Structural characterization of fucose-containing disaccharides prepared from exopolysaccharides of Enterobacter sakazakii.

Fucose-containing oligosaccharides (FCOs) have important applications in the food, medicine, and cosmetics industries owing to their unique biological activities. The degradation of microbial fucose-containing exopolysaccharide (FcEPS) is a promising strategy for obtaining FCOs, and bacteriophage-borne glycanase is a useful tool for degrading FcEPS. Here, we aimed to obtain FCOs using bacteriophage-borne glycanase to depolymerize FcEPS from Enterobacter sakazakii. The FcEPS was mainly composed of l-fucose (42.72 %), d-galactose (20.59 %), and d-glucose (21.81 %). Based on the results of nuclear magnetic resonance and mass spectrometry, the obtained FCOs were disaccharide fragments with backbones of ß-d-Glcp-(1→4)-ß-l-Fucp and α-d-Galp-(1→3)-ß-l-Fucp, respectively. So far, few studies of disaccharides prepared from FcEPS have been reported. This study demonstrated that the FcEPS of E. sakazakii was a reliable fucose-containing disaccharide source and that bacteriophage-borne glycanase was an effective degradation tool for obtaining FCOs fragments from FcEPS.

Comparison of Chromogenic Selective Media for the Detection of Cronobacter spp. (Enterobacter sakazakii).

　The four types of chromogenic selective media that are commercially available in Japan were compared for establishing a Japanese standard method for detecting Cronobacter spp. based on ISO/TS 22964:2006. When assessed using 9 standard Cronobacter spp. strains and 29 non-Cronobacter strains, Enterobacter sakazakii isolation agar, ChromocultTM Enterobacter sakazakii agar, CHROMagarTM E. sakazakii, and XM-sakazakii agar demonstrated excellent inclusivity and exclusivity. Using the ISO/TS 22964:2006 method, the recovered numbers of 38 Cronobacter spp. strains, including 29 C. sakazakii isolates obtained from each medium, were equivalent, indicating that there was no significant difference (p > 0.05) among the four types of chromogenic selective media. Thus, we demonstrated that these four chromogenic selective media are suitable alternatives when using the standard method for detecting Cronobacter spp. in Japan, based on the ISO/TS 22964:2006.

Reassessment of Cronobacter spp. originally isolated as Enterobacter sakazakii from infant food.

Cronobacter spp. cause infant disease, several cases have been associated with powdered infant formulae (PIF). In the early 2000s, contamination of German PIF with these opportunistic pathogens was quite common. Before 2008, all isolates Cronobacter spp. had been classified as Enterobacter sakazakii, therefore little is known about species diversity within such isolates. Genetic, serologic, and biochemical traits of 80 Cronobacter isolates, originally obtained 2003-2006 within infant food surveys in Germany, were reassessed in this study. By sequencing of the fusA gene, all isolates were unambiguously assigned to two species, C. sakazakii (n = 73) and C. malonaticus (n = 7). PCR serotyping identified five C. sakazakii serotypes and two C. malonaticus serotypes, biochemical profiling yielded five biogroups. PFGE analysis also showed high heterogeneity in both species. Multilocus sequence typing of 26 selected isolates yielded 16 different sequence types (ST), including C. sakazakii ST 1 (n = 6) and the highly virulent ST 4 (n = 2). The results suggest that just two, but highly heterogeneous species were responsible for the Cronobacter contamination problem which challenged the German PIF industry in the beginning of this century. This fact may have influenced the success of efforts to identify and eliminate sources of contamination.

Rapid Detection of Enterobacter Sakazakii in milk Powder using amino modified chitosan immunomagnetic beads.

