Previous Article | Next Article 
Journal of Clinical Microbiology, January 2001, p. 293-297, Vol. 39, No. 1
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.1.293-297.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Outbreak of Necrotizing Enterocolitis Associated
with Enterobacter sakazakii in Powdered
Milk Formula
Jos
van Acker,1
Francis
de Smet,1,*
Gaëtan
Muyldermans,1
Adel
Bougatef,2
Anne
Naessens,1 and
Sabine
Lauwers1
Department of
Microbiology1 and Neonatal Intensive
Care Unit,2 Academisch Ziekenhuis Vrije
Universiteit Brussel, Brussels, Belgium
Received 28 June 2000/Returned for modification 6 August
2000/Accepted 27 October 2000
We describe an outbreak of necrotizing enterocolitis (NEC) that
occurred in the neonatal intensive care unit of our hospital. A total
of 12 neonates developed NEC in June-July 1998. For two of them, twin
brothers, the NEC turned out to be fatal.
Enterobacter sakazakii, a known contaminant
of powdered milk formula, was isolated from a stomach aspirate, anal
swab, and/or blood sample for 6 of the 12 neonates. A review of feeding
procedures revealed that 10 of the 12 patients were fed orally with the
same brand of powdered milk formula. E. sakazakii was
isolated from the implicated prepared formula milk as well as from
several unopened cans of a single batch. Molecular typing by
arbitrarily primed PCR (AP-PCR) confirmed, although partially, strain
similarity between milk and patient isolates. No further cases of NEC
were observed after the use of the contaminated milk formula was
stopped. With this outbreak we show that intrinsic microbiological
contamination of powdered milk formula can be a possible contributive
factor in the development of NEC, a condition encountered almost
exclusively in formula-fed premature infants. The use of sterilized
liquid milk formula in neonatal care could prevent problems with
intrinsic and extrinsic contamination of powdered milk formula.
*
Corresponding author. Mailing address: Department of
Microbiology, Academisch Ziekenhuis Vrije Universiteit Brussel,
Laarbeeklaan 101, 1090 Brussels, Belgium. Phone: 32-2-4775000. Fax:
32-2-4775015. E-mail: labomicro{at}az.vub.ac.be.
Journal of Clinical Microbiology, January 2001, p. 293-297, Vol. 39, No. 1
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.1.293-297.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
This article has been cited by other articles:
-
Hunter, C. J., Williams, M., Petrosyan, M., Guner, Y., Mittal, R., Mock, D., Upperman, J. S., Ford, H. R., Prasadarao, N. V.
(2009). Lactobacillus bulgaricus Prevents Intestinal Epithelial Cell Injury Caused by Enterobacter sakazakii-Induced Nitric Oxide both In Vitro and in the Newborn Rat Model of Necrotizing Enterocolitis. Infect. Immun.
77: 1031-1043
[Abstract]
[Full Text]
-
Townsend, S. M., Hurrell, E., Caubilla-Barron, J., Loc-Carrillo, C., Forsythe, S. J.
(2008). Characterization of an extended-spectrum beta-lactamase Enterobacter hormaechei nosocomial outbreak, and other Enterobacter hormaechei misidentified as Cronobacter (Enterobacter) sakazakii. Microbiology
154: 3659-3667
[Abstract]
[Full Text]
-
Mullane, N. R., Ryan, M., Iversen, C., Murphy, M., O'Gaora, P., Quinn, T., Whyte, P., Wall, P. G., Fanning, S.
(2008). Development of Multiple-Locus Variable-Number Tandem-Repeat Analysis for the Molecular Subtyping of Enterobacter sakazakii. Appl. Environ. Microbiol.
74: 1223-1231
[Abstract]
[Full Text]
-
Kim, K.-P., Loessner, M. J.
(2008). Enterobacter sakazakii Invasion in Human Intestinal Caco-2 Cells Requires the Host Cell Cytoskeleton and Is Enhanced by Disruption of Tight Junction. Infect. Immun.
76: 562-570
[Abstract]
[Full Text]
-
Caubilla-Barron, J., Hurrell, E., Townsend, S., Cheetham, P., Loc-Carrillo, C., Fayet, O., Prere, M.-F., Forsythe, S. J.
