Abstract
Previously known as Enterobacter sakazakii from 1980 to 2007, Cronobacter sakazakii is an opportunistic bacterium that survives and persists in dry and low-moisture environments, such as powdered infant formula. Although C. sakazakii causes disease in all age groups, infections caused by this pathogen are particularly fatal in infants born premature and those younger than two months. The pathogen has been isolated from various environments such as powdered infant formula manufacturing facilities, healthcare settings, and domestic environments, increasing the chance of infection through cross-contamination. The current study discusses the outbreak history of C. sakazakii and the ability of the microorganism to produce biofilms on biotic and abiotic surfaces. The study further discusses the fate of the pathogen in low-moisture environments, articulates preventive measures for healthcare providers and nursing parents, and delineates interventions that could be utilized in infant formula manufacturing to minimize the risk of contamination with Cronobacter sakazakii.
Highlights
Cronobacter sakazakii is a recently classified and an emerging and opportunistic pathogen, found in a number of low-moisture foods including in powdered infant formula
A study published in 1997 shows the survival and multiplication of C. sakazakii in powdered infant formula and on Brain Heart Infusion (BHI) medium, as well as the incidence of C. sakazakii being present in a Canadian supermarket purchase of one of the popular powdered infant formula brands [58]
For the food strain in powdered infant formula, the results were similar at 12 ◦C as for the clinical strain but at 24 and 37 ◦C they were both reduced by one log immediately at 2 h and one strain continued to be at its detection limit for the duration of 2–10 h
Summary
Cronobacter sakazakii is a recently classified and an emerging and opportunistic pathogen, found in a number of low-moisture foods including in powdered infant formula. The growth temperature range is 6–45 ◦C with an optimum multiplication temperature of 37–43 ◦C It can survive low-moisture environments, such as infant formula, with a water activity of 0.30 to 0.83 for up to 12 months [9]. It is noteworthy that recent studies indicate that non-sakazakii species of Cronobacter including malonaticus, turicensis, universalis, dublinensis, muytjensii, and condimenti, could potentially cause morbidity and life-threatening complications in infants and adults [12,13]. Except for C. condimenti that has not been involved in any documented clinical episode, the other six species have clinical significance, with C. sakazakii and C. malonaticus as the major pathogenic species of public health concern followed by C. turicensis, C. universalis, C. muytjensii, and C. dublinensis [14,15,16]. Identification of Cronobacter species can only be made through the use of species-specific PCR analyses or by whole genome sequencing
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