Most cases of foodborne illness (food poisoning) in the United States are associated with various types of bacteria found in soil, water, airborne dust, vegetation, cereals, pasteurized food, and powdered milk. GI anthrax, due to ingestion of contaminated meat from an infected animal, has been reported in developing nations but rarely in the United States. Spices in meat have been reported to be contaminated with Bacillus spores. Bacillus cereus produces two toxins: an emetic toxin that causes vomiting and an enterotoxin that causes diarrhea. Unrefrigerated fried rice has been associated with the emetic toxin, whereas poultry, cooked meats, mashed potatoes, soups, and desserts have been associated with the enterotoxin. Salmonella, norovirus, C. perfringens, and E. coli are commonly associated with outbreaks of foodborne illnesses. The CDC estimates that 48 million people in the United States become sick each year due to foodborne illnesses, resulting in 128,000 hospitalizations and 3000 deaths. E. coli can be found in ground beef, leafy greens, and dairy. Changes in eating habits (e.g., raw natural diets) may contribute to increases in foodborne illnesses.
This test is used to detect one of the two toxins produced by B. cereus.
Collect stool specimens (25–50 g) for culture. Call your laboratory or public health department about special stool culture collection.
Procedural Alert
Suspected food specimens may also be tested.
Refrigerate specimen in clean, sealed, leak-proof containers.
If a delay of more than 2 hours is anticipated, the specimen should be placed in a Cary-Blair transport medium.
Positive abnormal findings of the special characteristics of B. cereus are consistent with food poisoning.
Pretest Patient Care
Explain purpose and procedure for diagnosing food poisoning. Assess for and document signs and symptoms of infection (diarrhea, fever, abdominal cramps). Document history of recently ingested foods.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care
Review test results; report and record findings. Modify the nursing care plan as needed. Monitor prescribed drug treatment (vancomycin, erythromycin).
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.