BAM Chapter 14 - Bacillus Cereus - FDA
BAM Chapter 14 - Bacillus Cereus - FDA
Revision History:
November 2019: Section H.8. Addition of link to protocol for quantitative analysis for cereulide in food
products.
January 2012: The Bacillus Chapter has been updated with the inclusion of a new optional chromogenic
agar, Bacara agar, for the detection and enumeration of Bacillus cereus in foods.
Bacillus cereus is an aerobic spore-forming bacterium that is commonly found in soil, on vegetables, and
in many raw and processed foods. B. cereus food poisoning may occur when foods are prepared and held
without adequate refrigeration for several hours before serving, with B. cereus reaching >106 cells/g.
Foods incriminated in past outbreaks include cooked meat and vegetables, boiled or fried rice, vanilla
sauce, custards, soups, and raw vegetable sprouts. Two types of illness have been attributed to the
consumption of foods contaminated with B. cereus. The first and better known is characterized by
abdominal pain and non-bloody diarrhea; it has an incubation period of 4-16 h following ingestion with
symptoms that last for 12-24 h. The second, which is characterized by an acute attack of nausea and
vomiting, occurs within 1-5 h after consumption of contaminated food; diarrhea is not a common feature
in this type of illness1. The MYP agar has been the standard media for plating B. cereus, but it has little
selectivity so background flora is not inhibited and can mask the presence of B. cereus. Bacara is a
chromogenic selective and differential agar that promotes the growth and identification of B. cereus, but
inhibits the growth of background flora. The chromogenic agar has been suggested for the enumeration of
B. cereus group as a substitute for MYP1,2. Typical colonies will grow as pink-orange uniform colonies
surrounded by a zone of precipitation. The identification would include all species from the B. cereus
group: B. cereus, B. thuringiensis, B. anthracis,B. mycoides, and B. weihenstephanensis. Biochemical
testing will be necessary to delineate to the species level. The Bacara media can be purchased as prepared
plates or media in flasks to which two supplied reagents are added. The media has a proprietary
formulation and cannot be purchased in a dehydrated form.
A. Sampling
If the quantity of food to be examined is large, take representative samples of 50 g each from
different parts of the suspect food because contamination may be unevenly distributed. If the food is
a powder or consists of small discrete particles, then it should be thoroughly mixed before taking
samples.
B. Transporting and storage of samples
Transport samples promptly in insulated shipping containers with enough gel-type refrigerant to
maintain them at 6°C or below. Upon receipt in the laboratory, store the samples at 4°C and analyze
as soon as possible. If analysis cannot be started within 4 days after collection, freeze samples
promptly and store at -20°C until examined. Thaw at room temperature and proceed with analysis as
usual. Maintain frozen samples at -20°C until examined. Ship on dry ice to avoid thawing.
Dehydrated foods may be stored at room temperature and shipped without refrigeration.
16. Water bath, 100 ± 2°C (melting Bacara agar prepared in flask)
17. Culture tube racks
18. Staining rack
21. Brain Heart Infusion Broth with 0.1% glucose for enterotoxin testing (Ch. 15).
C. Sample preparation
Using aseptic technique, weigh 50 g of sample into sterile blender jar. Add 450 mL Butterfield's
phosphate-buffered dilution water (1:10 dilution) and blend for 2 min at high speed (10,000-12,000
rpm). Prepare serial dilutions from 10-2 to 10-6 by transferring 10 mL homogenized sample (1:10
dilution) to 90 mL dilution blank, mixing well with vigorous shaking, and continuing until 10-6
dilution is reached.
Inoculate duplicate Bacara or MYP agar plates with each dilution of sample (including 1:10) by
spreading 0.1 mL evenly onto surface of each plate with sterile glass spreading rod. Incubate plates
18-24 h at 30°C and observe for colonies surrounded by precipitate zone, which indicates that
lecithinase is produced. B. cereus colonies are usually a pink-orange color on Bacara or pink on MYP
and may become more intense after additional incubation (see Fig. 1).
