Global Epidemiology and health risks of Bacillus cereus Infections: Special focus on infant foods.

Bacillus cereus is a common pathogen responsible for gastrointestinal and other complicated disorders, yet epidemiological data and public health measures remain scarce. To bridge these gaps, a bilingual search spaning 50 years identified 266 relevant studies on global B. cereus infection, encompassing 6,135 cases. The global mortality rate for B. cereus infection is 0.9 %. Food poisoning cases account for 94.31 % (5786/6135) of the total infections, with a mortality rate of 0.05 %. B. cereus infections were primarily reported in East Asia, Europe, and North America, with frequent studies in eastern and southern China. Rice was recognized as the highest-risk food category for B. cereus-associated food poisoning, with 43 reported incidents. Younger populations, particularly infants and toddlers (<2 years) and school-age children (6-18 years), tend to exhibit more severe symptoms. These symptoms include fulminant liver failure, rhabdomyolysis, and metabolic acidosis. The outcomes of severe cases are associated with specific toxin types, with cereulide-producing strains linked to complicated clinical disorders and outcomes. These findings highlight the need for targeted epidemiological surveillance and public health interventions to mitigate B. cereus-associated infections.