Abstract
Cronobacter is a newly described bacterial genus that includes pathogens formerly known as Enterobacter sakazakii. Cronobacter spp. are capable of causing invasive diseases in all age groups, but are primarily associated with meningitis, necrotizing enterocolitis (NEC), and septicemia in neonates. Outbreaks within neonatal intensive care units and individual cases have been associated with the consumption of reconstituted, temperature-abused, intrinsically or extrinsically contaminated powdered infant formula (PIF). PIF is not a sterile product and can pose a significant risk if it is prepared and handled inappropriately. Poor hygiene has been reported as the most likely cause of some Cronobacter outbreaks and cases. Currently, our knowledge about its pathogenicity is largely derived from experimental animal models of meningitis. Studies using a newborn rat infection model suggest that enterocyte apoptosis, controlled by the induction of high levels of nitric oxide synthase, may be responsible for triggering apoptosis events leading to NEC with doses as low as 100 CFU/g of PIF.
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