Fig. 1. Colonies of B. cereus grown on MYP are pink and lecithinase positive, but other bacteria are
not inhibited and can interfere with isolation of B. cereus. Colonies of B. cereus grown on Bacara are
pink-orange and are lecithinase positive, but other organisms are inhibited.
If reactions are not clear, incubate plates for additional 24 h before counting colonies. Select plates
that contain an estimated 15-150 pink-orange (Bacara) or pink (MYP), lecithinase-producing
colonies. Mark bottom of plates into zones with black felt pen to facilitate counting and count
colonies that are typical of B. cereus. This is the presumptive plate count of B. cereus. Pick at least 5
presumptive positive colonies from the Bacara or MYP plates and transfer one colony to BHI with
0.1% glucose for enterotoxin studies (Chapter 15) and a nutrient agar slant for storage. Typical
colonies grown on Bacara or MYP must be confirmed with biochemical testing as described in
Sections F and H below.
Calculate number of B. cereus cells/g of sample, based on percentage of colonies that are
morphologically consistent with B. cereus. For example, if average count obtained with 10-4 dilution
of sample was 65 and 4 of 5 colonies tested were confirmed as B. cereus, the number of B. cereus
cells/g of food is 65 × 4/5 × 10,000 × 10 = 5,200,000. (NOTE: Dilution factor is tenfold higher than
sample dilution because only 0.1 mL was tested).
Inoculate 3-tube MPN series in trypticase soy-polymyxin broth, using 1 mL inoculum of 10-1, 10-2,
and 10-3 dilutions of sample with 3 tubes at each dilution. (Additional dilutions should also be tested
if B. cereus population is expected to exceed 103/g.) Incubate tubes 48 ± 2 h at 30 + 2°C and observe
for turbid growth, which is typical of B. cereus. Streak cultures from turbid, positive tubes onto
separate agar plates (either Bacara or MYP) and incubate plates 18-24 h at 30°C. Pick one or more
pink-orange (Bacara) or pink (MYP), lecithinase-positive colonies from each agar plate and transfer
to BHI with 0.1% glucose for enterotoxin studies (Chapter 15) and nutrient agar slants for storage.
Typical colonies grown on Bacara or MYP must be confirmed with biochemical testing as described
in Sections F and G below.
Calculate MPN of B. cereus cells/g of sample (see BAM Appendix 2) based on the number of tubes
at each dilution in which the presence of B. cereus was confirmed. Biochemical testing will be
necessary to delineate to the species level, however, enterotoxins can be carried by Bacillus spp.
other than B. cereus.
F. Confirmation of B. cereus
Pick 5 or more eosin pink, lecithinase-positive colonies from MYP agar plates and transfer to
nutrient agar slants. Incubate slants 24 h at 30°C. Prepare Gram-stained smears from slants and
examine microscopically. B. cereus will appear as large Gram-positive bacilli in short-to-long chains;
spores are ellipsoidal, central to subterminal, and do not swell the sporangium. Transfer 3 mm
loopful of culture from each slant to 13 × 100 mm tube containing 0.5 ml of sterile phosphate-
buffered dilution water and suspend culture in diluent with Vortex mixer. Use suspended cultures
including ATCC 14579 B. cereus and ATCC 64 Brevibacillus laterosporus as positive and negative
controls respectively to inoculate the following confirmatory media:
1. Phenol red glucose broth. Inoculate 3 mL broth with 2 mm loopful of culture. Incubate
tubes anaerobically 24 h at 35°C in GasPak anaerobic jar. Shake tubes vigorously and observe
for growth as indicated by increased turbidity and color change from red to yellow, which
indicates that acid has been produced anaerobically from glucose. A partial color change from
red to orange/yellow may occur, even in uninoculated control tubes, due to a pH reduction
upon exposure of media to CO2 formed in GasPak anaerobic jars.
