Investigation on the Factors Affecting Cronobacter sakazakii Contamination Levels in Reconstituted Powdered Infant Formula

Parra‐Flores, Julio; Rodríguez, Alejandra; Riffo, Francisca; Arvizu-Medrano, Sofía M.; Arias-Rios, Elba Veronica; Aguirre, Juan

doi:10.3389/fped.2015.00072

Cited by 18 publications

(16 citation statements)

References 41 publications

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“…(Of note, in end-product testing, that cluster would appear as one CFU, even though all 10 cells could multiply independently.) Let us be conservative and round up the generation time determined by Dr. Parra Flores in his article in this Frontiers Topic symposium ( 35 ), which is consistent with the value found by others. Using a generation time of a half hour at 35°C (a temperature roughly comparable to the 36–37°C body temperature of an afebrile neonate) and assuming virulent Cronobacter strains thrive in the neonatal gastrointestinal tract, the 10-cell cluster would reach an infectious dose of 1,000 CFU within 3.5 h, a time interval consistent with the time it takes an infant to consume and digest a formula feeding.…”

Section: The Epidemiology Of Cronobacter Infectionsupporting

confidence: 79%

“…These resulted in a risk assessment model, as well as a series of reports and recommendations [FAO/WHO 1 ]. In this Frontiers Topic symposium, Dr. Parra Flores applies the WHO’s risk assessment tool to explore the effect of temperature on Cronobacter growth ( 35 ). In 2006, WHO stated that “ contaminated PIF has been convincingly shown, both epidemiologically and microbiologically, to be the vehicle and source of infection in infants ” ( 36 ).…”

Section: The Epidemiology Of Cronobacter Infectionmentioning

confidence: 99%

“…The World Health Organization’s current recommendations related to Cronobacter are that PIF be reconstituted with water that has been boiled and then cooled to 70°C, to inactivate any Cronobacter contaminating the PIF ( 55 , 56 ). There are at least three problems with this recommendation, one of which was highlighted in Dr. Parra Flores’ Frontiers Topic manuscript ( 35 ). First, it is unlikely that this recommendation will be accurately followed in a home setting.…”

Section: The Epidemiology Of Cronobacter Infectionmentioning

confidence: 99%

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The Roles of Epidemiologists, Laboratorians, and Public Health Agencies in Preventing Invasive Cronobacter Infection

Jason¹

2015

Front. Pediatr.

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BackgroundCronobacter can cause severe, invasive infection in very young infants. These bacteria can also colonize or cause insignificant infections in immunocompromised, elderly, and/or hospitalized adults.MethodsThis editorial review highlights key points addressed in the Frontiers Research Topic on Cronobacter, discusses the clinical presentation and epidemiology of Cronobacter infections, and examines the responses of public health agencies to this problem.ResultsCronobacter is rarely isolated from hospitalized, immunocompromised and/or elderly adults and does not cause significant disease in those patients. Certain species and strains, especially of Cronobacter sakazakii, can cause invasive illness in previously healthy infants <2 months of age. Multilocus sequence type 4 and clonal complex 4 (ST4/MLST 4) C. sakazakii are the predominant cause of Cronobacter meningitis, which occurs only in infants. These infections and this strain type are strongly linked to powdered infant formulas (PIF), which can also be contaminated with other Cronobacter strains. End-product testing is not intended to guarantee the absence of these organisms. WHO has made recommendations that can help decrease but will not eliminate the risk of this infection.ConclusionTo further define the spectrum of Cronobacter-associated disease, all isolates should be genetically typed using every currently available method, typing results should be linked to the associated epidemiologic and clinical data, and these data should be analyzed in a scientifically sound manner. Based on currently available information, more can be done now to prevent cause invasive infection in young infants. This includes encouragement of exclusive breastfeeding and/or use of commercially sterile ready-to-feed formulas in the first 2 months of life.

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Section: The Epidemiology Of Cronobacter Infectionsupporting

confidence: 79%

Section: The Epidemiology Of Cronobacter Infectionmentioning

confidence: 99%

Section: The Epidemiology Of Cronobacter Infectionmentioning

confidence: 99%

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The Roles of Epidemiologists, Laboratorians, and Public Health Agencies in Preventing Invasive Cronobacter Infection

Jason¹

2015

Front. Pediatr.

