Abstract
Staphylococcal food poisoning represents the most prevalent foodborne intoxication worldwide. It is caused by oral intake of enterotoxins preformed by Staphylococcus aureus in food. The relevance of newly described enterotoxins in outbreaks of staphylococcal food poisoning is controversially discussed. Although the staphylococcal enterotoxins SEG, SEI, SEM, SEN, and SEO elicit emesis in a monkey feeding assay, there has been no conclusive proof of their emetic activity in humans. In this study, we provide further evidence suggesting that one of these enterotoxins or a combination of SEG, SEI, SEM, SEN, and SEO cause staphylococcal food poisoning. We investigated two outbreaks registered with the Swiss Federal Office of Public Health, in which only Staphylococcus aureus strains harboring the egc cluster, including seg, sei, sem, sen, and seo linked to typical signs of staphylococcal food poisoning were isolated. The outbreaks were caused by consumption of raw goat cheese and semi-hard goat cheese, and were linked to strains assigned to CC45 (agr type I) and CC9 (agr type II), respectively. These outbreaks provide further evidence that newly-described staphylococcal enterotoxins are likely to cause staphylococcal food poisoning in humans.
Highlights
The CDC (Centers for Disease Control) estimates that 240,000 cases of Staphylococcal FoodPoisoning (SFP) occur each year in the US, leading to hopitalization in 1000 cases and to six deaths [1].In the EU, the number of Staphylococcal FoodPoisoning (SFP) outbreaks is rising, with 386 SFP outbreaks reported in 2013 [2]
The results of our study illustrate that risk factor analysis in SFP outbreak investigations should not be solely based on CPS counts
In the outbreak in 2007 due to Robiola fresh cheese from thermized goat milk, CPS count per g food considerably exceeded the legal limit of 105 CfU/g food, which is considered a health risk (EU 2073:2005)
Summary
The CDC (Centers for Disease Control) estimates that 240,000 cases of Staphylococcal FoodPoisoning (SFP) occur each year in the US, leading to hopitalization in 1000 cases and to six deaths [1].In the EU, the number of SFP outbreaks is rising, with 386 SFP outbreaks reported in 2013 [2]. Poisoning (SFP) occur each year in the US, leading to hopitalization in 1000 cases and to six deaths [1]. The causative agents are staphylococcal enterotoxins (SEs) preformed by Staphylococcus (S.) aureus in food. Within two to six hours after ingestion of food containing SEs, patients present with symptoms of acute gastroenteritis, including violent vomiting and diarrhea [3]. 10% of patients [4] seeking medical care, there are only a few SFP outbreaks, in which a causative. It was shown that strains harboring seg and sei only produce very low levels of SEG and SEI [7] and only weak emetic activity was demonstrated for SEI [8]. Only for the classical SEs [9] and SEH [10,11,12], there is evidence demonstrating emetic activity in humans. In recent years, there have been a growing number of studies indicating that
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