4. Tyrosine agar. Inoculate entire surface of tyrosine agar slant with 3 mm loopful of culture.
Incubate slants 48 h at 35°C. Observe for clearing of medium near growth, which indicates that
tyrosine has been decomposed. Examine negative slants for obvious signs of growth, and
incubate for a total of 7 days before considering as negative.
5. Lysozyme broth. Inoculate 2.5 ml of nutrient broth containing 0.001% lysozyme with 2 mm
loopful of culture. Also inoculate 2.5 ml of plain nutrient broth as positive control. Incubate
tubes 24 h at 35°C. Examine for growth in lysozyme broth and in nutrient broth control.
Incubate negative tubes for additional 24 h before discarding.
6. MYP agar. This test may be omitted if primary inoculation media was Bacara or test results
were clear-cut with original MYP agar plates and there was no interference from other
microorganisms.. Mark bottom of a plate into six equal sections with felt marking pen, and
label each section with sample number. Inoculate premarked 4 cm sq area of MYP agar plate
by gently touching surface of agar with 2 mm loopful of culture. Allow inoculum to be fully
absorbed before incubating for 24 h at 30°C. Check plates for lecithinase production as
indicated by zone of precipitation surrounding growth. Mannitol is not fermented by isolate if
growth and surrounding medium are eosin pink. (Yellow color indicates that acid is produced
from mannitol.) B. cereus colonies are usually lecithinase-positive and mannitol-negative on
MYP agar.
G. Record results obtained with the different confirmatory tests. Tentatively identify as B.
cereus those isolates which 1) produce large Gram-positive rods with spores that do not swell the
sporangium; 2) produce lecithinase and do not ferment mannitol on MYP agar; 3) grow and produce
acid from glucose anaerobically; 4) reduce nitrate to nitrite (a few strains may be negative); 5)
produce acetylmethylcarbinol (VP-positive); 6) decompose L-tyrosine; and 7) grow in the presence
of 0.001% lysozyme.
These basic characteristics are shared with other members of the B. cereus group, including the
rhizoid strains B. mycoides, the crystalliferous insect pathogen B. thuringiensis, and the mammalian
pathogen B. anthracis. However, these species can usually be differentiated from B. cereus by
determining specific characteristics typical of each species or variety. The tests described in H,
below, are useful for this purpose and can easily be performed in most laboratories. Strains that
produce atypical results from these tests require additional analysis before they can be classified as
B. cereus.
1. The following tests are useful for differentiating typical strains of B. cereus from other
members of the B. cereus group, including B. mycoides, B. thuringiensis, and B. anthracis also
non-motile.
Motility test. Inoculate BC motility medium by stabbing down the center with 3 mm loopful
of 24 h culture suspension. Incubate tubes 18-24 h at 30°C and examine for type of growth
along stab line. Motile organisms produce diffuse growth out into the medium away from the
stab. Non-motile organisms produce growth only in and along stab. Alternatively, add 0.2 mL
sterile distilled water to surface of nutrient agar slant and inoculate slant with 3 mm loopful of
culture suspension. Incubate slant 6-8 h at 30°C and suspend 3 mm loopful of liquid culture
from base of slant in a drop of sterile water on microscope slide. Apply cover glass and examine
immediately with microscope for motility. Report whether or not isolates tested were motile.
Most strains of B. cereus and B. thuringiensis are motile by means of peritrichous flagella. B.
anthracis and all except a few strains of B. mycoides are non-motile. A few B. cereus strains
are also non-motile.
