Abstract
Cronobacter spp. are bacterial pathogens that cause neonatal meningitis, septicemia, and necrotizing enterocolitis in infants with a lethality rate of 40–80%. Powdered infant formulas (PIF) have been implicated as the main vehicles of transmission. This pathogen can also cause infection through contaminated expressed breast milk, and it has been recovered from neonatal feeding tubes of neonates not fed reconstituted PIF and milk kitchen areas. This study analyzed antibiotic resistance profiles and the tissue virulence tests of Cronobacter sakazakii and Enterobacter spp. recovered from PIF, infant fecal matter‘s, and milk kitchen environment involved in a diarrheic hemorrhagic outbreak in 2011 in Mexico. The strains isolated from the outbreak had similar antibiotic resistance profiles and pathogenicity irrespective of isolation site, however, C. sakazakii strains isolated from PIF showed significantly higher invasive profiles than Enterobacter spp. (p = 0.001) and 83% were resistant to more than one antibiotic. The findings of this study can be used to complement existing information to better control Cronobacter and Enterobacter spp. contamination in PIF production, prevent its transmission, and improve infant food safety.
Highlights
Cronobacter infections are associated with adults and infants (Bowen and Braden, 2006; Holy and Forsythe, 2014; Alsonosi et al, 2015; Forsythe, 2018)
From 2003 to 2009, 544 cases of Cronobacter spp. infection were identified in 6 states of the United States, especially among children
This study is an extension of a previous study by Flores et al (2011) and Jackson et al (2015), who suggested that, after the fusA sequence analysis, isolates from the outbreak in Mexico 2011 were a mixture of C. sakazakii, Enterobacter hormaechei, and Enterobacter spp
Summary
Cronobacter infections are associated with adults and infants (Bowen and Braden, 2006; Holy and Forsythe, 2014; Alsonosi et al, 2015; Forsythe, 2018). From 2003 to 2009, 544 cases of Cronobacter spp. infection were identified in 6 states of the United States, especially among children
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