Table 1.
Analysis of Clostridium botulinum and botulinum neurotoxin in the patient and environmental samples
| Week | Date | Sample type | Mouse bioassay | Real-time PCR | Multiplex PCR | No. of isolates | AFLP genotype | Toxin subtype |
|---|---|---|---|---|---|---|---|---|
| Patient samples | ||||||||
| 1 | 3 Apr. 2010 | Serum | + | n.d. | n.d. | 0 | n.d. | n.d. |
| 1 | 9 Apr. 2010 | Stool* | n.d. | botA | botA | 1 | I | n.d. |
| 2 | 15 Apr. 2010 | Gastric content | − | n.d. | − | 0 | n.d. | n.d. |
| 2 | 15 Apr. 2010 | Serum | − | n.d. | n.d. | 0 | n.d. | n.d. |
| 3 | 21 Apr. 2010 | Stool* | + | botA | botA | 4 | I | A1 |
| 3 | 23 Apr. 2010 | Stool | + | botA | botA | 12 | I | n.d. |
| 5 | 2 May 2010 | Stool* | n.d. | botA | botA | 1 | I | n.d. |
| 5 | 3 May 2010 | Stool | n.d. | botA | botA | 2 | I | n.d. |
| 5 | 6 May 2010 | Stool* | + | botA | botA | 1 | I | n.d. |
| 5 | 8 May 2010 | Stool* | n.d. | botA | botA | 2 | I | n.d. |
| 6 | 9 May 2010 | Stool* | n.d. | botA | botA | 2 | I | n.d. |
| 6 | 10 May 2010 | Stool | n.d. | botA | botA | 2 | I | n.d. |
| 6 | 12 May 2010 | Stool | + | botA | botA | 1 | I | n.d. |
| 6 | 14 May 2010 | Stool | + | botA | botA | 1 | I | n.d. |
| 7 | 18 May 2010 | Stool | + | botA | botA | 1 | I | n.d. |
| 8 | 25 May 2010† | Stool | n.d. | botA | botA | 1 | I | n.d. |
| 12 | 21 June 2010 | Stool | + | botA | botA | 1 | I | n.d. |
| 20 | 19 Aug. 2010 | Stool* | n.d. | botA | botA | 1 | I | n.d. |
| 20 | 20 Aug. 2010 | Stool* | + | botA | botA | 1 | I | n.d. |
| 21 | 24 Aug. 2010 | Stool* | + | botA | botA | 1 | I | n.d. |
| 26 | 29 Sept. 2010 | Stool* | − | − | botA | 1 | I | n.d. |
| 27 | 6 Oct. 2010 | Stool* | − | botA | − | 1 | I | n.d. |
| 28 | 13 Oct. 2010 | Stool* | − | botA | botA | 1 | I | n.d. |
| 29 | 20 Oct. 2010 | Stool | − | − | − | 0 | n.d. | n.d. |
| 30 | 28 Oct. 2010 | Stool* | − | botA | − | 1 | I | A1 |
| 31 | 3 Nov. 2010 | Stool* | Un | botA | botA | 1 | I | n.d. |
| 32 | 13 Nov. 2010 | Stool | n.d. | − | − | 0 | n.d. | n.d. |
| 33 | 17 Nov. 2010 | Stool | n.d. | − | − | 0 | n.d. | n.d. |
| 40 | 6 Jan. 2011 | Stool | n.d. | − | − | 0 | n.d. | n.d. |
| Environmental samples | ||||||||
| 6 | 13 May 2010 | Household dust | n.d. | botA | botA | 28 | I | A1 |
| 6 | 13 May 2010 | Household dust | n.d. | botA | botA | 1 | II | A1 |
| 6 | 13 May 2010 | Household dust | n.d. | botA, botB | botA, botB | 1 | III | A1B |
| 6 | 13 May 2010 | Commercial soil | n.d. | − | − | 0 | n.d. | n.d. |
| 6 | 13 May 2010 | Rabbit bedding | n.d. | − | − | 0 | n.d. | n.d. |
| 6 | 13 May 2010 | Rabbit cage hay | n.d. | − | − | 0 | n.d. | n.d. |
| 9 | 23 June 2010 | Swab | n.d. | − | − | 0 | n.d. | n.d. |
| 9 | 23 June 2010 | Agar plates | n.d. | − | − | 0 | n.d. | n.d. |
PCR, Polymerase chain reaction; AFLP, amplified fragment length polymorphism; n.d., no data; Un, unspecific symptom.
*
Positive PCR and isolation only without ethanol treatment.
†
Day of discharge from hospital.