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Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

Enterobacter sakazakii or Cronobacter sakazakii – either way – in Infant Formula it is Devastating

Over at E. sakazakii blog there is a discussion of the naming and renaming of this very nasty bug.

Whatever the name it is a rare, but life-threatening cause of neonatal meningitis, sepsis, and necrotizing enterocolitis. In general, E. or C. sakazaii kills 40-80% of infected newborns diagnosed with this type of severe infection. E. or C. sakazakii meningitis may lead to cerebral abscess or infarction with cyst formation and severe neurologic impairment. E. or C. sakazakii can cause a variety of infections, though central nervous system infection has been most commonly described. For infants, infection typically manifests through signs of sepsis in the first week of life: irritability or lethargy, temperature instability, and feeding intolerance. Meningitis often produces overwhelming infection that rapidly moves through cerebral hemorrhage, infarct, necrosis, liquefaction, and eventually, cyst formation.

E. or C. sakazakii invasive infections occur more frequently in infants than in older children. The neonate’s immature immune system may increase the risk of acquiring an E. or C. sakazakii infection. In a study of E. or C. sakazakii cases over a 47-year period, investigators found that the median age at infection onset was two days and 94% of cases were less than 28 days old.

While the reservoir for E. or C. sakazakii is unknown in many cases, a growing number of reports have established powdered infant formula as the source and vehicle of infection. In several investigations of outbreaks of E. or C. sakazakii infection that occurred among neonates in neonatal intensive care units, investigators were able to show both statistical and microbiological association between infection and powdered infant formula consumption.