Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 17, Number 9—September 2011
Dispatch

Predominance of Cronobacter sakazakii Sequence Type 4 in Neonatal Infections

Susan Joseph and Stephen J. ForsytheComments to Author 
Author affiliations: Author affiliation: Nottingham Trent University, Nottingham, UK

Main Article

Table 1

Strains used in study of Cronobacter sakazakii genotypes and disease severity and clinical details derived from original case histories*

Strain Patient type/age (EGA)† Clinical signs/outcome Isolation site Year Country ST Reference
553 Neonate/1 d UNK UNK 1977 Netherlands 4 (15)
557 Neonate/5 d UNK UNK 1979 Netherlands 4 (15)
693 Neonate/13 d (41 wk) Asymptomatic Feces 1994 France 13 (3)
695 Neonate/15 d (32 wk) Fatal NEC II Trachea 1994 France 4 (3,6)
701 Neonate/28 d (28 wk) Fatal NEC III Peritoneal fluid 1994 France 4 (3,6)
709 Neonate/18 d (29 wk) Septicemia Trachea 1994 France 4 (3,6)
767 Neonate/19 d (31 wk) Fatal meningitis Trachea 1994 France 4 (3,6)
721 Neonate/2 wk Meningitis CSF 2003 USA 4
978 Neonate/<1 wk UNK Enteral feeding tube 2007 UK 3 (12)
696 Neonate/17 d (32 wk) NEC II Feces 1994 France 12 (3,6)
984 Neonate/3–4 wk UNK Enteral feeding tube 2007 UK 3 (12)
690 Neonate/27 d (31 wk) Asymptomatic Feces 1994 France 12 (3)
1218 Neonate/<1 mo (30 wk) Fatal meningitis CSF 2001 USA 1
1219 Neonate/<1 mo (36 wk) Fatal meningitis CSF 2002 USA 4
1221 Neonate/<1 mo Meningitis, adverse neurologic outcome CSF 2003 USA 4
1225 Neonate/<1 mo (35 wk) Fatal meningitis Blood 2007 USA 4
1231 Neonate (33 wk) Fatal neurologic damage Feces 2004 New Zealand 4 (2)
HPB 3290 Neonate (33 wk) Meningitis CSF 2001 USA 1 (1)
1249 Neonate Fatal infection UNK 2009 UK 31
1220 Infant/6 wk (37 wk) Brain abscess, nonfatal CSF 2003 USA 4
1223 Infant/6 wk (31 wk) UNK, in ICU Blood 2004 USA 4
1240 Infant/7 wk Fatal meningitis CSF 2008 USA 4 (11)
1242 Infant/7 wk Fatal meningitis Brain 2008 USA 4 (11)
1241 Infant/7 mo Sudden infant death syndrome Blood 2008 USA 1 (11)
1222 Infant/8 mo Fever, recovered Blood 2003 USA 4
1224 Infant/10 mo Fever, severe combined immunodeficiency Blood 2004 USA 4
HPB 2856 Child/6 y UNK UNK 2002 Canada 15 (10)
ATCC 29544 Child UNK Throat 1980 USA 8 (13)
20 Child/6 y UNK Feces 2004 Czech Rep 4
12 Adult/74 y UNK Feces 2004 Czech Rep 1
CDC 0743–75 UNK Foot wound Wound 1975 USA 41 (13)
CDC 407–77 UNK UNK Sputum 1977 USA 8 (13)
CDC 996–77 UNK UNK Spinal fluid 1977 USA 8 (13)
NCTC 9238 UNK UNK Abdomen pus 1953 UK 18 (15)
HPB 2852 UNK UNK UNK 1990 Canada 8 (10)
HPB 2853 UNK UNK UNK 1990 Canada 4 (10)
511 UNK UNK UNK 1983 Czech Rep 8 (14)
513 UNK UNK UNK 1983 Czech Rep 8 (14)
520 UNK UNK UNK 1983 Czech Rep 12 (14)
526 UNK UNK UNK 1983 Czech Rep 8 (14)
558 UNK UNK UNK 1983 Netherlands 4 (15)

*EGA, estimated gestational age; ST, sequence type; UNK, unknown; NEC, necrotizing enterocolitis; CSF, cerebrospinal fluid; ICU, intensive care unit; Czech Rep, Czech Republic; CDC, Centers for Disease Control and Prevention.
†Values <37 weeks are considered premature.

