Investigation on Food Poisoning Outbreak Caused by Staphylococcusaureus Enterotoxin A and Incidence of Staphylococcal Food Poisoning in the Kingdom of Bahrain
Staphylococcal food poisoning (SFP) is one of the most common foodborne diseases resulting from the ingestion of food contaminated with Staphylococcusaureus enterotoxins. The aim of the study is to provide an overview of the incidence of staphylococcal food poisoning in Bahrain and to describe the epidemiological and microbiological investigations of food poisoning outbreak among school members in 2018. A single-center, retrospective study was conducted at Public Health Laboratories (PHL) in Bahrain. All food poisoning samples received at PHL from 2013 to 2021 were included in this study. The epidemiological and laboratory investigations of an outbreak in 2018 among school members were included. Overall, staphylococcal enterotoxin food poisoning accounted for 28.1% of confirmed food poisoning cases; Staphylococcal enterotoxin A (SEA) was the most prevalent toxin (60%). In the school outbreak, the laboratory investigation showed the presence of SEA in chicken shawarma. SEA has also been isolated from patients’ stool samples and food handlers’ hands, nose and throat swabs. Outbreak investigations revealed that poor hygiene practices during food processing and improper food handling practices accounted for this outbreak. SEA was the cause of food poisoning outbreak among members of the school due to poor personal hygiene of the food handlers and improper food handling. Training workers to follow all hygienic protocols and practices for preparing, handling, and cooking food should be considered to avoid future outbreaks.
References
[1]
Karimzadeh, R. and Ghassab, R.K. (2022) Identification of Nuc Nuclease and Sea Enterotoxin Genes in Staphylococcus Aureus Isolates from Nasal Mucosa of Burn Hospital Staff: A Cross-Sectional Study. NewMicrobesandNewInfections, 47, Article 100992. https://doi.org/10.1016/j.nmni.2022.100992
[2]
Hu, W.D. (2016) Distribution of Food-Borne Staphylococcus Aureus Enterotoxin Genes. Genetics and Molecular Research, 15, Article 15016084.
[3]
Fetsch, A. and Johler, S. (2018) Staphylococcus Aureus as a Foodborne Pathogen. Current Clinical Microbiology Reports, 5, 88-96. https://doi.org/10.1007/s40588-018-0094-x
[4]
Centers for Disease Control and Prevention (2024) About Staph Food Poisoning. https://www.cdc.gov/staph-food-poisoning/about/index.html
[5]
Mekhloufi, O.A., Chieffi, D., Hammoudi, A., Bensefia, S.A., Fanelli, F. and Fusco, V. (2021) Prevalence, Enterotoxigenic Potential and Antimicrobial Resistance of Staphylococcus Aureus and Methicillin-Resistant Staphylococcus Aureus (MRSA) Isolated from Algerian Ready to Eat Foods. Toxins, 13, Article 835. https://doi.org/10.3390/toxins13120835
[6]
Grispoldi, L., Karama, M., Armani, A., Hadjicharalambous, C. and Cenci-Goga, B.T. (2021) Staphylococcus aureus Enterotoxin in Food of Animal Origin and Staphylococcal Food Poisoning Risk Assessment from Farm to Table. Italian Journal of Animal Science, 20, 677-690. https://doi.org/10.1080/1828051x.2020.1871428
[7]
Chen, D., Song, Q., Xu, Z. and Zhang, D. (2018) Characterization of Enterotoxin A-Producing Staphylococcus aureus. Infection and Drug Resistance, 11, 531-538. https://doi.org/10.2147/idr.s164278
[8]
Wu, S., Duan, N., Gu, H., Hao, L., Ye, H., Gong, W., et al. (2016) A Review of the Methods for Detection of Staphylococcus aureus Enterotoxins. Toxins, 8, Article 176. https://doi.org/10.3390/toxins8070176
[9]
Fisher, E.L., Otto, M. and Cheung, G.Y.C. (2018) Basis of Virulence in Enterotoxin-Mediated Staphylococcal Food Poisoning. Frontiers in Microbiology, 9, Article 436. https://doi.org/10.3389/fmicb.2018.00436
[10]
