To Determine the Frequency of Bacillus cereus in Powdered Milk Infant Formula Consuming in Neonatal Intensive Care Unit (NICU) in Tehran Hospitals in 2013-14

This study was the first conducted in Brazil to evaluate the presence of Enterobacter sakazakii in milk-based powdered infant formula manufactured for infants 0 to 6 months of age and to examine the conditions of formula preparation and service in three hospitals in São Paulo State, Brazil. Samples of dried and rehydrated infant formula, environments of milk kitchens, water, bottles and nipples, utensils, and hands of personnel were analyzed, and E. sakazakii and Enterobacteriaceae populations were determined. All samples of powdered infant formula purchased at retail contained E. sakazakii at <0.03 most probable number (MPN)/100 g. In hospital samples, E. sakazakii was found in one unopened formula can (0.3 MPN/100 g) and in the residue from one nursing bottle from hospital A. All other cans of formula from the same lot bought at a retail store contained E. sakazakii at <0.03 MPN/100 g. The pathogen also was found in one cleaning sponge from hospital B. Enterobacteriaceae populations ranged from 101 to 105 CFU/g in cleaning aids and <5 CFU/g in all formula types (dry or rehydrated), except for the sample that contained E. sakazakii, which also was contaminated with Enterobacteriaceae at 5 CFU/g. E. sakazakii isolates were not genetically related. In an experiment in which rehydrated formula was used as the growth medium, the temperature was that of the neonatal intensive care unit (25°C), and the incubation time was the average time that formula is left at room temperature while feeding the babies (up to 4 h), a 2-log increase in levels of E. sakazakii was found in the formula. Visual inspection of the facilities revealed that the hygienic conditions in the milk kitchens needed improvement. The length of time that formula is left at room temperature in the different hospitals while the babies in the neonatal intensive care unit are being fed (up to 4 h) may allow for the multiplication of E. sakazakii and thus may lead to an increased health risk for infants.

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Two unrelated episodes of Bacillus cereus bacteremia in a neonatal intensive care unit

American Journal of Infection Control ◽

10.1016/j.ajic.2014.01.025 ◽

2014 ◽

Vol 42 (6) ◽

pp. 694-695 ◽

Cited By ~ 16

Author(s):

Nalini Ramarao ◽

Laure Belotti ◽

Stephanie Deboscker ◽

Marylene Ennahar-Vuillemin ◽

Jerôme de Launay ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Bacillus Cereus ◽

Neonatal Intensive Care

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Outbreak of Bacillus cereus Infections in a Neonatal Intensive Care Unit Traced to Balloons Used in Manual Ventilation

Journal of Clinical Microbiology ◽

10.1128/jcm.38.11.4131-4136.2000 ◽

2000 ◽

Vol 38 (11) ◽

pp. 4131-4136 ◽

Cited By ~ 55

Author(s):

Wil C. Van Der Zwet ◽

Gerard A. Parlevliet ◽

Paul H. Savelkoul ◽

Jeroen Stoof ◽

Annie M. Kaiser ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Bacillus Cereus ◽

Neonatal Intensive Care ◽

Case Control Study ◽

Case Control ◽

Manual Ventilation ◽

Prospective Surveillance ◽

Control Study

In 1998, an outbreak of systemic infections caused byBacillus cereus occurred in the Neonatal Intensive Care Unit of the University Hospital Vrije Universiteit, Amsterdam, The Netherlands. Three neonates developed sepsis with positive blood cultures. One neonate died, and the other two neonates recovered. An environmental survey, a prospective surveillance study of neonates, and a case control study were performed, in combination with molecular typing, in order to identify potential sources and transmission routes of infection. Genotypic fingerprinting by amplified-fragment length polymorphism (AFLP) showed that the three infections were caused by a single clonal type of B. cereus. The same strain was found in trachea aspirate specimens of 35 other neonates. The case control study showed mechanical ventilation with a Sensormedics ventilation machine to be a risk factor for colonization and/or infection (odds ratio, 9.8; 95% confidence interval, 1.1 to 88.2). Prospective surveillance showed that colonization with B. cereusoccurred exclusively in the respiratory tract of mechanically ventilated neonates. The epidemic strain of B. cereus was found on the hands of nursing staff and in balloons used for manual ventilation. Sterilization of these balloons ended the outbreak. We conclude that B. cereus can cause outbreaks of severe opportunistic infection in neonates. Typing by AFLP proved very useful in the identification of the outbreak and in the analysis of strains recovered from the environment to trace the cause of the epidemic.

