{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:35:03Z","timestamp":1787063703126,"version":"build-2736575974"},"reference-count":47,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","award":["PID2021127477OBI00\/MPY-302\/22"],"award-info":[{"award-number":["PID2021127477OBI00\/MPY-302\/22"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>The neurotoxin BoNT\/B2 is the predominant Clostridium parabotulinum subtype in foodborne and infant botulism cases in Spain. This study characterizes a novel case of foodborne botulism in Spain caused by a dual-toxin A1(B5) strain. A 64-year-old male presented with acute, progressive flaccid paralysis including diplopia, dysphagia, and respiratory failure. Although botulism was not initially suspected, the patient recovered with supportive care and without antitoxin administration. Genomic characterization confirmed the presence of both bont\/A1 and silent bont\/B5 genes. The bont\/A1 gene was associated with an orfX+ neurotoxin gene cluster, while the silent bont\/B5 gene was in an ha+ cluster. Phylogenetic analysis of both bont\/A1 and bont\/B5 sequences showed 100% amino acid identity, respectively, to previously reported A1(B5) strains (e.g., CDC_69094, FE9504ACG). Multi-locus sequence typing (MLST) assigned the ST10, a genotype previously undetected in Spanish botulism cases, yet found in other European countries. This case highlights the importance of considering botulism in differential diagnosis due to its varied presentation and the significance of timely laboratory confirmation for effective management. The identification of this dual-toxin BoNT\/A1(B5) orfX+\/ha+ ST10 strain expands our understanding of C. botulinum epidemiology and genetic diversity in Spain.<\/jats:p>","DOI":"10.3390\/toxins17090429","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:43:16Z","timestamp":1756366996000},"page":"429","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Features of the First Case of Foodborne Botulism Caused by Dual-Toxin Clostridium parabotulinum Subtype A1(B5) in Spain"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3931-2162","authenticated-orcid":false,"given":"Sylvia","family":"Valdezate","sequence":"first","affiliation":[{"name":"Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Valiente","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0215-6503","authenticated-orcid":false,"given":"Gema","family":"Carrasco","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda J.","family":"Medina-Pascual","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel","family":"Hurtado","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4876-0896","authenticated-orcid":false,"given":"Maite Ruiz","family":"de Pipa\u00f3n","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Virgen del Roc\u00edo, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelia","family":"Garrido","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Paradas","sequence":"additional","affiliation":[{"name":"CSUR\/ERN de Enfermedades Neuromusculares, UGC Neurolog\u00eda, Hospital Universitario Virgen del Roc\u00edo\/IBiS, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ram\u00f3n","family":"Hern\u00e1ndez-Bello","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Epidemiolog\u00eda, Servicio de Salud, Delegaci\u00f3n Territorial de Salud y Consumo en Sevilla, 41018 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3026-2178","authenticated-orcid":false,"given":"Pilar","family":"Villal\u00f3n","sequence":"additional","affiliation":[{"name":"Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2205251","DOI":"10.1080\/21505594.2023.2205251","article-title":"Pathogenicity and virulence of Clostridium botulinum","volume":"14","author":"Rawson","year":"2023","journal-title":"Virulence"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1038\/nrmicro3295","article-title":"Botulinum neurotoxins: Genetic, structural and mechanistic insights","volume":"12","author":"Rossetto","year":"2014","journal-title":"Nat. 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