Denayer, S., Delbrassinne, L., Nia, Y. and Botteldoorn, N. (2017) Food-Borne Outbreak Investigation and Molecular Typing: High Diversity of Staphylococcus aureus Strains and Importance of Toxin Detection. Toxins, 9, Article 407. https://doi.org/10.3390/toxins9120407
[11]
Alhashimi, H.M.M., Ahmed, M.M. and Mustafa, J.M. (2017) Nasal Carriage of Enterotoxigenic Staphylococcus aureus among Food Handlers in Kerbala City. Karbala International Journal of Modern Science, 3, 69-74. https://doi.org/10.1016/j.kijoms.2017.02.003
[12]
Şanlıbaba, P. (2022) Prevalence, Antibiotic Resistance, and Enterotoxin Production of Staphylococcus Aureus Isolated from Retail Raw Beef, Sheep, and Lamb Meat in Turkey. International Journal of Food Microbiology, 361, Article 109461. https://doi.org/10.1016/j.ijfoodmicro.2021.109461
[13]
Kadariya, J., Smith, T.C. and Thapaliya, D. (2014) Staphylococcus aureus and Staphylococcal Food-Borne Disease: An Ongoing Challenge in Public Health. BioMed Research International, 2014, 1-9. https://doi.org/10.1155/2014/827965
[14]
Sergelidis, D. and Angelidis, A.S. (2017) Methicillin-Resistant Staphylococcus aureus: A Controversial Food-Borne Pathogen. Letters in Applied Microbiology, 64, 409-418. https://doi.org/10.1111/lam.12735
[15]
Etter, D., Schelin, J., Schuppler, M. and Johler, S. (2020) Staphylococcal Enterotoxin C—An Update on SEC Variants, Their Structure and Properties, and Their Role in Foodborne Intoxications. Toxins, 12, Article 584. https://doi.org/10.3390/toxins12090584
[16]
Mourenza, Á., Gil, J.A., Mateos, L.M. and Letek, M. (2021) Novel Treatments and Preventative Strategies against Food-Poisoning Caused by Staphylococcal Species. Pathogens, 10, Article 91. https://doi.org/10.3390/pathogens10020091
[17]
Beyene, G., Mamo, G., Kassa, T., Tasew, G. and Tiku Mereta, S. (2019) Nasal and Hand Carriage Rate of Staphylococcus aureus among Food Handlers Working in Jimma Town, Southwest Ethiopia. Ethiopian Journal of Health Sciences, 29, 605-612. https://doi.org/10.4314/ejhs.v29i5.11
[18]
Freitas, J.K.G.R., Assis, C.F.D., Oliveira, T.R.M.D., Maia, C.M.D.M., de Sousa, B.J., Medeiros, G.C.B.S.D., et al. (2023) Prevalence of Staphylococcal Toxin in Food Contaminated by Staphylococcus Spp.: Protocol for a Systematic Review with Meta-Analysis. PLOS ONE, 18, e0282111. https://doi.org/10.1371/journal.pone.0282111
[19]
Medvedova, A., Havlíková, A. and Valík, L. (2017) Staphylococcus aureus Enterotoxin Production in Relation to Environmental Factors. In: Enany, S. and Crotty Alexander, L.E., Eds., The Rise of Virulence and Antibiotic Resistance in Staphylococcus aureus, Intech Open, 145-167. https://doi.org/10.5772/66736
[20]
Le, H.H.T., Dalsgaard, A., Andersen, P.S., Nguyen, H.M., Ta, Y.T. and Nguyen, T.T. (2021) Large-Scale Staphylococcus aureus Foodborne Disease Poisoning Outbreak among Primary School Children. Microbiology Research, 12, 43-52. https://doi.org/10.3390/microbiolres12010005
[21]
Kenneth Oshiokhayamhe, I. (2022) Prevalence of Staphylococcus aureus in Nasal and Skin of Apparently Healthy Food Handlers and Attendants in Restaurants. Journal of Clinical Case Reports Medical Images and Health Sciences, 1. https://doi.org/10.55920/jcrmhs.2022.01.001006
[22]
Çakici, N., Demirel Zorba, N.N. and Akçali, A. (2023) Carriage of Enterotoxigenic Staphylococcus aureus and Hygiene Practices of Food Workers. Journal of Basic and Clinical Health Sciences, 7, 618-627. https://doi.org/10.30621/jbachs.1137869
[23]
Ahmed, O.B. (2020) Prevalence of Methicillin-Resistant Staphylococcus aureus and Classical Enterotoxin Genes among Sudanese Food Handlers. Cureus, 12, e12289. https://doi.org/10.7759/cureus.12289
[24]
Bencardino, D., Amagliani, G. and Brandi, G. (2021) Carriage of Staphylococcus aureus among Food Handlers: An Ongoing Challenge in Public Health. Food Control, 130, Article 108362. https://doi.org/10.1016/j.foodcont.2021.108362
