Bacillus cereus is an endemic, soil-dwelling, Gram-positive, rod-shaped, motile, beta hemolytic
bacterium.
Some strains are harmful to humans and cause foodborne illness, while other strains can
be beneficial as probiotics for animals.
It is the cause of "fried rice syndrome", as the bacteria are classically contracted
from fried rice dishes that have been sitting at room temperature for hours.
B. cereus bacteria are facultative anaerobes, and like other members of the genus Bacillus,
can produce protective endospores.
Its virulence factors include cereolysin and phospholipase C.
Symbiosis B. cereus competes with other microorganisms
such as Salmonella and Campylobacter in the gut, so its presence reduces the numbers of
those microorganisms.
In food animals such as chickens, rabbits and pigs, some harmless strains of B. cereus
are used as a probiotic feed additive to reduce Salmonella in the intestines and cecum.
This improves the animals' growth as well as food safety for humans who eat their meat.
Pathogenesis B. cereus is responsible for a minority of
foodborne illnesses, causing severe nausea, vomiting, and diarrhea.
Bacillus foodborne illnesses occur due to survival of the bacterial endospores when
food is improperly cooked.
Cooking temperatures less than or equal to 100°C allow some B. cereus spores to survive.
This problem is compounded when food is then improperly refrigerated, allowing the endospores
to germinate.
Cooked foods not meant for either immediate consumption or rapid cooling and refrigeration
should be kept at temperatures below 10°C or above 50°C. Germination and growth generally
occur between 10°C and 50°C, though some strains are psychrotrophic.
Bacterial growth results in production of enterotoxins, one of which is highly resistant
to heat and acids; ingestion leads to two types of illness, diarrheal and emetic syndrome.
The diarrheal type is associated with a wide range of foods, has an 8.0- to 16-hour incubation
time, and is associated with diarrhea and gastrointestinal pain.
Also known as the 'long-incubation' form of B. cereus food poisoning, it might be difficult
to differentiate from poisoning caused by Clostridium perfringens.
The 'emetic' form is commonly caused by rice cooked for a time and temperature insufficient
to kill any spores present, then improperly refrigerated.
It can produce a toxin, cereulide, which is not inactivated by later reheating.
This form leads to nausea and vomiting one to five hours after consumption.
It can be difficult to distinguish from other short-term bacterial foodborne toxins such
as Staphylococcus aureus.
The diarrhetic syndromes observed in patients are thought to stem from the three toxins:
hemolysin BL, nonhemolytic enterotoxin and cytotoxin K.
The nhecytK genes are located on the chromosome of the bacteria.
Transcription of these genes is controlled by PlcR.
These genes occur in the taxonomically related B. thuringiensis and B. anthracis, as well.
These enterotoxins are all produced in the small intestine of the host, thus thwarting
digestion by host endogenous enzymes.
The Hbl and Nhe toxins are pore-forming toxins closely related to ClyA of E. coli.
The proteins exhibit a conformation known as "beta-barrel" that can insert into cellular
membranes due to a hydrophobic exterior, thus creating pores with hydrophilic interiors.
The effect is loss of cellular membrane potential and eventually cell death.
CytK is a pore-forming protein more related to other hemolysins.
The timing of the toxin production was previously thought to be possibly responsible for the
two different courses of disease, but in fact the emetic syndrome is caused by a toxin,
cereulide, found only in emetic strains and is not part of the "standard toolbox" of B.
cereus.
Cereulide is a cyclic polypeptide containing three repeats of four amino acids: D-oxy-Leu—D-Ala—L-oxy-Val—L-Val
produced by nonribosomal peptide synthesis.
Cereulide is believed to bind to 5-hydroxytryptamine 3 serotonin receptors, activating them and
leading to increased afferent vagus nerve stimulation.
It was shown independently by two research groups to be encoded on multiple plasmids:
pCERE01 or pBCE4810.
Plasmid pBCE4810 shares homology with the Bacillus anthracis virulence plasmid pXO1,
which encodes the anthrax toxin.
Periodontal isolates of B. cereus also possess distinct pXO1-like plasmids.
Like most of cyclic peptides containing nonproteogenic amino acids, cereulid is resistant to heat,
proteolysis, and acid conditions.
B. cereus is also known to cause difficult-to-eradicate chronic skin infections, though less aggressive
than necrotizing fasciitis.
B. cereus can also cause keratitis.
Diagnosis In case of foodborne illness, the diagnosis
of B. cereus can be confirmed by the isolation of more than 105 B. cereus organisms per gram
from epidemiologically implicated food, but such testing is often not done because the
illness is relatively harmless and usually self-limiting.
Prognosis Most emetic patients recover within six to
24 hours, but in some cases, the toxin can be fatal.
References
External links Bacillus cereus genomes and related information
at PATRIC, a Bioinformatics Resource Center funded by NIAID