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Dual-Toxin ("Bivalent") Infant Botulism in California, 1976-2020: Epidemiologic, Clinical, and Laboratory Aspects.
Panditrao, Mayuri V; Chung, Connie H; Khouri, Jessica M; Barash, Jason R; Motter, Ruth N; Dover, Nir; Arnon, Stephen S.
Afiliación
  • Panditrao MV; Epidemiology, Surveillance, and Modeling Branch, COVID-19 Response California Department of Public Health, Richmond, CA.
  • Chung CH; Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA.
  • Khouri JM; Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA. Electronic address: jessica.khouri@cdph.ca.gov.
  • Barash JR; Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA.
  • Motter RN; Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA.
  • Dover N; Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA.
  • Arnon SS; Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA.
J Pediatr ; 253: 8-13, 2023 02.
Article en En | MEDLINE | ID: mdl-35977619
OBJECTIVE: To assess the consequences of infant botulism that result from Clostridium botulinum strains that produce 2 botulinum toxin serotypes, termed "bivalent." STUDY DESIGN: Epidemiologic investigations used a standard questionnaire. Clostridium botulinum strains were isolated by standard methods. Botulinum neurotoxin (BoNT) serotypes and the relative amounts of toxins produced were identified using the standard mouse bioassay. BoNT subtypes and genomic locations were identified by DNA nucleotide sequencing. RESULTS: Thirty bivalent cases of infant botulism occurred in the 45 years (1976-2020), representing 2.0% of all California infant botulism cases, in the 3 geographic regions of southern California, the southern Central Valley, and mid-northern California. Toxin serotype combinations were Ba (n = 22), Bf (n = 7), and Ab (n = 1). More patients with illness caused by bivalent C botulinum Ba and Bf strains needed endotracheal intubation at hospital admission, 60.0% (18/30), than did patients with illness caused by monovalent BoNT/B strains, 34.3% (152/443). The Cbotulinum Ba and Bf strains produced BoNT/B5 and either BoNT/A4 or /F2. The Ab strain produced BoNT/A2 and /B1. All toxin gene clusters were on plasmids. CONCLUSIONS: Infant botulism caused by bivalent Cbotulinum strains occurs sporadically and in diverse locations in California. Affected patients with bivalent Ba and Bf strains lacked distinguishing epidemiological features but appeared to be more severely paralyzed at hospital presentation than patients with illness caused by only BoNT/B. These bivalent strains produced BoNT subtypes A2, A4, B1, B5, and F2, and all toxin gene clusters were on plasmids.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Botulismo / Clostridium botulinum Límite: Animals País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Botulismo / Clostridium botulinum Límite: Animals País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos