Enterobacter sakazakii in Dried Infant Formulas and Milk Kitchens of Maternity Wards in São Paulo, Brazil

2009 ◽  
Vol 72 (1) ◽  
pp. 37-42 ◽  
Author(s):  
GABRIELA PALCICH ◽  
CINTIA de MORAES GILLIO ◽  
LINA CASALE ARAGON-ALEGRO ◽  
FRANCO J. PAGOTTO ◽  
JEFFREY M. FARBER ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Infant Formula ◽  
Neonatal Intensive Care ◽  
Room Temperature ◽  
Sao Paulo ◽  
Powdered Infant Formula ◽  
São Paulo ◽  
Enterobacter Sakazakii

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.

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

1989 ◽  
Vol 10 (9) ◽  
pp. 398-401 ◽  
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.

scholarly journals 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

2017 ◽  
Vol 19 (6) ◽  
pp. 982-988
Author(s):  
Mohammad Mehdi Soltan Dallal ◽  
Shirin Nezamabadi ◽  
Mohammadkazem Sharifi Yazdi ◽  
Jalal Mardaneh ◽  
Mehrnaz Taheripoor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Bacillus Cereus ◽  
Infant Formula ◽  
Neonatal Intensive Care ◽  
Powdered Milk

Growth of Enterobacter sakazakii in Reconstituted Infant Formula as Affected by Composition and Temperature

2007 ◽  
Vol 70 (9) ◽  
pp. 2095-2103 ◽  
Author(s):  
JOSHUA B. GURTLER ◽  
LARRY R. BEUCHAT
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Infant Formula ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Initial Population ◽  
Powdered Infant Formula ◽  
Infant Formulas ◽  
Enterobacter Sakazakii ◽  
Commercial Milk

The ability of Enterobacter sakazakii to cause infections in infants, coupled with its documented presence in some lots of commercially manufactured powdered infant formula, raises a concern about the potential for its growth in reconstituted formula, with consequent increased safety risk. A study was done to determine these characteristics in four commercial milk-based powdered infant formulas and two soy-based formulas reconstituted with water and inoculated with a 10-strain mixture of E. sakazakii at populations of 0.02 and 0.53 CFU/ml (ca. 13 CFU/100 g and ca. 409 CFU/100 g of powdered formula, respectively). Reconstituted formulas were stored at 4, 12, 21, and 30°C, and populations were monitored up to 72 h. E. sakazakii did not grow in formulas stored at 4°C, although it was detected by enrichment of all formulas 72 h after reconstitution. Initially at a population of 0.02 CFU/ml, E. sakazakii grew to populations ≥1 log CFU/ml of reconstituted formulas held at 12, 21, and 30°C for 48, 12, and 8 h, respectively. At an initial population of 0.53 CFU/ml, the pathogen grew to populations ≥1 log CFU/ml in reconstituted infant formula held at 12 and 21°C for 24 and 8 h, respectively, and to populations 2.55 to 3.14 log CFU/ml when held at 30°C for 8 h. Populations initially at 0.02 and 0.53 CFU/ml of reconstituted formula increased to ≤0.25 and 0.4 log CFU/ml, respectively, when formulas were held at 30°C for 4 h. Growth was not greatly influenced by the composition of formulas. Results show that the hang time for reconstituted infant formula held at temperatures in neonatal intensive care units should be no longer than 4 h. Portions of reconstituted infant formula not fed to infants should be stored at ≤4°C, a temperature at which E. sakazakii will not grow.

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

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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