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“…Infant formulas and other cereal-based foods consumed by infants and young children must be free of this pathogen according to national and international authorities. In addition, C. sakazakii contamination has repeatedly been detected in factories processing baby foods and ingredients used for making baby foods (PARRA-FLORES et al, 2015). Dust particles in the air of such a facility may act as a vector of C. sakazakii dissemination.…”

Section: Introductionmentioning

confidence: 99%

Occurrence and molecular characterization of different virulence-associated genes of Cronobacter sakazakii isolates from some foods and dust samples

Demirci

Tekiner

Çakmak³

et al. 2018

Cienc. Rural

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Among the Cronobacter genus, Cronobacter sakazakii is the most common species posing a severe health risk for newborns, infants and children. Some infant formulas, cereal-based foods, and food production environments may be the potential reservoirs of C. sakazakii. This pathogen possesses different virulence factors encoded by different virulence genes. Therefore, characterizing these genes is important for distinguishing pathogenic strains from nonpathogenic ones. The objective of this study was to characterize some virulence genes [OmpA, OmpX, zpx, and Cpa] by real-time polymerase chain reaction (PCR) in C. sakazakii isolates from a total of 120 samples (20 each of milk powder, starch, rice flour, semolina, infant formula and dust samples from food production environments). Overall, 13 isolates (7 from milk powder, 2 rice flour, 1 semolina, and 3 dust) were cultured, identified by bioMérieux API® 20E test kit, and then subjected to real-time PCR application for screening the target virulence-associated genes. Our results showed that all of 13 isolates were positive for the virulence genes OmpA, OmpX, zpx, and Cpa. In summary, our study revealed that some of the analyzed foods and environmental samples were contaminated with pathogenic C. sakazakii with its virulence-associated markers, far above the allowable limit; and therefore, this level of contamination may pose a severe health threat for newborns, infants, and children.

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“…As Cronobacter spp. does not survive the standard pasteurization process, a Cronobacter contamination critical for causing disease can only occur during filling and packaging and/or during reconstitution of PIF (Nazarowec-White and Farber, 1997 ; Parra-Flores et al, 2015 ). Furthermore, a hallmark of Cronobacter spp.…”

Section: Introductionmentioning

confidence: 99%

Multiplexed Lateral Flow Test for Detection and Differentiation of Cronobacter sakazakii Serotypes O1 and O2

et al. 2017

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The ubiquitous and opportunistic pathogen Cronobacter sakazakii is responsible for severe meningitis, sepsis, and necrotizing enterocolitis in neonates and infants associated with ingestion of contaminated powdered infant formula (PIF). The current ISO method for isolation and detection of Cronobacter spp. is laborious, time-consuming and expensive. In this study, a multiplexed lateral flow test strip was developed to rapidly detect and simultaneously serotype O1 and O2 C. sakazakii serotypes. The assay is based on two monoclonal antibodies (MAb) that specifically bind to the lipopolysaccharides (LPS) of these pathogens. The test strip provides results very quickly; C. sakazakii could be detected in pure culture within 15 min with a sensitivity of 107 CFU/ml. After non-selective enrichment for 18 h as low as one Cronobacter cell per g PIF could be detected. Moreover, the established lateral flow assay (LFA) offers excellent specificity showing no cross-reactivity with other C. sakazakii serotypes, Cronobacter species or Enterobacteriaceae tested. These characteristics, together with several advantages such as speed, simplicity in performance, low analysis cost, and no requirement of specialized skills or sophisticated equipment make the developed multiplexed LFA suitable for reliable detection and serotyping of C. sakazakii serotypes O1 and O2.

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Investigation on the Factors Affecting Cronobacter sakazakii Contamination Levels in Reconstituted Powdered Infant Formula

Cited by 18 publications

References 41 publications

The Roles of Epidemiologists, Laboratorians, and Public Health Agencies in Preventing Invasive Cronobacter Infection

The Roles of Epidemiologists, Laboratorians, and Public Health Agencies in Preventing Invasive Cronobacter Infection

Occurrence and molecular characterization of different virulence-associated genes of Cronobacter sakazakii isolates from some foods and dust samples

Multiplexed Lateral Flow Test for Detection and Differentiation of Cronobacter sakazakii Serotypes O1 and O2

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