Bacteria	Source	Other “BizzBuzz”
Staph aureus	Picnic potato salad/mayo; cream filled pastries	- MCC foodborne illness - heat-stable enterotoxin - quick onset sxs within 6 hrs - frequently vomiting
Bacillus cereus	Fried rice	- Two forms: 1 - heat-stable enterotoxin = vomiting (2–3 hrs post ingestion) 2- heat-labile enterotoxin = diarrhea (6–14 hrs after ingestion)
Botulism	Home canned food; honey	- Heat-labile toxin - Sxs: DIPLOPIA; Ptosis; DESCENDING PARALYSIS; FLOPPY BABY SYNDROME
Clostridium perfringens	Undercooked or sitting out too long (buffet) sausages/meats	- Heat resistant spore ingested → enterotoxin - Cramps and watery diarrhea
ETEC (enterotoxigenic E. coli)	Food from street vendors; water/ice cubes in Mexico, Latin America, southern Asia, Africa	- MCC TRAVELER’S diarrhea - heat-labile & heat-stable toxins - Prophylactic abx not recommended; but should take 2 tabs of busmuth subsalicylate 4x a day preventatively - Tx: cipro or azithro
Clostridium difficile Aka Pseudomembranous Enterocolitis	Occurs after antibiotics (clindamycin, cephalosporins, amoxicillin); Toxin A & B produced	- MCC bacterial/secretory diarrhea in inpatients - Dx: C. diff toxin immunoassay - Tx: oral vancomycin 1st line (old tx was flagyl) - Complication: Toxic megacolon
Vibrio cholera	Contaminated food/water; associated w/shellfish/raw oysters	- Enterotoxin mediated Rice water diarrhea (copious amounts, very watery) = large volume loss → hypokalemic hypochloremic acidosis (loss of K+ & bicarb in feces) - Tx: IVF, doxycycline, zinc
Listeria	Cold meats, soft cheeses	- Increases risk for preterm delivery = pregnant pts should avoid these foods
Aeromonas hydrophila	Summer; untreated drinking water from well or spring	- Lactobacillus (probiotic) decreases duration
Scombroid	Heat stable toxin found in tuna, mahi mahi (dolphin fish), mackerel - Hawaii, Florida	- Heat-stable toxins - caused by not properly refrigerating fish = sharp, metallic, bitter/peppery taste to fish - HISTAMINE LIKE REACTION sxs = flushed, headache, cramps, vomiting, diarrhea, bronchospasm or hypotension - Tx: H1 blockers (diphenhydramine) & H2 blockers (ranitidine)
Ciguatera	Reef fish = grouper, barracuda, king fish, red snapper → when these fish eat a dinoflagellate	- Heat-stable neurotoxin - Acts on sodium channels = Neuro, Cardio, GI sxs - Sxs: paresthesias, ataxia, bradycardia, HOT/COLD REVERSAL → these sxs can actually last for years! ⇒ absolute abstinence from alcohol, seafood, and nuts until all sxs resolve and then 3–6 months after - Tx: H1/H2 blockers; amitriptyline; mannitol for severe sxs no longer recommended