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Bacillus infection

Category: Illness or disabilities

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Involuntary

Introduction and description

Bacillus is a genus of Gram-positive, rod-shaped (bacillus) bacteria and a member of the phylum Firmicutes.

The 266 species of Bacillus are almost ubiquitous in nature, for example in soil, but also occur in extreme environments such as high pH (B. alcalophilus), high temperature (B. thermophilus), or high salt (B. halodurans). The genus has both a very large ribosomal 16S diversity and is environmentally diverse. Functionally, a number of the bacteria appear to provide a check on fungi. Thus in Nature they are the plant world’s natural anti-fungals.

Under stressful environmental conditions, the bacteria can produce oval endospores that are not true 'spores', but to which the bacteria can reduce themselves and remain in a dormant state for very long periods.

Bacillus species can be obligate aerobes (oxygen reliant), or facultative anaerobes (having the ability to be aerobic or anaerobic). Bacillus includes both free-living (nonparasitic) and parasitic pathogenic species. They also have their own bacteriophages, for example, SalinJah is a double-stranded DNA (dsDNA) Myoviridae Bacillus cereus group bacteriophage isolated from soil collected in Gyeonggi-do, South Korea. [PMID: 27688335]. And soil from George Town, Grand Cayman Island, yielded the bacteriophage Belinda, isolated on Bacillus thuringiensis [PMID: 27738022].

Some species of Bacillus are dangerous pathogens, causing illnesses such as anthrax and food poisoning. And it is these we will be examining in this section. It is possible that in common with a number of other bacteria, it is the phages that are the pathogens, as such anti-biotics will have little effect on these bacteria. Bacillus is also a notable food spoiler, causing ‘ropiness’ in bread and related food. Some strains of B. coagulans, for example, may play a role in food spoilage of highly acidic, tomato-based products.

Species

One ‘clade’, formed by B. anthracis, B. cereus, B. mycoides, B. pseudomycoides, B. thuringiensis, and B. weihenstephanensis under current classification standards, should be a single species (within 97% 16S identity), but due to medical reasons, they are each considered separate species. Thus the main B. cereus strains of medical interest are:

B. cereus – which is pathogenic or opportunistic to insects or mammals
B. anthracis – which is pathogenic or opportunistic to insects or mammals
B. thuringiensis – which is theoretically pathogenic or opportunistic to insects only.
B. weihenstephanensis – NOT believed to be pathogenic or opportunistic to insects or mammals
B. mycoides - NOT considered pathogenic or opportunistic to insects or mammals
B. pseudomycoides - NOT considered pathogenic or opportunistic to insects or mammals.

Identification can sometimes be difficult. B. cereus, for example, is not easily differentiated from B. cereus var. mycoides, B. thuringiensis, and B. anthracis . Differentiation of these organisms depends upon determination of motility (most B. cereus are motile), presence of toxin crystals (B. thuringiensis), hemolytic activity (B. cereus and others are beta hemolytic whereas B. anthracis is usually non-hemolytic), and rhizoid growth which is characteristic of B. cereus var. mycoides.

Symptoms by species

If we now look at the symptoms of each of the various strains:

B. weihenstephanensis

As we saw above the belief appears to be that this species does not cause food poisoning or other illness. There are reasons, however, for doubting this belief.

The aim of this study was to evaluate the food poisoning potential of strains of the new species in the Bacillus cereus group, B. weihenstephanensis. Fifty strains were tested for cytotoxicity …., and 23 of the strains were also tested for production of enterotoxin components .. and for presence of enterotoxin gene components …The majority of the strains (72%) were not cytotoxic, although all of the strains that were tested … had part of at least one of the B. cereus enterotoxins Hbl, Nhe or CytK. PMID: 12393199

So maybe it is no different to B. cereus.

Bacillus thuringiensis

Bacillus thuringiensis is a Gram-positive, soil-dwelling bacterium, commonly marketed and used as a ‘biological’ pesticide.

Many strains produce crystal proteins (proteinaceous inclusions), called δ-endotoxins, that have insecticidal action. The toxins in B. thuringiensis are also now found in “insect-resistant genetically modified crops.”

When insects ingest toxin crystals, their alkaline digestive tracts denature the insoluble crystals, making them soluble and thus amenable to being cut with proteases found in the insect gut. This liberates the toxin from the crystal which then enters the insect’s gut, paralyzing the digestive tract. The insect stops eating and starves to death.

There are a number of very worrying aspects of this use of the bacteria as an insecticide.