Chitosan immunomagnetic beads (CIBs) were first prepared through converting hydroxyl groups of natural polymer material-chitosan into amino groups using epichlorohydrin and ethylenediamine as modification agent and then coupling with polyclonal antibodies of Enterobacter sakazakii using glutaraldehyde as cross-linking agent. The beads before coupling with antibodies were characterized by magnetic property measurement, FTIR, SEM and XRD technologies. In the assay a natural polysaccharide-chitosan, which has good biological and chemical properties such as non-toxicity, biocompatibility and high chemical reactivity was first used for synthesis of immunomagnetic beads. The detection method first established in this paper that combined the beads with chromogenic medium together to rapid detect E. sakazakii in milk powder could greatly improve the detection specificity and working efficiency. The beads exhibited a maximum capturing capacity of 1×106cfu/g with the detection sensitivity of 4cfu/g. The results demonstrate that the assay is a straightforward, specific and sensitive alternative for rapid detection of E.sakazakii in food matrix. The total analysis time was as little as about 25h, which greatly shorten the detection time. The method can provides new ideas not only to preparation technique of immunomagnetic beads but to imunne detection technique in food safety.

My 40-Year History with Cronobacter/Enterobacter sakazakii - Lessons Learned, Myths Debunked, and Recommendations.

Much has been learned about organism in the Cronobacter/Enterobacter sakazakii complex since I first named and described Enterobacter sakazakii in 1980. However, there are still wide knowledge gaps. One of the most serious is that are still many uncertainties associated with assessing the public health risk posed by these bacteria, particularly in neonatal meningitis. Over the last few decades, Cronobacter contamination of commercial powdered infant formula products has apparently been reduced, but it is still an ongoing problem. The powdered infant formula industry still cannot produce powdered formula that is free of bacterial contamination with Cronobacter, other Enterobacteriaceae, other pathogenic bacteria, and other microorganisms. Until this happens, infants and other will be at risk of becoming infected when they ingest contaminated formula.

Isolation of Cronobacter spp. (Enterobacter Sakazakii) from Artisanal Mozzarella.

Cronobacter spp. (Enterobacter sakazakii) is an opportunistic bacterial pathogen capable of causing disease and even fatalities in newborn infants within the first weeks of life if consumed as part of the diet. Premature and immunocompromised newborn infants are at particular risk. The microorganism has been isolated from a variety of foods including contaminated infant milk formula powder and milk powder substitute. The study aimed to evaluate the level of microbiological contamination in 47 samples of mozzarella cheese made with cow's milk collected from artisan cheese producers in Southern Italy. Samples were collected from commercial sales points and underwent qualitative and quantitative microbiological analyses to test for the bacterial contaminants most commonly found in milk and cheese products. The 47 samples underwent qualitative and quantitative microbiological tests according to ISO UNI EN standards. Analyses focused on Staphylococcus aures, Salmonella spp., Listeria monocytogenes, Pseudomonas spp., E. coli, Yersinia spp., total coliforms and Cronobacter sakazakii. The ISO/TS 22964:2006 method was used to investigate possible contamination by C. sakazakii. Biochemical identification was carried out using an automated system for identification and susceptibility tests. None of the samples examined resulted positive for Salmonella spp. or Listeria spp. Only one sample resulted positive for Staphylococcus aureus. Pseudomonas spp. was isolated in 10 (21%) of 47 samples. High levels of total coliforms were found in 10 of 47 samples. Cronobacter spp. (Enterobacter sakazakii) was isolated in one sample. This is the first study to confirm isolation of C. sakazakii in artisan mozzarella cheese made from cow's milk. The presence of C. sakazakii could be related to external contamination during the phases of production or to the use of contaminated milk. Since mozzarella is recommended in the diet of children and adults of all ages, this present study helps define it as a potential vehicle for C. sakazakii in subjects at particular risk.

Inhibitory activity of Paenibacillus polymyxa on the biofilm formation of Cronobacter spp. on stainless steel surfaces.

