Abstract
Much has been learned about organism in the Cronobacter/Enterobacter sakazakii complex since I first named and described Enterobacter sakazakii in 1980. However, there are still wide knowledge gaps. One of the most serious is that are still many uncertainties associated with assessing the public health risk posed by these bacteria, particularly in neonatal meningitis. Over the last few decades, Cronobacter contamination of commercial powdered infant formula products has apparently been reduced, but it is still an ongoing problem. The powdered infant formula industry still cannot produce powdered formula that is free of bacterial contamination with Cronobacter, other Enterobacteriaceae, other pathogenic bacteria, and other microorganisms. Until this happens, infants and other will be at risk of becoming infected when they ingest contaminated formula.
Highlights
When a culture with one of the above names exits in a culture collection, it can be tested with current methods to determine its correct identification and name. This was done with the cultures deposited in England’s National Collection of Type Cultures (NCTC) and several were determined to be in the Enterobacter sakazakii complex as described in Farmer et al [2]
Food and Drug Administration issued a letter to American health community: “Health Professionals Letter on Enterobacter sakazakii Infections Associated with Use of Powdered (Dry) Infant Formulas in Neonatal Intensive Care Units.” [16]
Conclusion: the two cases of neonatal meningitis are separated in both time and geography, they were both probably, to a high degree of scientific certainty, infected by the same strain of Cronobacter that can be traced back to a contaminated powdered formula made at factory A
Summary
“Those who don’t know history are destined to repeat it.” – Edmund Burke (1729–1797, British Statesman and Philosopher). It was re-characterized in the late 1970’s and identified as E. sakazakii biogroup 1 [2] This is the earliest date for a strain of this organism and is the first documented isolate of Cronobacter from food and from a “dried milk” type of product. 2001: There was an outbreak of Enterobacter sakazakii at a Tennessee hospital with one case of meningitis and eight additional cases with Enterobacter sakazakii colonization It was caused when infants were fed Portagen, a commercial powdered formula produced by Mead Johnson. S. Food and Drug Administration issued a letter to American health community: “Health Professionals Letter on Enterobacter sakazakii Infections Associated with Use of Powdered (Dry) Infant Formulas in Neonatal Intensive Care Units.” [16]. Additional Cronobacter species probably exist but await discovery and description
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