There appear to have been no tests done that the same effects are not experienced by human beings eating these genetically modified crops.

Furthermore these toxins are indiscriminate killers of insects – they kill insect species of the orders Lepidoptera (moths and butterflies), Diptera (flies and mosquitoes), Coleoptera (beetles), and Hymenoptera (wasps, bees, ants and sawflies). The particular action against bees is particularly worrying, but the natural world is in balance and all these species have a role – often as pollinators.

The concern here and the problem here is thus environmental. It may also be that the use of genetically modified crops is also a very major problem, but at the moment our most immediate concern should be the effect on the environment.

Cry-toxin genes originating from Bacillus thuringiensis are inserted into genetically modified (GM) plants, often called Bt-plants, to provide insect resistance to pests. Significant amounts of Bt-plant residues, and thus Cry-toxins, will be shed to soil and aquatic environments. We exposed Daphnia magna to purified Cry1Ab and Cry2Aa toxins for the full life-span of the animals.We conclude that i) purified Cry-toxins in high concentrations are toxic to D. magna, indicating alternative modes-of-action for these Cry-toxins; ii) Cry-toxins act in combination, indicating that 'stacked events' may have stronger effects on non-target organisms; iii) further studies need to be done on combinatorial effects of multiple Cry-toxins and herbicides that co-occur in the environment. PMID: 26993955

Perhaps more worrying is that the insecticides are marketed as ‘environmentally friendly’, with the marketing literature indicating that they have “little or no effect on humans, wildlife, pollinators, and most beneficial insects”, which patently is not true. Most worrying of all is that they are approved in organic farming.

The existence of genetically modified crops has already caused problems in Mexico.

Concerns have been raised about the potential effects of transgenic introductions on the genetic diversity of crop landraces and wild relatives in areas of crop origin and diversification, as this diversity is considered essential for global food security. Direct effects on non-target species, and the possibility of unintentionally transferring traits of ecological relevance onto landraces and wild relatives have also been sources of concern. The degree of genetic connectivity between industrial crops and their progenitors in landraces and wild relatives is a principal determinant of the evolutionary history of crops and agroecosystems throughout the world. Recent introductions of transgenic DNA constructs into agricultural fields provide unique markers to measure such connectivity. …Here we report the presence of introgressed transgenic DNA constructs in native maize landraces grown in remote mountains in Oaxaca, Mexico, part of the Mesoamerican centre of origin and diversification of this crop. PMID: 11734853

Bacillus cereus

Bacillus cereus is a Gram-positive, rod-shaped, aerobic, motile, beta hemolytic bacterium. Some strains are harmful to humans and cause food poisoning. Bacterial growth results in production of enterotoxins, which can cause severe nausea, vomiting, and diarrhoea. Once the enterotoxins have been formed, cooking at high temperatures makes little difference – the toxins are highly resistant to both heat and acids (pH levels between 2 and 11). Overall the symptoms of Bacillus cereus infection include the following.

Diarrhoea

The diarrheal type of food poisoning caused by this bacteria is associated with a wide range of foods, has an 8.0- to 16-hour incubation time, and is associated with both diarrhoea and gastrointestinal pain. Also known as the 'long-incubation' form of B. cereus food poisoning, it can be difficult to differentiate from poisoning caused by other bacteria such as Clostridium perfringens. The symptom of diarrhoea is thought to stem from three toxins:

hemolysin BL (Hbl),
nonhemolytic enterotoxin (Nhe) and
cytotoxin K (CytK).

These enterotoxins are all produced in the small intestine of the host. The toxins are dangerous and 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. In other words they can damage the intestines. Thus the diarrhoea is essential to attempt to flush the pathogens away. Any doctor who prescribes anti-diarrhoeal medication is not exactly helping you. Keep up the fluid intake to help the flushing mechanism. In effect, this bacteria has the potential to cause far more diseases than are at first apparent, as the intestine is a part of the immunological response, protecting us from pathogens that enter the system via the mouth

Nausea and vomiting

The 'emetic' form of food poisoning is commonly caused by a toxin, cereulide, which is not inactivated by heating, it can withstand a temperature of 121 °C (250 °F) even for 90 minutes. This form leads to nausea and vomiting one to five hours after consumption. It too can be difficult to distinguish from other short-term bacterial foodborne intoxications such as by Staphylococcus aureus.

Cereulide 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. Cereulid is resistant to heat, proteolysis, and acid conditions. It is thus essential that vomiting is encouraged in order to rid oneself of the toxins. Any doctor who prescribes anti-emetic medication is not exactly helping you.

