Fenicia L, Anniballi F, Aureli P
National Reference Center for Botulism, National Center for Food Quality and Risk Assessment, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy.
Eur J Clin Microbiol Infect Dis. 2007 Jun;26(6):385-94. doi: 10.1007/s10096-007-0301-9.
Botulism in humans is caused by botulinum neurotoxins, produced in most cases by Clostridium botulinum, although other Clostridia species are implicated as well. Of the five forms of botulism in humans, three are referred to as "infective": wound botulism, infant botulism, and adult intestinal botulism; the latter two forms are also referred to as "intestinal toxemia botulism" because the organism colonizes the lumen of the intestinal tract and produces botulinum neurotoxin in vivo. Twenty-three cases of infant botulism and three cases of adult intestinal botulism occurred in Italy between 1984 and 2005. Microbiological analyses of clinical, environmental, and food samples and analysis of clinical and epidemiological data revealed two main characteristics of intestinal toxemia botulism in Italy that are not common in cases in other countries: the isolation of a strain of C. butyricum that produced botulinum neurotoxin type E in 6 of 26 cases, including two cases of adult intestinal toxemia botulism, and the onset of botulism in these cases with concomitant severe gastrointestinal symptomatology. This report summarizes the microbiological, clinical, and epidemiological data of all cases of intestinal toxemia botulism that have occurred in Italy in the period 1984-2005.
人类肉毒中毒是由肉毒杆菌神经毒素引起的，在大多数情况下由肉毒梭菌产生，不过其他梭菌属物种也有牵连。在人类肉毒中毒的五种形式中，有三种被称为“感染性”：伤口肉毒中毒、婴儿肉毒中毒和成人肠道肉毒中毒；后两种形式也被称为“肠道毒血症肉毒中毒”，因为该生物体在肠道腔内定殖并在体内产生肉毒杆菌神经毒素。1984年至2005年期间，意大利发生了23例婴儿肉毒中毒和3例成人肠道肉毒中毒。对临床、环境和食品样本的微生物分析以及临床和流行病学数据分析揭示了意大利肠道毒血症肉毒中毒的两个主要特征，这在其他国家的病例中并不常见：在26例中的6例中分离出一株产生E型肉毒杆菌神经毒素的丁酸梭菌，其中包括2例成人肠道毒血症肉毒中毒病例，并且这些病例中的肉毒中毒发作伴有严重的胃肠道症状。本报告总结了1984 - 2005年期间在意大利发生的所有肠道毒血症肉毒中毒病例的微生物学、临床和流行病学数据。
