Food poisoning caused by mannitol nonfermenting Staphylococcus aureus: case report.

On August 4, 2005, 20 people who participated in the closing ceremonies of a community festival experienced nausea, vomiting, diarrhea and abdominal pain. The community where the festival took place was under the jurisdiction of the Aizu Health Center of Fukushima Prefecture. The foods that all of these patients had consumed were rice balls prepared by caterer A. Another 8 people, who did not participate in the festival but who had ingested the rice balls, also became ill. The Aizu Branch of the Fukushima Institute of Public Health examined 3 specimens of the remaining rice balls, 6 finger swab specimens from the cooks, 6 kitchen utensil swab specimens, 6 stool specimens from the patients with symptoms and 5 stool specimens from the cooks. Additionally, the Niigata City Institute of Public Health and the Niigata Prefectural Instiute of Public Health and Environmental Sciences examined one stool specimen from each of the other patients. The Aizu Branch isolated 7 Staphylococcus aureus strains and the Niigata City Institute of Public Health isolated 2 strains. The characteristics of the 9 isolates are summarized in Table 1. Bacterial identification was conducted using an ID test SP-18 (Nissui Pharmaceutical Co., Ltd., Tokyo, Japan), a coagulase test for Staphylocoagulase antisera (Denka Seiken, Co., Ltd., Tokyo, Japan) and the detection and typing of staphylococcal enterotoxin by reversed passive latex agglutination (RPLA) for types A D (Denka Fig. 1. Pulsed-field gel electrophoresis of SmaI digests of the chromosomal DNAs of S. aureus isolates. Lane 1, rice ball (pickled plum); 2, rice ball (seaweed); 3, fried food; 4, swab specimen from an employee (caterer A shop B); 5, swab specimen from an employee (caterer A shop B); 6, swab specimen from the handle of the refrigerator (caterer A shop B); 7, swab specimen from a cook (caterer A); 8-9, patient’s stool specimen (Niigata City Institute of Public Health); the same patient. M, molecular size marker (Salmonella Braenderup strain H9812, XbaI digest).