Skin disease

As we can see, if the bacteria gets into the blood stream via the intestines, for example, it has the potential to cause other illnesses, for example, B. cereus is known to cause difficult-to-eradicate chronic skin infections, though less aggressive than the necrotizing fasciitis found in anthrax.

Eye disease

B. cereus can also cause keratitis. Keratitis is a condition in which the eye's cornea, the front part of the eye, becomes inflamed. The condition often produces pain, impaired eyesight, photophobia, red eye and a 'gritty' sensation.

Heart diseases

Incidence of infective endocarditis during pregnancy is around 0.006% with high maternal and fetal mortality. Bacillus cereus is an extremely rare cause for endocarditis in intravenous drug abusers (IVDA) or those with valvular disease or devices such as pacemakers. We report a case of B. cereus endocarditis, ….in a 30-year-old, 25-week pregnant female …... PMID: 26793477

Brain tumours and brain damage

We report a case of intratumoral brain abscess due to Bacillus cereus in an adult male patient, which was managed successfully with excision of lesion and piperacillin-tazobactam for the duration of 5 weeks. To the best of our knowledge, this is a first case report of B. cereus infection leading to intratumoral brain abscess … PMID: 27721298

Other diseases

Bacillus cereus can cause serious infections in immunosuppressed patients. This population may be susceptible to B. cereus pneumonia, bacteremia, cellulitis, and rarely cerebral abscess. ….. A review of the literature over the past 25 years identified another 11 cases (3 children and 8 adults) of B. cereus cerebral abscess in patients undergoing cancer therapy. B. cereus cerebral abscesses were associated with a high mortality rate (42%) and significant morbidity. PMID:23619116

Bacillus anthracis

B anthracis is the ‘etiologic agent’ – cause - of anthrax, a disease that can affect livestock and humans. The symptoms in anthrax depend on the type of infection and can take anywhere from 1 day to more than 2 months to appear. All types of anthrax have the potential, if untreated, to spread throughout the body and cause severe illness and even death.

One major symptom irrespective of point of entry is anaemia. As with most other pathogenic bacteria, B. anthracis must acquire iron to grow and proliferate in its host environment. The most readily available iron sources for pathogenic bacteria are the heme groups used by the host in the transport of oxygen. For this reason the anaemia should not be treated with iron, as it simply provides more fuel for them to proliferate. The body will naturally reduce the red blood cells and increase the white – immunological defence – cells, if left to combat the invader.

B anthracis is the only obligate pathogen within the genus Bacillus and is a “Gram-positive, endospore-forming, rod-shaped bacterium, with a width of 1.0–1.2 µm and a length of 3–5 µm.” As of October 2016, there were 89 known strains of B. anthracis.

The organism produces three exotoxins:

Anthrax oedema factor - causes elevation of intracellular cAMP, and is responsible for the severe oedema usually seen in B. anthracis infections
Anthrax lethal toxin - is responsible for tissue necrosis
Anthrax protective antigen - mediates cell entry of oedema factor and lethal toxin.

Four forms of human anthrax disease are recognized based on their portal of entry.

Cutaneous – via the skin. The most common form (95%), causes a localized, inflammatory, black, necrotic lesion (eschar). The species name anthracis is from the Greek anthrax (ἄνθραξ), meaning "coal" referring to the large, black skin lesions formed.
Inhalation - a rare but highly fatal form, is characterized by flu like symptoms, toredness, fever, shortness of breath, headache, chest discomfort, diaphoresis [sweating, especially to an unusual degree], and body aches. All these symptoms show the body is trying to kill the invader [heat], or flush it out [sweat]
Gastrointestinal - a rare but also fatal (causes death in 25% of cases) type, results from ingestion of spores. Symptoms include: fever and chills, swelling of neck, painful swallowing, hoarseness, nausea and vomiting (especially bloody vomiting), diarrhoea, flushing and red eyes, and swelling of abdomen.
Injection - symptoms are similar to those of cutaneous anthrax, but injection anthrax can spread throughout the body faster and can be harder to recognize and treat compared to cutaneous anthrax.

Cause - the Sources of bacteria

We know that the bacteria are the cause of these symptoms, but where do the bacteria come from and thus how can we avoid them?

Food

A source of Bacillus cereus is food. Food that is kept out and not refrigerated or handled in unhygienic conditions.