Main Article

References
  1. Himelright  I, Harris  E, Lorch  V, Anderson  M. Enterobacter sakazakii infections associated with the use of powdered infant formula—Tennessee, 2001. JAMA. 2002;287:22045. DOIPubMedGoogle Scholar
  2. Jarvis  C. Fatal Enterobacter sakazakii infection associated with powdered infant formula in a neonatal intensive care unit in New Zealand. Am J Infect Control. 2005;33:e19. DOIGoogle Scholar
  3. Caubilla-Barron  J, Hurrell  E, Townsend  S, Cheetham  P, Loc-Carrillo  C, Fayet  O, Genotypic and phenotypic analysis of Enterobacter sakazakii strains from an outbreak resulting in fatalities in a neonatal intensive care unit in France. J Clin Microbiol. 2007;45:397985. DOIPubMedGoogle Scholar
  4. Bowen  AB, Braden  CR. Clinical characteristics and outcomes of infants with invasive Enterobacter sakazakii disease. Emerg Infect Dis. 2006;12:11859.PubMedGoogle Scholar
  5. Bowen  AB, Braden  CR. Enterobacter sakazakii disease and epidemiology. In: Farber JM, Forsythe SJ, editors. Emerging issues in food safety: Enterobacter sakazakii. Washington: American Society for Microbiology Press; 2008;4:101–25.
  6. Townsend  S, Hurrell  E, Forsythe  SJ. Virulence studies of Enterobacter sakazakii isolates associated with a neonatal intensive care unit outbreak. BMC Microbiol. 2008;8:64. DOIPubMedGoogle Scholar
  7. Kucerova  E, Clifton  SW, Xia  X-Q, Long  F, Porwollik  S, Fulton  L, Genome sequence of Cronobacter sakazakii BAA-894 and comparative genomic hybridization analysis with other Cronobacter species. PLoS ONE. 2010;5:e9556. DOIPubMedGoogle Scholar
  8. Kucerova  E, Joseph  S, Forsythe  S. The Cronobacter genus: ubiquity and diversity. Quality Assurance and Safety of Crops and Foods. 2011. In press. DOIGoogle Scholar
  9. Baldwin  A, Loughlin  M, Caubilla-Barron  J, Kucerova  E, Manning  G, Dowson  C, Multilocus sequence typing of Cronobacter sakazakii and Cronobacter malonaticus reveals stable clonal structures with clinical significance, which do not correlate with biotypes. BMC Microbiol. 2009;9:223. DOIPubMedGoogle Scholar
  10. Pagotto  FJ, Nazarowec-White  M, Bidawid  S, Farber  JM. Enterobacter sakazakii: infectivity and enterotoxin production in vitro and in vivo. J Food Prot. 2003;66:3705.PubMedGoogle Scholar
  11. Centers for Disease Control and Prevention. Cronobacter species isolation in two infants—New Mexico, 2008. MMWR Morb Mortal Wkly Rep. 2009;58:117983 .DOIPubMedGoogle Scholar
  12. Hurrell  E, Kucerova  E, Loughlin  M, Caubilla-Barron  J, Hilton  A, Armstrong  R, Neonatal enteral feeding tubes as loci for colonisation by members of the Enterobacteriaceae. BMC Infect Dis. 2009;9:146. DOIPubMedGoogle Scholar
  13. Farmer  JJ III, Asbury  MA, Hickman  FW, Brenner  DJ. The Enterobacteriaceae study group. Enterobacter sakazakii: a new species of “Enterobacteriaceae” isolated from clinical specimens. Int J Syst Bacteriol. 1980;30:56984. DOIGoogle Scholar
  14. Aldová  E, Hausne  O, Postupa  R. Tween esterase activity in Enterobacter sakazakii. Zentralbl Bakteriol Mikrobiol Hyg [A]. 1983;256:1038.PubMedGoogle Scholar
  15. Muytjens  HL, Zanen  HC, Sonderkamp  HJ, Kollée  LA, Washsmuth  K, Farmer  JJ. Analysis of eight cases of neonatal meningitis and sepsis due to Enterobacter sakazakii. J Clin Microbiol. 1983;18:11520.PubMedGoogle Scholar

Main Article

Page created: September 06, 2011
Page updated: September 06, 2011
Page reviewed: September 06, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external