The objective of this study was to control the survival or biofilm formation of Cronobacter spp. on stainless steel surfaces using Paenibacillus polymyxa. The antibacterial activity of a cell-free culture supernatant (CFCS) of P. polymyxa against Cronobacter spp. was found to vary with P. polymyxa incubation time. Maximum activity occurred when P. polymyxa was incubated at 25 or 30 °C for 96 h. When the CFCS was introduced to Cronobacter spp. adhered to stainless steel strips at 25 °C for up to 72 h, the CFCS successfully inhibited Cronobacter biofilm formation. Additionally, stainless steel surfaces with a preformed P. polymyxa biofilm were exposed to Cronobacter spp. suspensions in PBS or 0.1% peptone water at 3, 5, or 7 log CFU/mL to facilitate its attachment. The Cronobacter population significantly decreased on this surface, regardless of inoculum level or carrier, when the P. polymyxa biofilm was present. However, the microbial population decreased within 6 h and remained unchanged thereafter when the surface was immersed in an inoculum suspended in 0.1% peptone water at 5 or 7 log CFU/mL. These results indicate that P. polymyxa is able to use a promising candidate competitive-exclusion microorganism to control Cronobacter spp.

Work of adhesion of dairy products on stainless steel surface

The adhesion of the solids presents in food can difficult the process of surface cleaning and promotes the bacterial adhesion process and can trigger health problems. In our study, we used UHT whole milk, chocolate based milk and infant formula to evaluate the adhesion of Enterobacter sakazakii on stainless steel coupons, and we determine the work of adhesion by measuring the contact angle as well as measured the interfacial tension of the samples. Inaddition we evaluated the hydrophobicity of stainless steel after pre-conditioning with milk samples mentioned. E. sakazakii was able to adhere to stainless steel in large numbers in the presence of dairy products. The chocolate based milk obtained the lower contact angle with stainless steel surface, higher interfacial tension and consequently higher adhesion work. It was verified a tendency of decreasing the interfacial tension as a function of the increasing of protein content. The pre-conditioning of the stainless steel coupons with milk samples changed the hydrophobic characteristics of the surfaces and became them hydrophilic. Therefore, variations in the composition of the milk products affect parameters important that can influence the procedure of hygiene in surface used in food industry.

Phenotypic profiles and detection of target genes by PCR in isolates from different sources and reference strains, identified as Cronobacter spp. (Enterobacter sakazakii)

Cronobacter, formerly known as Enterobacter sakazakii, is a novel genus of the Enterobacteriaceae family recognized as a cause of high number of fatal cases in neonates, after consuming infant formula. The conventional methods for detecting these organisms are time-consuming and lack sensitivity. The ISO/TS 22964:2006 is the most recently standardized methodology for detecting Cronobacter in powderedinfant formula. This study aimed at confirming the Brazilian isolates previously identified as E. sakazakiias Cronobacter spp. by biochemical assays, and also to compare characteristics of 37 Cronobacter andnon-Cronobacter isolates; and the miniaturized kits and the ISO/TS methodology were evaluated. A conventional PCR protocol targeting dna G was also developed and a previously described gluA targeting protocol was used. The majority of the Brazilian isolates were not confirmed as Cronobacter spp., and the selective enrichment step of ISO/TS methodology was inhibitory to some Cronobacter strains. The ID 32 Ewas the most reliable kit. The PCR protocol targeting gluA showed consistent results with ID 32E and the developed dnaG PCR protocol was 100% sensitive and specific. Thus, the PCR protocols targeting gluA and dnaG might be used to complement the Cronobacter spp. detection or identification after performing the conventional isolation and identification methods.

Work of adhesion of dairy products on stainless steel surface.

The adhesion of the solids presents in food can difficult the process of surface cleaning and promotes the bacterial adhesion process and can trigger health problems. In our study, we used UHT whole milk, chocolate based milk and infant formula to evaluate the adhesion of Enterobacter sakazakii on stainless steel coupons, and we determine the work of adhesion by measuring the contact angle as well as measured the interfacial tension of the samples. In addition we evaluated the hydrophobicity of stainless steel after pre-conditioning with milk samples mentioned. E. sakazakii was able to adhere to stainless steel in large numbers in the presence of dairy products. The chocolate based milk obtained the lower contact angle with stainless steel surface, higher interfacial tension and consequently higher adhesion work. It was verified a tendency of decreasing the interfacial tension as a function of the increasing of protein content. The preconditioning of the stainless steel coupons with milk samples changed the hydrophobic characteristics of the surfaces and became them hydrophilic. Therefore, variations in the composition of the milk products affect parameters important that can influence the procedure of hygiene in surface used in food industry.