November 28th 2014 The Risk of Bacillus cereus to Pharmaceutical Manufacturing - Tim Sandle, PhD
The organism has long been associated with foodborne illnesses (it is most notoriously linked with “Fried Rice Syndrome,” since the bacterium can be contracted from fried rice dishes that have been sitting at room temperature for several hours).

At 30 °C (86 °F), a population of B. cereus can double in as little as 20 minutes or as long as 3 hours, depending on the food product.

Food	Minutes to double, 30 °C (86 °F)	Hours to multiply by 1,000,000
Milk	20-36	6.6 - 12
Cooked rice	26-31	8.6 - 10.3
Infant formula	56	18.6

But the farming industry are also to blame. B. cereus competes with other microorganisms such as Salmonella and Campylobacter in the gut, so its presence reduces the numbers of those microorganisms. Thus in farms where inhumane factory farming is present leading to these other microorganisms appearing in food animals such as chickens, rabbits and pigs, some strains of B. cereus are used as a feed additive to reduce the Salmonella in the intestines and cecum. In effect factory farmed animals kept in poor conditions may be contaminated with Salmonella, Campylobacter and B. cereus.

Medicines and pharmaceutical products

Another source of Bacillus cereus is medicines and, somewhat alarmingly, even so called anti-bacterial wipes!

November 28th 2014 The Risk of Bacillus cereus to Pharmaceutical Manufacturing - Tim Sandle, PhD

A review of warning letters U.S. Food and Drug Administration indicates that contamination events associated with Bacillus species represents a relatively high proportion of microbiological related citations. During the period March 2013 to August 2014, 7 warning letters relating to contamination from spore-forming bacteria were issued. Extending the review back to 2007, it is noteworthy that the most common microorganism associated with contamination is Bacillus cereus.
The foremost reason for the detection of species of Bacillus in pharmaceutical products, according to FDA warning letters, relates to inadequate cleaning and disinfection regimes. This includes a failure to include a sporicidal agent as part of the disinfection regime or, where such a sporicide is used, a failure to qualify it in a way that demonstrates that the disinfectant can kill or inactivate spores.
A secondary reason is due to insufficient material control and in not ensuring that materials are of a suitable cleanliness (or sterile, where appropriate) for entry into pharmaceutical controlled environments.
The third most common reason is attributable to problems with air handling systems……
With sterile products, all microorganisms are a risk because the product is intended to be free of contamination and any contamination has the potential of causing serious harm to patients, especially given that most of these types of medicines are quite often used with the immunocompromised…..
……of the species of Bacillus most likely to be found, Bacillus cereus is one of the most virulent. It is both interesting and concerning that Bacillus cereus has been associated with some recent examples of pharmaceutical contamination. In a review by Sutton,^…. it is noted that there have been several cases of B. cereus contamination in relation to alcohol wipes.

Most patients recover from B. cereus within six to 24 hours, as long as they are left to be sick or have diarrhoea. But in some cases, the toxins in B. cereus can be fatal. In 2014, 23 neonates receiving total parenteral nutrition contaminated with B. cereus developed septicaemia; three of the infants later died as a result of infection.

From September 1990 to October 1990, 15 patients who were admitted to four different departments of the National Taiwan University Hospital, including nine patients in the emergency department, three in the hematology/oncology ward, two in the surgical intensive care unit, and one in a pediatric ward, were found to have positive blood (14 patients) or pleural effusion (1 patient) cultures for Bacillus cereus.
After extensive surveillance cultures, 19 additional isolates of B. cereus were recovered from 70% ethyl alcohol that had been used as a skin disinfectant (14 isolates from different locations in the hospital) and from 95% ethyl alcohol (5 isolates from five alcohol tanks in the pharmacy department), and 10 isolates were recovered from 95% ethyl alcohol from the factory which supplied the alcohol to the hospital. PMID: 10364598

Soil in general and the soil in contaminated military areas and war zones

Bacillus reproduces using spores. The endospore is a dehydrated cell with thick walls and additional layers that form inside the cell membrane. It can remain inactive for many years, but if it finds itself in a favourable environment, it begins to grow again.

