Genotyping and Source Tracking of Cronobacter sakazakii and C. malonaticus Isolates from Powdered Infant Formula and an Infant Formula Production Factory in China
ABSTRACTCronobacterspp. (formerly defined asEnterobacter sakazakii) are opportunistic bacterial pathogens of both infants and adults. In this study, we analyzed 70Cronobacterisolates from powdered infant formula (PIF) and an infant formula production facility in China to determine possible contamination routes. The strains were profiled by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), PCR-based O-antigen serotyping, andompAandrpoBsequence analyses. The isolates were primarilyCronobacter sakazakii(66/70) orCronobactermalonaticus(4/70). The strains were divided into 38 pulsotypes (PTs) using PFGE and 19 sequence types (STs) by MLST. In contrast,rpoBandompAsequence analyses divided the strains into 10 overlapping clusters each. PCR serotyping of the 66C. sakazakiiand 4C. malonaticusstrains resulted in the identification of fourC. sakazakiiserotypes (O1, O2, O4, and O7) and a singleC. malonaticusserotype, O2. The dominantC. sakazakiisequence types from PIF and an infant formula production factory in China wereC. sakazakiiclonal complex 4 (CC4) (n= 19), ST1 (n= 14), and ST64 (n= 11).C. sakazakiiCC4 is a clonal lineage strongly associated with neonatal meningitis. In the process of manufacturing PIF, the spray-drying, fluidized-bed-drying, and packing areas were the main areas withCronobactercontamination.C. sakazakiistrains with the same pulsotypes (PT3 and PT2) and sequence types (ST1 and ST64) were isolated both from processing equipment and from the PIF finished product.