title: Growth and enterotoxin production by diarrhoeagenic Bacillus cereus in dietary supplements prepared for hospitalized HIV patients.
abstract: This study was initiated because of an increase in diarrhoeal episodes in a ward caring for patients infected with the human immunodeficiency virus (HIV). An examination of hospital-prepared dietary supplements (build-up food) found Bacillus cereus to be a potential problem. Due in part to inadequate refrigeration conditions (13 +/- 4 degrees C), the microbial flora in commercially pasteurized semi-skimmed milk (PSSM) reached potentially hazardous levels (> 10(6) cfu/mL). While refrigerated PSSM did not support enterotoxin production, reconstitution of build-up powder in PSSM followed by storage in the HIV ward (4 h at 28 +/- 3 degrees C) resulted in growth of B. cereus (> 10(7) cfu/mL) and synthesis of diarrhoeal enterotoxin. While insufficient epidemiological data was available to establish conclusively a causal relationship between patients' symptoms and source, the study highlights a potential B. cereus problem with hospital-prepared dietary supplements and recommendations are proposed to prevent this re-occurrence.
authors.affiliation: Department of Bioscience and Biotechnology, University of Strathclyde, Glasgow, Scotland.
authors.forename: N J
authors.initials: NJ
authors.lastname: Rowan
authors.forename: J G
authors.initials: JG
authors.lastname: Anderson
mesh_terms: D001409:Bacillus cereus / Q000254:growth & development / Q000302:isolation & purification*; D003967:Diarrhea / Q000209:etiology; D019587:Dietary Supplements / Q000382:microbiology*; D004768:Enterotoxins / Q000302:isolation & purification; D005516:Food Microbiology; D005521:Food Service, Hospital; D015658:HIV Infections / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D007841:Latex Fixation Tests; D012034:Refrigeration
chemical_list: D004768:Enterotoxins