Bacillus cereus

Bacillus cereus is an endemic, soil-dwelling, Gram-positive, rod shaped, beta hemolytic bacteria that causes foodborne illness. It is the cause of "Fried Rice Syndrome". B. cereus bacteria are facultative aerobes, and like other members of the genus Bacillus can produce protective endospores.

Pathogenesis
B. cereus is responsible for a minority of foodborne illnesses (2–5%). It is known to create heavy nausea, vomiting, and abdominal periods. Generally speaking, Bacillus foodborne illnesses occur due to survival of the bacterial spores when food is improperly cooked. This problem is compounded when food is then improperly refrigerated, allowing the spores to germinate. Bacterial growth results in production of enterotoxin, and ingestion leads to two types of illness, diarrheal and emetic syndrome.
 * The diarrheal type is associated with a wide-range of foods, has an 8–16 hour incubation time and is associated with diarrhea and gastrointestinal pain. Also know as the long-incubation form of B. cereus food poisoning, it can be difficult to differentiate from poisoning caused by Clostridium perfringens.
 * In the emetic form, cooked rice that is improperly refrigerated is the most common cause, leading to nausea and vomiting 1–5 hours after consumption. This form can be difficult to distinguish from other short-term bacterial foodborne pathogens (e.g. Staphylococcus aureus).

It was previously thought that the timing of the toxin production might be responsible for the two different types, but in fact the emetic syndrome is caused by a toxin called cereulide that is found only in emetic strains and is not part of the 'standard toolbox' of B. cereus. Cereulide a dodecadepsipeptide produced by non-ribosomal peptide synthesis (NRPS), which is somewhat unusual in itself. It was shown independently by two research groups to be encoded on a plasmid, which is called pCERE01 or pBCE4810. Interestingly, this plasmid shares a common backbone with the virulence plasmid pXO1, which encodes the anthrax toxin genes in B. anthracis, but with a different pathogenicity island. Periodontal isolates of B. cereus also possess distinct pXO1-like plasmids.