Primer aislamiento de Cronobacter spp (Enterobacter sakazakii) en fórmula láctea en polvo producida en Chile / First isolation of Cronobacter spp (Enterobacter sakazakii) in powdered baby formula in Chile

La familia Enterobacteriaceae contempla agentes comunes en las enfermedades transmitidas por los alimentos. De esta familia Cronobacter spp, es considerado un patógeno que afecta principalmente a recién nacidos, los que pueden adquirirla a través de fórmulas lácteas infantiles en polvo contaminadas. Objetivo: Pesquisar Cronobacter spp, en una fórmula láctea en polvo producida en Chile. Material y método: En julio de 2008, se obtuvieron 80 muestras desde una planta ubicada en la Región de Los Lagos. Para el aislamiento de Cronobacter spp, se utilizó el método descrito en la norma ISO/TS 22964. Las muestras fueron analizadas en el Laboratorio de Alimentos del Instituto de Medicina Preventiva Veterinaria de la Universidad Austral de Chile. Resultados: Del total de muestras analizadas, el 5 por ciento (4 / 80) fueron confirmadas como Cronobacter spp, constituyendo así el primer reporte de esta bacteria en Chile. Conclusión: Cronobacter spp, está presente en una fórmula láctea en polvo producida en Chile. Su presencia en este producto representa un riesgo que no es considerado en el actual Reglamento Sanitario de los Alimentos de nuestro país.

The family Enterobacteriaceae includes agents that are commonly transmitted through food. Within this family, Cronobacter spp, is considered to be a pathogen that primarily affects newborns, which can acquire it through contaminated powdered formula. Objective: Isolate Cronobacter spp, in a powdered milk formula produced in Chile. Material and method: In July of 2008, 80 samples were obtained from a factory in the Los Lagos Region. To isolate Cronobacter spp, the methods described in the ISO/TS 22964 specifications were used. The samples were analyzed at the Food Laboratory at the Institute of Preventative Veterinary Medicine and the Universidad Austral de Chile. Results: Of all analyzed samples, 5 percent (4/80) were contaminated with Cronobacter spp, which constitutes the first report of this bacterium in Chile. Conclusion: Cronobacter spp is present in powdered baby formula produced in Chile. It’s presence in this product represents a risk that is not considered in the current food safety standards in this country.

Cronobacter sakazakii Infection Induced Fatal Clinical Sequels Including Meningitis in Neonatal ICR Mice.

Cronobacter sakazakii (C. sakazakii), formerly Enterobacter sakazakii, is an emerging pathogen associated with the ingestion of contaminated reconstituted formula that causes serious illnesses such as bacteremia, septicemia, necrotizing enterocolitis, meningitis and death in low-birth-weight preterm neonatal infants. The objective of this study was to develop an animal model for human neonatal C. sakazakii infections. We acquired timed-pregnant ICR mice and allowed them to give birth naturally. On postnatal day 3.5, each pup was administered orally a total dose of approximately 10(7) CFU C. sakazakii strain 3439. Mice were observed twice daily for morbidity and mortality. At postnatal day 10.5, the remaining pups were euthanized, and brain, liver, and cecum were excised and analyzed for the presence of C. sakazakii. C. sakazakii was isolated from cecum and other tissues in inoculated mice. In the tissues of C. sakazakii infected mice, meningitis and gliosis were detected in brain. In this study, we confirmed the neonatal ICR mice may be used a very effective animal model for human neonatal C. sakazakii infections.