Table 1. Differential characteristics of large-celled Group I Bacillus species
Feature B. cereus B. thuringiensis B. mycoides B. weihenstephanensis B. anthracis B. megaterium
Catalase + + + + + +
Reduction of + + + + + −(d)
nitrate
Lysozyme- + + + + + −
resistant
Egg yolk + + + + + −
reaction
Anaerobic + + + + + −
utilization of
glucose
VP reaction + + + + + −
Acid produced − − − − − +
from mannitol
Hemolysis + + + ND −(d) −
(Sheep RBC)
ND Not determined
2. Rhizoid growth. Pour 18-20 mL nutrient agar into sterile 15 × 100 mm petri dishes and
allow agar to dry at room temperature for 1-2 days. Inoculate by gently touching surface of
medium near center of each plate with 2 mm loopful of 24 h culture suspension. Allow
inoculum to be absorbed and incubate plates 48-72 h at 30°C. Examine for development of
rhizoid growth, which is characterized by production of colonies with long hair or root-like
structures that may extend several centimeters from site of inoculation. Rough galaxy-shaped
colonies are often produced by B. cereus strains and should not be confused with typical
rhizoid growth, which is the definitive characteristic of B. mycoides. Most strains of this
species are also non-motile.
3. Test for hemolytic activity. Mark bottom of a plate into 6-8 equal sections with felt
marking pen, and label each section. Inoculate a premarked 4 cm sq area of trypticase soy-
sheep blood agar plate by gently touching medium surface with 2 mm loopful of 24 h culture
suspension. (Six or more cultures can be tested simultaneously on each plate.) Incubate plates
24 h at 35°C. Examine plates for hemolytic activity. B. cereus cultures usually are strongly
hemolytic and produce 2-4 mm zone of complete (β) hemolysis surrounding growth. Most B.
thuringiensis and B. mycoides strains are also β-hemolytic. B. anthracis strains are usually
nonhemolytic after 24 h incubation.
4. Test for protein toxin crystals. Inoculate nutrient agar slants with 3 mm loopfuls of 24 h
culture suspensions. Incubate slants 24 h at 30°C and then at room temperature 2-3 days.
Prepare smears with sterile distilled water on microscope slides. Air-dry and lightly heat-fix by
passing slide through flame of Bunsen burner. Place slide on staining rack and flood with
methanol. Let stand 30 s, pour off methanol, and allow slide to air-dry. Return slide to staining
rack and flood completely with 0.5% basic fuchsin or TB carbolfuchsin ZN stain (Difco). Heat
slide gently from below with small Bunsen burner until steam is seen.
Wait 1-2 min and repeat this step. Let stand 30 s, pour off stain, and rinse slide thoroughly
with clean tap water. Dry slide without blotting and examine under oil immersion for presence
of free spores and darkly stained tetragonal (diamond-shaped) toxin crystals. Crystals are
usually somewhat smaller than spores. Toxin crystals are usually abundant in a 3- to 4-day-old
culture of B. thuringiensis but cannot be detected by the staining technique until lysis of the
sporangium has occurred. Therefore, unless free spores can be seen, cultures should be held at
room temperature for a few more days and re-examined for toxin crystals. B. thuringiensis
usually produces protein toxin crystals that can be detected by the staining technique either as
free crystals or parasporal inclusion bodies within the exosporium. B. cereus and other
members of the B. cereus group do not produce protein toxin crystals.
5. Test for psychrotolerant strains. To determine psychrotolerance streak out two TSA
plates. Incubate one plate at 6°C for 28 days and the second at 43°C for 4 days. B.
weihenstephanensis will grow at 6°C but not at 43°C.
6. Interpreting test results. On the basis of the test results, identify as B. cereus those isolates
which are actively motile and strongly hemolytic and do not produce rhizoid colonies or
protein toxin crystals. Nonmotile B. cereus strains are also fairly common and a few strains are
weakly hemolytic. These nonpathogenic strains of B. cereus can be differentiated from B.
anthracis by their resistance to penicillin and gamma bacteriophage. CAUTION: Nonmotile,
nonhemolytic isolates that are suspected to be B. anthracis should be submitted to a pathology
laboratory such as the Centers for Disease Control and Prevention, Atlanta, GA, for
identification or destroyed by autoclaving. Acrystalliferous variants of B. thuringiensis and
nonrhizoid strains derived from B. mycoides cannot be distinguished from B. cereus by the
cultural tests.