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Identification and Containment of a Cluster of Two Bacillus cereus Infections in a Neonatal Intensive Care Unit

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2019/1506583 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Cihan Papan ◽

Kai Förster ◽

Reinhard Herterich ◽

Andreas Schulze ◽

Sören Schubert ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Bacillus Cereus ◽

Molecular Characterization ◽

Neonatal Intensive Care ◽

Clinical Course ◽

Severe Pneumonia ◽

Common Source ◽

Adequate Therapy

We report a cluster of invasive Bacillus cereus infections in a neonatal intensive care unit. We describe the clinical course of two infected patients, one of whom died of severe pneumonia after successfully being weaned from ECMO. Environmental analyses failed to yield a common source. Molecular characterization confirmed the homogeneity of both isolates. Rigorous hygiene control and adequate therapy enabled the containment of the cluster.

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A Cluster of Bacillus cereus Infections in the Neonatal Intensive Care Unit

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0000000000002441 ◽

2019 ◽

Vol 38 (11) ◽

pp. e301-e306

Author(s):

Maskit Bar-Meir ◽

Livnat Kashat ◽

David A. Zeevi ◽

Yonit Wiener Well ◽

Marc V. Assous

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Bacillus Cereus ◽

Neonatal Intensive Care

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Centralized Infant Formula Preparation Room in the Neonatal Intensive Care Unit Reduces Incidence of Microbial Contamination

Journal of the American Dietetic Association ◽

10.1016/j.jada.2008.07.009 ◽

2008 ◽

Vol 108 (10) ◽

pp. 1700-1703 ◽

Cited By ~ 12

Author(s):

Caroline Steele ◽

Robert Short

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Infant Formula ◽

Neonatal Intensive Care ◽

Microbial Contamination ◽

Formula Preparation

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Enterobacter sakazakiiInfections in Neonates Associated with Intrinsic Contamination of a Powdered Infant Formula

Infection Control and Hospital Epidemiology ◽

10.1086/646060 ◽

1989 ◽

Vol 10 (9) ◽

pp. 398-401 ◽

Cited By ~ 71

Author(s):

Bryan P. Simmons ◽

Michael S. Gelfand ◽

Michael Haas ◽

Linda Metts ◽

John Ferguson

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Infant Formula ◽

Manufacturing Process ◽

Neonatal Intensive Care ◽

Powdered Infant Formula ◽

Enterobacter Sakazakii ◽

Intravenous Antibiotics ◽

Enteral Formulas

AbstractWe report an outbreak ofEnterobacter sakazakiiinfection and colonization in neonates related to an infant formula contaminated during the manufacturing process. The outbreak occurred in a 2O-bed neonatal intensive care unit during a six-week period in 1988, and involved a total of four infants. Three infants had sepsis and three had bloody diarrhea; all patients responded to intravenous antibiotics and recovered without complications. TheE sakazakiiisolated from the formula had the same plasmid and multilocus enzyme profile as those isolated from patients. This outbreak demonstrates the significance of commercially contaminated formulas and emphasizes the need to limit contamination and multiplication of bacteria in enteral formulas.

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The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00097 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1507-1515

Author(s):

Lauren L. Madhoun ◽

Robert Dempster

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Hospital Discharge ◽

Neonatal Intensive Care ◽

Oral Feeding ◽

Medical Attention ◽

Primary Role ◽

Speech Language Pathologists ◽

The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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