Cronobacter sakazakii Infection Induced Fatal Clinical Sequels Including Meningitis in Neonatal ICR Mice / 한국실험동물학회지

Cronobacter sakazakii (C. sakazakii), formerly Enterobacter sakazakii, is an emerging pathogen associated with the ingestion of contaminated reconstituted formula that causes serious illnesses such as bacteremia, septicemia, necrotizing enterocolitis, meningitis and death in low-birth-weight preterm neonatal infants. The objective of this study was to develop an animal model for human neonatal C. sakazakii infections. We acquired timed-pregnant ICR mice and allowed them to give birth naturally. On postnatal day 3.5, each pup was administered orally a total dose of approximately 107 CFU C. sakazakii strain 3439. Mice were observed twice daily for morbidity and mortality. At postnatal day 10.5, the remaining pups were euthanized, and brain, liver, and cecum were excised and analyzed for the presence of C. sakazakii. C. sakazakii was isolated from cecum and other tissues in inoculated mice. In the tissues of C. sakazakii infected mice, meningitis and gliosis were detected in brain. In this study, we confirmed the neonatal ICR mice may be used a very effective animal model for human neonatal C. sakazakii infections.

Aislamiento e identificación de Enterobacter sakazakii en lactarios de Bogotá / Isolation and identification of Enterobacter sakazakii in milk feeders of Bogotá, D. C

Introducción. Enterobacter sakazakii es un patógeno oportunista emergente de alto riesgo, responsable de meningitis grave y enterocolitis necrosante. El principal vehículo de transmisión de esta bacteria son los productos infantiles deshidratados, debido a su contaminación después del tratamiento térmico. Objetivo. Identificar cepas de E. sakazakii en muestras de lactarios recolectadas en la ciudad de Bogotá, D.C. Materiales y métodos. Se analizaron 222 muestras de 9 lactarios, de superficies estériles y no estériles, utensilios empleados para la preparación de biberones y operarios. Se realizó recuento de coliformes totales y detección de E. sakazakii utilizando el protocolo propuesto por la Food and Drug Administration y por el Sistema Automático Bax® Dupont Qualicon. Resultados. De las 222 muestras recolectadas en las clínicas de Bogotá, se reportó que 27,4% (61) de las muestras analizadas presentaban coliformes totales; se detectó la presencia de E. sakazakii en 3,6% por el método automatizado de PCR BAX Dupont a partir de muestras de biberones y superficies. Conclusiones. Se demostró la presencia de E. sakazakii en lactarios en Colombia. Debido a que este microorganismo es un patógeno oportunista de alto riesgo para neonatos y que está asociado a las prácticas higiénicas en los lactarios, la información de este estudio puede ser útil para la toma de medidas profilácticas que reduzcan el riesgo de contaminación con este patógeno para la población infantil y, también, aporta información importante para la salud pública.

Introduction: Enterobacter sakazakii is an emergent opportunistic pathogen of high risk responsible of severe meningitis and necrotizing enterocolitis in neonates and infants with underlying medical conditions. One of the principal transmission vehicles for the transmission of these bacteria, is the infant dehydrated formula after exposing them to the heating treatment. Objective: To identify strains of E. sakazakii in milk feeders’ samples from Bogotá. Materials and methods: 222 samples from 9 milk feeders including sterile and non sterile surfaces, utensils used for the formula preparation and food handlers were analyzed. Total coliforms counts and identification of E. sakazakii was done using the FDA protocol and the automatic system Bax ® Dupont Qualicon. Results: From de 222 samples collected from hospitals in Bogotá, it was reported that 27.4% (61) had total coliforms, and the presence of E. sakazakii was detected in 3.6% (8) from one feeding bottle and surfaces. Conclusion: The presence of E. sakazakii strains was reported in Colombian milk feeders. Because this microorganism is a high risk opportunistic pathogen for newborn infants, usually associated with hygiene practices in milk feeders, the information of this research could be useful to develop preventive measurements to reduce the risk of contamination in the infant population and provides important public health information.