(2007). 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.
45: 3979-3985
[Abstract]
[Full Text]
-
Iversen, C., Lehner, A., Mullane, N., Marugg, J., Fanning, S., Stephan, R., Joosten, H.
(2007). Identification of "Cronobacter" spp. (Enterobacter sakazakii). J. Clin. Microbiol.
45: 3814-3816
[Abstract]
[Full Text]
-
Townsend, S. M., Hurrell, E., Gonzalez-Gomez, I., Lowe, J., Frye, J. G., Forsythe, S., Badger, J. L.
(2007). Enterobacter sakazakii invades brain capillary endothelial cells, persists in human macrophages influencing cytokine secretion and induces severe brain pathology in the neonatal rat. Microbiology
153: 3538-3547
[Abstract]
[Full Text]
-
See, K. C., Than, H. A., Tang, T.
(2007). Enterobacter sakazakii bacteraemia with multiple splenic abscesses in a 75-year-old woman: a case report. Age Ageing
36: 595-596
[Abstract]
[Full Text]
-
Kim, H., Ryu, J.-H., Beuchat, L. R.
(2007). Effectiveness of Disinfectants in Killing Enterobacter sakazakii in Suspension, Dried on the Surface of Stainless Steel, and in a Biofilm. Appl. Environ. Microbiol.
73: 1256-1265
[Abstract]
[Full Text]
-
Iversen, C., Forsythe, S. J.
(2007). Comparison of Media for the Isolation of Enterobacter sakazakii. Appl. Environ. Microbiol.
73: 48-52
[Abstract]
[Full Text]
-
Kim, H., Ryu, J.-H., Beuchat, L. R.
(2006). Attachment of and Biofilm Formation by Enterobacter sakazakii on Stainless Steel and Enteral Feeding Tubes. Appl. Environ. Microbiol.
72: 5846-5856
[Abstract]
[Full Text]
-
Mullane, N. R., Murray, J., Drudy, D., Prentice, N., Whyte, P., Wall, P. G., Parton, A., Fanning, S.
(2006). Detection of Enterobacter sakazakii in Dried Infant Milk Formula by Cationic-Magnetic-Bead Capture. Appl. Environ. Microbiol.
72: 6325-6330
[Abstract]
[Full Text]
-
Mohan Nair, M. K., Venkitanarayanan, K. S.
(2006). Cloning and Sequencing of the ompA Gene of Enterobacter sakazakii and Development of an ompA-Targeted PCR for Rapid Detection of Enterobacter sakazakii in Infant Formula. Appl. Environ. Microbiol.
72: 2539-2546
[Abstract]
[Full Text]
-
Gurtler, J. B., Beuchat, L. R.
(2005). Performance of Media for Recovering Stressed Cells of Enterobacter sakazakii as Determined Using Spiral Plating and Ecometric Techniques. Appl. Environ. Microbiol.
71: 7661-7669
[Abstract]
[Full Text]
-
Oh, S.-W., Kang, D.-H.
(2004). Fluorogenic Selective and Differential Medium for Isolation of Enterobacter sakazakii. Appl. Environ. Microbiol.
70: 5692-5694
[Abstract]
[Full Text]
-
Updegrove, K.
(2004). Necrotizing Enterocolitis: the Evidence for Use of Human Milk in Prevention and Treatment. J Hum Lact
20: 335-339
[Abstract]
-
Kaufman, D., Fairchild, K. D.
(2004). Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants. Clin. Microbiol. Rev.
17: 638-680
[Abstract]
[Full Text]
-
Kho, C. L., Tan, W. S., Tey, B. T., Yusoff, K.
(2003). Newcastle disease virus nucleocapsid protein: self-assembly and length-determination domains. J. Gen. Virol.
84: 2163-2168
[Abstract]
[Full Text]
-
Ongradi, J
(2002). Vaginal infection by Enterobacter sakazakii. Sex. Transm. Infect.
78: 467-467
[Full Text]
-
Baker, R. D.
(2002). Infant Formula Safety. Pediatrics
110: 833-835
[Full Text]