7. Limitations of method for B. cereus. The method described is intended primarily for use
in the routine examination of foods. As noted in F above and in Table 1, the confirmatory tests
recommended may in some instances be inadequate for distinguishing B. cereus from
culturally similar organisms that could occasionally be encountered in foods. These organisms
include 1) the insect pathogen B. thuringiensis, which produces protein toxin crystals; 2) B.
mycoides, which characteristically produces rhizoid colonies on agar media; and 3) B.
anthracis, which exhibits marked animal pathogenicity and is non-motile. With the exception
of B. thuringiensis, which is currently being used for insect control on food and forage crops,
these organisms are seldom encountered in the routine examination of foods. The tests
described above are usually adequate for distinguishing the typical strains of B. cereus from
other members of the B. cereus group. However, results with atypical strains of B. cereus are
quite variable, and further testing may be necessary to identify the isolates.
8. Test for cereulide (emetic toxin). (/food/laboratory-methods-food/bam-
quantitative-analysis-cereulide-food-products) Intoxication is caused by the pre-
formed cereulide produced by B. cereus spores after germinating in food that has not been
stored properly. Ingestion of the pre-formed toxin typically begets nausea and vomiting. The
cereulide is resistant to acid, heat and digestive enzymes. The cyclic dodecadepsipeptide acts as
an ionophore disrupting oxidative phosphorylation in the mitochondria and has been
associated with several cases of liver failure (Mahler et al. 1997; Dierick et al. 2005; Pósfay-
Barbe et al. 2008). This method outlines procedures to perform quantitative analysis for
cereulide, or emetic toxin, associated with some strains of Bacillus cereus. The toxin can be
produced in foods contaminated with enterotoxigenic strains causing human illness.
Symptoms include nausea and vomiting, but intoxication has been associated with severe
illness and death.
References
1. Stenfors, Arnesen LP, Fagerlund A, Granum PE. (2008) From Soil to gut: Bacillus cereus and its
food poisoning toxins. FEMS Microbiol Rev. 32: 579-606.
2. Tallent, SM, KM Kotewicz, EA Strain and RW Bennett. 2012. Efficient Isolation and Identification of
Bacillus cereus Group
(http://aoac.publisher.ingentaconnect.com/content/aoac/jaoac/2012/00000095/00000002/art00025)
(http://www.fda.gov/about-fda/website-policies/website-disclaimer). Journal of AOAC
International, 95(2): 446-451. Available as PDF (/media/84610/download) (278 Kb)
3. Anonymous. (1993) 2nd Ed., International Organization for Standardization, Geneva, Switzerland,
Method ISO 793.
4. Mahler, H., Pasi, A., Kramer, J.M., Schulte, Pl, Scoging, A.C., Bar, W. and Krahenbuhl, L.S. (1997).
(1997). Fulminant liver failure in association with the emetic toxin of Bacillus cereus. N. Engl. J.
Med. 336: 1142–1148.
5. Dierick, K. Van Coillie, E., Swiecicka, I., Meyfroidt, G., Devlieger, H., Meulemans, A., Hoedemaekers,
G., Fopurie, L., Heyndricks, M., and Mahillon, J. (2005). Fatal family outbreak of Bacillus cereus-
associated food poisoning.
6. Posfay-Barbe, K.M., Schrenzel, J., Frey, J., Studer, R., Korff, C., Belli, D.C., Parvex, Pl,
Rimensberger, P.C., and Schappi, M.G. (2008). Food poisoning as a cause of acute liver failure.
Pediatr. Infect. Dis. J. 27: 846–847.
Hypertext Source: Bacteriological Analytical Manual, 8th Edition, Revision A, 1998. Chapter 14.