Primer estudio de Enterobacter sakazakii en alimentos en Cuba / First study on Enterobacter sakazakii in foodstuffs in Cuba

Enterobacter sakazakii es uno de los microorganismos patógenos emergentes que han hecho su aparición en los últimos años, fundamentalmente como contaminante ocasional de las fórmulas infantiles en polvo. En países en vías de desarrollo no existen suficientes investigaciones sobre este microorganismo, en Cuba este constituye el primer estudio realizado. Conocer la presencia de E. sakazakii en muestras de leche en polvo de importación. Se analizaron 60 muestras de leche en polvo, entera y descremada, provenientes de nueve países, se siguió la técnica recomendada por autoridades reguladoras de EE.UU., con la inclusión de pruebas bioquímicas convencionales como alternativa antes de aplicar el sistema de identificación API 20E. Se empleó el agar hierro Kligler y el agar citrato de Simmons; en aquellas cepas con imagen sugestiva de Enterobacter se comprobó la obtención de triptofano a partir de indol, reacción de Voges Proskauer y rojo de metilo, descarboxilación de lisina y ornitina, dihidrólisis de la arginina, producción de ácido de sacarosa, dulcitol, adonitol, rafinosa y sorbitol. Se obtuvo crecimiento de enterobacterias en 26 muestras. Una sola cepa dio resultado presuntivo de E. sakazakii por pruebas bioquímicas, la misma se confirmó por API 20E para 1,6 por ciento de positividad. En general la calidad microbiológica de las muestras de leche estudiadas fue buena. La técnica empleada para determinar E. sakazakii en muestras de leche en polvo, con la inclusión de pruebas bioquímicas convencionales, es factible de realizar en Cuba, para minimizar los costos asociados a la utilización de API 20E. Sería importante continuar estos estudios en áreas hospitalarias, especialmente aquellas donde se preparan fórmulas lácteas para recién nacidos(AU)

Enterobacter sakazakii is an emerging pathogen that has been isolated in milk powder preparations for infant in the last few years. Practically there is no research works about this microorganism in developing countries; in Cuba this is the first study. To detect the presence of E. sakazakii in imported milk powder samples. Sixty samples of whole and skimmed powdered milk imported from 9 countries were analyzed. Before applying API 20E Kit, the recommended technique by US regulatory bodies including conventional biochemical tests was used. Kligler´s iron agar and Simmons´s citrate agar were employed; other tests such as obtaining of triptophane from indole, Voges Proskauer reaction, methyl red, lysine and ornitine decarboxylation, arginine dihydrolysis, production of sucrose acid, dulcit, adonit, raffinose and sorbitol were performed in presumptive Enterobacter strains. Enterobacteria were isolated in 26 samples. Just one strain was classified as E. sakasakii using the traditional biochemical tests and further confirmed by API 20E for 1.6 percent possitivity of the sample. Generally speaking, the microbiological quality of powered milk samples was good. The technique used to determine E. sakazakii in powered milk samples, including conventional biochemical tests, is feasible to be performed in Cuba in order to reduce costs inherent to the use of API 20E. It is important to conduct these studies in hospital settings, particularly in those areas where milk formulae for neonates are prepared(AU)

Primer estudio de Enterobacter sakazakii en alimentos en Cuba / First study on Enterobacter sakazakii in foodstuffs in Cuba

Enterobacter sakazakii es uno de los microorganismos patógenos emergentes que han hecho su aparición en los últimos años, fundamentalmente como contaminante ocasional de las fórmulas infantiles en polvo. En países en vías de desarrollo no existen suficientes investigaciones sobre este microorganismo, en Cuba este constituye el primer estudio realizado. Conocer la presencia de E. sakazakii en muestras de leche en polvo de importación. Se analizaron 60 muestras de leche en polvo, entera y descremada, provenientes de nueve países, se siguió la técnica recomendada por autoridades reguladoras de EE.UU., con la inclusión de pruebas bioquímicas convencionales como alternativa antes de aplicar el sistema de identificación API 20E. Se empleó el agar hierro Kligler y el agar citrato de Simmons; en aquellas cepas con imagen sugestiva de Enterobacter se comprobó la obtención de triptofano a partir de indol, reacción de Voges Proskauer y rojo de metilo, descarboxilación de lisina y ornitina, dihidrólisis de la arginina, producción de ácido de sacarosa, dulcitol, adonitol, rafinosa y sorbitol. Se obtuvo crecimiento de enterobacterias en 26 muestras. Una sola cepa dio resultado presuntivo de E. sakazakii por pruebas bioquímicas, la misma se confirmó por API 20E para 1,6 por ciento de positividad. En general la calidad microbiológica de las muestras de leche estudiadas fue buena. La técnica empleada para determinar E. sakazakii en muestras de leche en polvo, con la inclusión de pruebas bioquímicas convencionales, es factible de realizar en Cuba, para minimizar los costos asociados a la utilización de API 20E. Sería importante continuar estos estudios en áreas hospitalarias, especialmente aquellas donde se preparan fórmulas lácteas para recién nacidos.

