It is a facultative parasite and can live intracellularly or in
extracellular body ﬂuids.
• During the febrile stage, caused by circulating endotoxin, the
organism may be isolated from the bloodstream but in the majority
of laboratory-conﬁrmed cases diagnosis is based on serological
tests rather than cultural techniques.

Infections in Human
• The incubation period is difficult to
determine in humans but has been
estimated at five days to three months.
• Most infections seem to become apparent
within two weeks.
• Aerosolization of bacteria in biological
weapons could result in a shorter
incubation period.

Clinical Signs
• Brucellosis is a multisystemic disease with a broad spectrum of
symptoms.
• Asymptomatic infections are common.
• In symptomatic cases, the disease is extremely variable and the
clinical signs may appear insidiously or abruptly.
• Typically, brucellosis begins as an acute febrile illness with
nonspecific flu-like signs such as fever, headache, malaise, back
pain, myalgia and generalized aches.
• Drenching sweats can occur, particularly at night.
• Splenomegaly, hepatomegaly, coughing and pleuritic chest pain are
sometimes seen.
• Gastrointestinal signs including anorexia, nausea, vomiting, diarrhea
and constipation occur frequently in adults but less often in children.

Treatment
•Brucellae are sensitive to a number of oral antibiotics and
aminoglycosides.
•The combination of tetracycline and doxycycline is effective against
most species of Brucella.
Prevention
•Persons handling the animals should use protective clothing and
gloves.
•Pasteurization or boiling of milk should be done.
•Cattle should be vaccinated with live attenuated Br. abortus strain 19,
RB 51 for cows. Vaccine is given intradermally.
•Unimmunized infected animals should be slaughtered.

• Brucella are quite fastidious organisms and do not grow in
conventional laboratory media.
• Liver infusions or calf serum are normally added.
• The organism grows slowly and cultures are normally
incubated for three weeks before they are considered
negative.
• In view of this, testing foods for the organism is not practically
feasible or useful.
• Cattle are tested for the presence of antibodies to the
organism in the ‘Ring Test’.
• Stained antigen is mixed with the test milk, if antibodies to
Brucella are present (indicative of infection) then they will
cause the antigen to clump and rise with the milkfat on
standing to form an intense blue-violet ring at the top of the
milk.

Transmission
• B. abortus, B. melitensis, B. suis and B. canis are usually
transmitted between animals by contact with the placenta, fetus,
fetal fluids and vaginal discharges from an infected animal.
• Animals are infectious after either an abortion or full term
parturition.
• Although ruminants are usually asymptomatic after their first
abortion, they can become chronic carriers, and continue to shed
Brucella in milk and uterine discharges during subsequent
pregnancies.
• Dogs may also shed B. canis in later pregnancies, with or without
symptoms.
– Entry into the body occurs by ingestion and through the mucous membranes,
broken skin and possibly intact skin.
• Most or all Brucella species are also found in semen

• Although brucellosis has sometimes been associated
with the consumption of inadequately cooked meat from
an infected animal, raw milk or cream are the principal
food vehicles.
• Brucella is readily killed by normal milk pasteurization
conditions so there is no risk from pasteurized milk or
products made from it.
• Cheeses made from unpasteurized milk can sometimes
pose a problem since the organism can survive the
cheesemaking processes and subsequent storage in the
product.

Campyl obact er
Domain: Bacteria
Class: Epsilonproteobacteria
Order: Campylobacterales
Family: Campylobacteraceae
Genus:
Campylobacter
Sebald & Véron, 1963

• In the 1970s, with the development of suitable selective media, it
was established that Campylobacter jejuni, and to a lesser extent
Campylobacter coli, are a major cause of diarrhoeal illness, rivalling
and even surpassing Salmonella in importance in many countries.
• Campylobacter laridis, C. concisus and C. hyointestinalis have also
been isolated occasionally from patients with diarrhoea and C.
pylori, now reclassiﬁed as Helicobacter pylori, has been associated
with gastritis and stomach and duodenal ulcers.
• The Campylobacter-like genus Arcobacter is frequently associated
with abortion and enteritis in cattle and pigs.
• Two species, Arcobacter butzleri and A. cryaerophilus, have also
been implicated in human infections causing diarrhoea, bacteraemia
and other extra-enteric infections.

Epidemiology
• Source of infection is food of animal origin, especially raw milk.
• It is part of the normal intestinal flora of domestic animals and birds and is
shed in their feces.
• Contaminated poultry are responsible for more than half of the Campylobacter
infection.
• Human acquire infection with C.jejuni and C.coli after consumption of
contaminated food, milk or water.
• Once a person is infected, the organism can be transmitted from person to
person by faecal-oral route.
• Incidence rate high among children less than 2 year old and young adults(20 to
40 years old).

• Enteropathogenic campylobacters cause an acute enterocolitis
which, in the absence of microbiological evidence, is not easily
distinguished from illness caused by other pathogens.
• The incubation period is from 1 to 11 days, most commonly 3–5
days, with malaise, fever, severe abdominal pain and diarrhoea as
the main symptoms.
• The diarrhoea produces stools which are often foul-smelling and
can vary from being profuse and watery to bloody and dysenteric.
• Gastrointestinal symptoms are sometimes preceded by a prodromal
stage of fever, headache and malaise which lasts about a day.
• Excretion of the organism continues for up to 2–3 weeks.
• Vomiting is a less common feature.
• Reactive arthritis can develop
• Campylobacter has been shown to cause the serious neurological
disease, Guillain–Barre syndrome.

Treatment
•Gastroenteritis, Infection is self-limited and is managed by
fluid and electrolyte replacement.
•Severe gastroenteritis treated with erythromycin and
Ciprofloxacin.
Prevention
•Potentially contaminated food, such as poultry, should be
throughly cooked, and milk and milk prodcuts should be
pasteurised.

• Although most of the isolation procedures and media used were
designed for C. jejuni, they are also suitable for C. coli and C.
laridis.
• Pathogenic campylobacters have a reputation for being di cult toﬃ
grow but in fact their nutritional requirements are not particularly
complex and they can be grown on a number of peptone-based
media including nutrient broth.
• Where problems can sometimes arise is in their sensitivitiy to
oxygen and its reactive derivatives.
• Although pathogenic campylobacters possess catalase and
superoxide dismutase, the accumulation of peroxides and
superoxide in media during storage or incubation can inhibit growth.
• For this reason an incubation atmosphere of 5–6% oxygen with
about 10% carbon dioxide and media containing oxygen scavenging
compounds such as blood, pyruvate, ferrous salts, charcoal and
metabisulﬁte are commonly used.

• The incidence of Campylobacter infection is
characterized by large numbers of sporadic cases rather
than single source outbreaks.
• Infection can be acquired by a number of routes. Direct
transmission person-to-person or from contact with
infected animals, particularly young pets such as kittens
or puppies, has been reported, as have occasional
waterborne outbreaks.

• As a common inhabitant of the gastrointestinal tract of warm-
blooded animals, Campylobacter inevitably finds its way on to meat
when carcasses are contaminated with intestinal contents during
slaughter and evisceration.
• Poultry carcasses which cool more rapidly due to their size su erff
less surface drying when air-chilled and this, probably coupled with
the surface texture of poultry skin, enhances survival
• Milk can contain Campylobacter as a result of faecal contamination
on the farm or possibly Campylobacter mastitis. The bacterium
cannot survive correct pasteurization procedures and the majority of
outbreaks, m
• Other foods recognized as potential sources of Campylobacter
infection include shellfish and mushrooms. any quite large, have
involved unpasteurized milk.

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