Bacillus cereus - is found in soil. It is an extremely hardy and resilient organism. B. cereus bacteria are ‘facultative anaerobes’. This means that under certain conditions the bacteria can produce endospores that enable them to survive in extremely inhospitable environments. B. cereus can grow over a temperature range from 5°C to 50°C, with an optimum growth of between 28°C to 35°C; a pH range 5 to 9; and at a water activity (aw) greater than 0.94.5

B. anthracis - endospores are highly resilient, surviving extremes of temperature, low-nutrient environments, and harsh chemical treatment over decades or centuries. It can survive in aerobic or anaerobic conditions. And as Wikipedia says and here I quote:

Because of these attributes, B. anthracis endospores are extraordinarily well-suited to use (in powdered and aerosol form) as biological weapons. Such weaponization has been accomplished in the past by at least five state bioweapons programs—those of the United States, Russia, Japan, the United Kingdom, and Iraq—and has been attempted by several others.

In other words, the main reason why these bacteria proliferate and are around in any numbers at all, is because of man’s inhumanity to man.

The bacteria is especially nasty as it is able to synthesize a ‘poly-γ-D-glutamic acid (polyglutamate) capsule’ that enables it to evade the host immune system by protecting itself from phagocytosis.

Prevention and treatment

One way of ensuring we don’t get infected is to wear gloves when we are gardening and to simply wash our hands after handling soil.

Eat organic food, from farmers who practise humane farming practises. Wash all food in clean water, cook all meat well, refrigerate food before and after cooking.

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 (212 °F) allow some B. cereus spores to survive. This problem is compounded when food is then improperly refrigerated, allowing the endospores to germinate. Germination and growth generally occur between 10 °C and 50 °C, so cooked and uncooked foods needs to be kept at a temperate outside this range.

Anthrax

A number of anthrax vaccines have been developed for preventive use in livestock and humans. Anthrax Vaccine Adsorbed (AVA) may protect against cutaneous and inhalation anthrax. However, ‘this vaccine is only used for at-risk adults before exposure to anthrax and has not been approved for use after exposure’.

Wikipedia
Infections with B. anthracis can be treated with β-lactam antibiotics such as penicillin, and others which are active against Gram-positive bacteria. Penicillin-resistant B. anthracis can be treated with fluoroquinolones such as ciprofloxacin or tetracycline antibiotics such as doxycycline.

The observations provide alternative healing approaches from PubMed papers.

How it works

Hallucinations and other spiritual experiences are generally caused by the fever and high temperatures during by the fight of the immune system against the pathogen.

Each observations provide the reason why that particular approach to healing works.

References and further reading

FEMS Microbiol Lett. 2002 Sep 24;215(1):47-51. Pathogenic potential of fifty Bacillus weihenstephanensis strains. Stenfors LP1, Mayr R, Scherer S, Granum PE.
Genome Announc. 2016 Sep 29;4(5). pii: e00953-16. doi: 10.1128/genomeA.00953-16. Genome Sequence of Bacillus cereus Group Phage SalinJah. Erill I1, Caruso SM2; 2015 UMBC Phage Hunters.
Genome Announc. 2016 Oct 13;4(5). pii: e00571-16. doi: 10.1128/genomeA.00571-16. Complete Genome Sequence of Bacillus Phage Belinda from Grand Cayman Island. Breslin EF1, Cornell J1, Schuhmacher Z1, Himelright M1, Andos A1, Childs A1, Clem A1, Gerber M1, Gordillo A1, Harb L1, Hossain R1, Hutchinson T1, Miller I1, Morton E1, Walters R1, Webb D1, Temple L2.
IDCases. 2015 Oct 17;2(4):120-3. doi: 10.1016/j.idcr.2015.10.003. eCollection 2015. Infective endocarditis due to Bacillus cereus in a pregnant female: A case report and literature review. Shah M1, Patnaik S2, Wongrakpanich S2, Alhamshari Y2, Alnabelsi T2.
Indian J Pathol Microbiol. 2016 Oct-Dec;59(4):554-556. doi: 10.4103/0377-4929.191799. Bacillus cereus causing intratumoral brain abscess. Saigal K1, Gautam V1, Singh G1, Ray P1. 1Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Pediatr Hematol Oncol. 2014 Apr;36(3):e197-201. doi: 10.1097/MPH.0b013e31828e5455. Bacillus cereus bacteremia and multiple brain abscesses during acute lymphoblastic leukemia induction therapy. Hansford JR1, Phillips M, Cole C, Francis J, Blyth CC, Gottardo NG.
Plant Pathol J. 2016 Oct;32(5):481-488. Epub 2016 Oct 1. Feasible Management of Southern Corn Leaf Blight via Induction of Systemic Resistance by Bacillus cereus C1L in Combination with Reduced Use of Dithiocarbamate Fungicides. Lai YR1, Lin PY1, Chen CY2, Huang CJ1.

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Bacillus infection

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Introduction and description

Species