Enterobacter sakazakii is an emerging pathogen that has been isolated in milk powder preparations for infant in the last few years. Practically there is no research works about this microorganism in developing countries; in Cuba this is the first study. To detect the presence of E. sakazakii in imported milk powder samples. Sixty samples of whole and skimmed powdered milk imported from 9 countries were analyzed. Before applying API 20E Kit, the recommended technique by US regulatory bodies including conventional biochemical tests was used. Kligler´s iron agar and Simmons´s citrate agar were employed; other tests such as obtaining of triptophane from indole, Voges Proskauer reaction, methyl red, lysine and ornitine decarboxylation, arginine dihydrolysis, production of sucrose acid, dulcit, adonit, raffinose and sorbitol were performed in presumptive Enterobacter strains. Enterobacteria were isolated in 26 samples. Just one strain was classified as E. sakasakii using the traditional biochemical tests and further confirmed by API 20E for 1.6 percent possitivity of the sample. Generally speaking, the microbiological quality of powered milk samples was good. The technique used to determine E. sakazakii in powered milk samples, including conventional biochemical tests, is feasible to be performed in Cuba in order to reduce costs inherent to the use of API 20E. It is important to conduct these studies in hospital settings, particularly in those areas where milk formulae for neonates are prepared.

Surveillance of Stool Samples for the Presence of Enterobacter sakazakii among Korean People

PURPOSE: Enterobacter sakazakii (E. sakazakii) infections are an important cause of life-threatening meningitis, septicemia, and necrotizing enterocolitis in infants. Dried infant formula milk is an important vehicle for E. sakazakii infection. E. sakazakii was isolated in Korea from dried infant formula milk. Although E. sakazakii infection of infants may occur in Korea, its prevalence has not yet been documented. Therefore, we determined the prevalence of E. sakazakii and documented symptoms. MATERIALS AND METHODS: Between March and October 2006, 1,146 stool samples were collected from patients at Uijeongbu St. Mary's Hospital. Each fecal swab was dissolved in 10mL of buffered peptone solution, and enriched culture was streaked onto Druggan-Forsythe-Iversen (DFI) agar. Presumptive E. sakazakii colonies that exhibited a blue-green color during culture on DFI medium were selected. The identity of colonies that developed yellow pigment during culture on TSA was determined using the Vitek system and PCR. RESULTS: We isolated 4 E. sakazakii strains whose 16S rRNA sequence alignments had a similarity of 99% with those of 3 E. sakazakii ATCC strains. CONCLUSION: This is the first report on isolation of E. sakazakii from stool samples and to document the symptoms of Korean patients.

A Case of Enterobacter sakazakii Epidural Abscess in Neonate / 대한소아신경학회지

Enterobacter sakazakii previously known as a 'yellow-pigmented Enterobacter cloacae', was designated as a unique species in 1980. This reclassification was based on differences from E. cloacae in DNA relatedness, pigment production and biochemical reactions. In 1961, Urmenyi and Franklin reported the first two known cases of neonatal meningitis and septicemia caused by E. sakazakii, although at that time it was still considered as an E. cloacae strain. Since 1961, a number of cases of neonatal infection caused by E. sakazakii have been reported worldwide. Usually newborn with E. sakazakii meningitis have a poor prognosis, many of them dying within days of infection. The reported case-fatality rate vary from 40-80%. We diagnosed and experienced a case of epidural abscess caused by E. sakazakii in a 1 month old male patient, who was asymptomatic with brain mass detected on brain ultrasound examination. We presented this case with a brief review of literatures.