#Antimicrobial susceptibility of 260 #Clostridium botulinum types A, B, Ba and Bf strains and a #neurotoxigenic Clostridium baratii type F strain isolated from #California infant #botulism patients (AAC, abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Antimicrobial susceptibility of 260 Clostridium botulinum types A, B, Ba and Bf strains and a neurotoxigenic Clostridium baratii type F strain isolated from California infant botulism patients

Jason R. Barash, Joe B. Castles, III, Stephen S. Arnon

DOI: 10.1128/AAC.01594-18



Infant botulism is an infectious intestinal toxemia that results from colonization of the infant large bowel by Clostridium botulinum (or rarely, by neurotoxigenic C. baratii or C. butyricum), with subsequent intraintestinal production and absorption of botulinum neurotoxin that then produces flaccid paralysis. The disease is often initially misdiagnosed as suspected sepsis or meningitis, diagnoses that require prompt empiric antimicrobial therapy. Antibiotics may also be needed to treat infectious complications of infant botulism, such as pneumonia or urinary tract infection. Clinical evidence suggests (see included case report) that broad-spectrum antibiotics that are eliminated by biliary excretion may cause progression of the patient’s paralysis by lysing C. botulinum vegetative cells in the large bowel lumen and thereby increasing the amount of botulinum neurotoxin available for absorption. The purpose of this antimicrobial susceptibility study was to identify an antimicrobial agent with little or no activity against C. botulinum that could be used to treat infant botulism patients initially diagnosed with suspected sepsis or meningitis, or who acquired secondary infections, without lysing C. botulinum. Testing of 12 antimicrobial agents indicated that almost all California infant botulism patient isolates are susceptible to most clinically utilized antibiotics and are also susceptible to newer antibiotics not previously tested against large numbers of C. botulinum patient isolates. No antibiotic with little or no activity against C. botulinum was identified. These findings reinforce the importance of promptly treating infant botulism patients with Human Botulism Immune Globulin (BIG-IV; BabyBIG®).

Copyright © 2018 American Society for Microbiology. All Rights Reserved.

Keywords: Infant botulism; Antibiotics; USA; California; Clostridium botulinum.


Reoccurrence of #botulinum #neurotoxin subtype A3 inducing food-borne #botulism, #Slovakia, 2015 (@eurosurveillanc, abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Eurosurveillance, Volume 22, Issue 32, 10 August 2017  / Surveillance and outbreak report

Reoccurrence of botulinum neurotoxin subtype A3 inducing food-borne botulism, Slovakia, 2015

L Mad’arová 1 , BG Dorner 2 3 , L Schaade 3 , V Donáth 4 , M Avdičová 1 , M Fatkulinová 1 , J Strhársky 1 , I Sedliačiková 1 , C Klement 1 5 , MB Dorner 2 3

Author affiliations: 1. Regional Authority of Public Health Banská Bystrica, Banská Bystrica, Slovakia; 2. Robert Koch Institute, Consultant laboratory for neurotoxin-producing clostridia (botulism, tetanus), Berlin, Germany; 3. Robert Koch Institute, Centre for Biological Threats and Special Pathogens, Berlin, Germany; 4. F. D. Roosevelt Teaching Hospital, Department of Neurology, Slovak Medical University, Banská Bystrica, Slovakia; 5. Slovak Medical University, Faculty of Public Health, Bratislava, Slovakia

Correspondence: Martin Bernhard Dorner (dornerm@rki.de)

Citation style for this article: Mad’arová L, Dorner BG, Schaade L, Donáth V, Avdičová M, Fatkulinová M, Strhársky J, Sedliačiková I, Klement C, Dorner MB. Reoccurrence of botulinum neurotoxin subtype A3 inducing food-borne botulism, Slovakia, 2015. Euro Surveill. 2017;22(32):pii=30591. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2017.22.32.30591

Received:10 June 2016; Accepted:25 November 2016



A case of food-borne botulism occurred in Slovakia in 2015. Clostridium botulinum type A was isolated from three nearly empty commercial hummus tubes. The product, which was sold in Slovakia and the Czech Republic, was withdrawn from the market and a warning was issued immediately through the European Commission’s Rapid Alert System for Food and Feed (RASFF). Further investigation revealed the presence of botulinum neurotoxin (BoNT) subtype BoNT/A3, a very rare subtype implicated in only one previous outbreak (Loch Maree in Scotland, 1922). It is the most divergent subtype of BoNT/A with 15.4% difference at the amino acid level compared with the prototype BoNT/A1. This makes it more prone to evading immunological and PCR-based detection. It is recommended that testing laboratories are advised that this subtype has been associated with food-borne botulism for the second time since the first outbreak almost 100 years ago, and to validate their immunological or PCR-based methods against this divergent subtype.

Keywords: Clostridium Botulinum; Botulism; Slovakia.