Food Poisoning: Bacterial
Food-borne bacteria and bacterial toxins are a common cause of epidemic gastroenteritis. In general, the illness is relatively mild and self-limited, with recovery within 24 hours. However, severe and even fatal poisoning may occur with listeriosis, salmonellosis, or botulism (See Botulism) and with certain strains of Escherichia coli. Poisoning after the consumption of fish and shellfish is discussed in Food Poisoning: Fish and Shellfish. Mushroom poisoning is discussed in Mushrooms. Viruses such as the Norwalk virus and Norwalk-like caliciviruses, enteroviruses, and rotaviruses are the causative agent in as many as 80% of food-related illness. Other microbes that can cause food-borne illness include Cryptosporidium and Cyclospora, which can cause serious illness in immunocompromised patients. However, in over half of reported food-borne outbreaks, no microbiological pathogens are identified.
Mechanism of toxicity. Gastroenteritis may be caused by invasive bacterial infection of the intestinal mucosa or by a toxin elaborated by bacteria. Bacterial toxins may be preformed in food that is improperly prepared and improperly stored before use or may be produced in the gut by the bacteria after they are ingested (Table II–26).
Table II-26 Bacterial Food Poisoning
Table II-26 Bacterial Food Poisoning
Organism
Incubation Period
Common Symptomsa and Mechanism
Common Foods
Bacillus cereus
1–6 h (emetic) 8–16 h (diarrheal)
V > D; toxins produced in food and gut
Reheated fried rice, improperly refrigerated meats.
Campylobacter jejuni
1–8 d
D+, F; invasive and possibly toxin produced in gut
Poultry, water, milk; direct contact (eg, food handlers).
Clostridium perfringens
6–16 h
D > V; toxin produced in food and gut
Meats, gravy, dairy products.
Escherichia coli “enterotoxigenic”
12–72 h
D > V; toxin produced in gut
“Traveler’s diarrhea”: water, various foods; direct contact (eg, food handlers).
E coli “enteroinvasive”
24–72 h
D+; invasive infection
Water, various foods; direct contact (eg, food handlers).
E coli “enterohemorrhagic” (STEC)
1–8 d
D+, S; toxin produced in gut
Water, ground beef, salami and other meats, unpasteurized milk and juice, contaminated lettuce and sprouts; direct contact (eg, food handlers).
Listeria monocytogenes
9–32 h
D+, S; invasive infection
Milk, soft cheeses, raw meat.
Salmonella spp
12–36 h
D+, F; invasive infection
Meat, dairy, eggs, water, sprouts; direct contact (eg, food handlers).
Shigella spp
1–7 d
D+; invasive infection
Water, fruits, vegetables; direct contact (eg, food handlers, contact with contaminated reptiles/frogs).
Staphylococcus aureus
1–6 h
V > D; toxin preformed in food; heat-resistant
Very common: meats, dairy, bakery foods; direct contact (eg, food handlers).
Vibrio parahemolyticus
8–30 h
V, D+; invasive and toxin produced in gut
Shellfish, water.
Yersinia enterocolytica
3–7 d
D+; invasive infection
Water, meats, dairy.
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
