Anthrax Toxin-Expressing Bacillus cereus Isolated from an Anthrax-Like Eschar.

Marston CK1, Ibrahim H2, Lee P3, Churchwell G3, Gumke M4, Stanek D4, Gee JE1, Boyer AE5, Gallegos-Candela M5, Barr JR5, Li H6, Boulay D6, Cronin L6,Quinn CP6, Hoffmaster AR1.

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Abstract

Bacillus cereus isolates have been described harboring Bacillus anthracis toxin genes, most notably B. cereus G9241, and capable of causing severe and fatal pneumonias. This report describes the characterization of a B. cereus isolate, BcFL2013, associated with a naturally occurring cutaneous lesion resembling an anthrax eschar. Similar to G9241, BcFL2013 is positive for the B. anthracis pXO1 toxin genes, has a multi-locus sequence type of 78, and a pagA sequence type of 9. Whole genome sequencing confirms the similarity to G9241. In addition to the chromosome having an average nucleotide identity of 99.98% when compared to G9241, BcFL2013 harbors three plasmids with varying homology to the G9241 plasmids (pBCXO1, pBC210 and pBFH_1). This is also the first report to include serologic testing of patient specimens associated with this type of B. cereus infection which resulted in the detection of anthrax lethal factor toxemia, a quantifiable serum antibody response to protective antigen (PA), and lethal toxin neutralization activity.