Clostridium Botulinum
DESCRIPTION
- Large, obligate anaerobe, fastidious, gram (+), either in chain or occurs single, motile (peritrichous flagellation), sporeforming with spore located centrally;
- Grow well on meat-infusion medium and in blood agar producing hemolysis of the red blood cells when incubated under anaerobic conditions;
- Spores are easily destroyed by burning
- Exotoxin destroyed by boiling for 10 minutes
- Common inhabitant of the soil and intestinal tract of animals
- Responsible for spoilage of improperly processed canned foods
- Causes botulism
BOTULISM
- It is a severe/serious intoxication due to ingestion of a potent neurotoxin from inadequately sterilized canned foods.
- Botulinin blocks the action of acetylcholine in the neuromuscular junction.
- The patient usually dies within 3 to 7 days from respiratory or cadia failure or from infectious complications.
- It is a rare kind of food poisoning but the mortality is very high.
TYPES AND CATEGORIES
- Food-borne botulism
- It is an intoxication caused by the ingestion of preformed botulinin in contaminated canned foods with incubation period of 1 to 2 days.
- The toxin is absorbed from the small intestine and carried by the blood to the motor nerves.
- Death may occur within 24 hours due to respiratory paralysis.
- Infant botulism
- It is an intoxication due to absorption of toxin within the baby’s body from dirt and dust.
- It is caused by the in vivo production of neurotoxin colonizing the gastrointestinal tract of young infants.
- It is common among infants less than 9 months old.
- Muscular involvement leads to respiratory insufficiency and death.
- Wound botulism
- This is the least common form of botulism which is caused by Type A botulinin.
- Develops in vivo toxin production in infected or contaminated traumatic wounds. Incubation period ranges from 4 to 14 days.
- Gastrointestinal symptoms are less prominent.
PREVENTION
- Boil/cook home canned or preserved food for 10 minutes.
- Gas-containing, off-color, off-smelling, or foods from bulging cans should never be eaten or even-tasted.
- Regulation and inspection of commercial processing of canned and preserved foods.
- Maintain food in acid pH or storage at 4oC.
- Polyvalent toxoid for active immunization of high risk laboratory workers, at 0 to 10 weeks with booster injection after 1 year to stimulate solid immunity.
TREATMENT
Medical care should be arranged at once. It is not possible to reverse the damage already done.
- Intramuscular injection of botulinus antitoxin. If administered early in its course, the patient’s chances of survival are better than after the disease is established.
- Adequate ventilatory support, elimination of the organisms from the gastrointestinal tract by the judicious use of gastric lavage.
- Penicillin therapy.
- Guanidine hydrochloride administration. It enhances acetylcholine release.
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
