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Bacillus cereus  is a well-characterized human pathogen that produces toxins associated with diarrheal and emetic foodborne diseases. To investigate the possible transmission of  B. cereus  on lettuce farms in China and determine its enterotoxicity, (I) a total of 524 samples (lettuce: 332, soil: 69, water: 57, manure: 57, pesticide: 9) were collected from 46 lettuce farms in five Chinese provinces, (II) multilocus sequence typing (MLST) was used to classify  B. cereus  isolates and for trace analysis, and (III) the presence of toxin genes and enterotoxins (Hbl and Nhe) was detected in 68 strains. The results showed that one hundred and sixty-one lettuce samples (48.5%) tested positive for  B. cereus  at levels ranging from 10 to 5.3 × 10 4  CFU/g. Among the environmental sample categories surveyed, the highest positive rate was that of the pesticide samples at 55.6%, followed by soil samples at 52.2% and manure samples at 12.3%. Moreover, one hundred isolates of  B. cereus  yielded 68 different sequence types (STs) and were classified into five phylogenetic clades. Furthermore, Nhe toxin genes ( nheA ,  nheB ,  nheC ) were broadly distributed and identified in all 68 strains (100%), while Hbl toxin genes ( hblA ,  hblC ,  hblD ) were present in 61 strains (89.7%),  entFM  was detected in 62 strains (91.2%), and  cytK  was found in 29 strains (42.6%). All strains were negative for  ces . As for the enterotoxin, Nhe was observed in all 68 isolates carrying  nheB , while Hbl was present in 76.5% (52/68) of the strains harboring  hblC.  This study is the first report of possible  B. cereus  transmission and of its potential enterotoxicity on lettuce farms in China. The results showed that soil and pesticides are the main sources of  B. cereus  on lettuce farms in China, and the possible transmission routes are as follows: soil-lettuce, manure-lettuce, pesticide-lettuce, manure-soil-lettuce, and water-manure-soil-lettuce. Furthermore, the  B. cereus  isolates, whether from lettuce or the environment, pose a potential risk to health.

The Possible Transmission and Potential Enterotoxicity of Bacillus cereus on Lettuce Farms in Five Chinese Provinces