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Cronobacter: An Opportunistic Pathogen
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Cronobacter is implicated in various types of infections involving newborns and infants, including necrotizing enterocolitis (NEC), meningitis, and sepsis. Although the Cronobacter genus comprises a diverse group of gram-negative bacilli (C. sakazakii, C. muytjensii, C. malonaticus, C. turicensis, C. universalis, C. dublinensis, and C. condimenti), C. sakazakii, C. malonaticus, and C. turicensis predominate clinical isolations from infants (1,2). Originally identified as yellow pigmented bacteria, Enterobacter cloacae was subsequently reclassified as C. sakazakii (1). Cronobacter infections are life threatening, with case fatality rates ranging between 40% and 80% (1,3,4). Apart from infections in neonates due to consumption of contaminated infant powdered formula, older and immunocompromised adults may also become infected occasionally. The Centers for Disease Control and Prevention (CDC) have dispatched warnings to public and hospital on the potential outbreaks of Cronobacter infection in neonatal intensive care units (5). Branded as a foodborne pathogen, the opportunistic Cronobacter bacteria are found in a variety of food sources that include dairy-based foods (cheese), dried meats, and rice (6). Soil, livestock facilities, and food preparation units are also sources for Cronobacter. Resistance to heat, dryness, and acidic conditions is a quality of Cronobacter compared to other Enterobacteriaceae family members, thereby enabling its survival in extreme environments (7). Cronobacter also forms biofilms that serve as protective barriers to withstand environmental stresses and escape immune surveillance by the host (8–11).
Cronobacter: Virulence and Pathogenesis
Published in Dongyou Liu, Laboratory Models for Foodborne Infections, 2017
Originally referred to as yellow-pigmented Enterobacter cloacae, it was later classified as a new species Enterobacter sakazakii. Subsequent characterization enabled the reclassification of these bacteria into a new genus called Cronobacter [1]. Cronobacter is composed of a diverse group of Gram-negative bacilli, which includes Cronobacter sakazakii, Cronobacter muytjensii, Cronobacter malonaticus, Cronobacter dublinensis, Cronobacter turicensis, Cronobacter universalis, and Cronobacter condimenti [2]. Except Cronobacter condimenti, all other Cronobacter spp. are associated with human infections. They cause life-threatening infections in neonates due to the consumption of powdered infant formula contaminated with Cronobacter [3,4]. Outbreaks of Cronobacter infections in neonatal intensive care units have resulted in several CDC warnings, and so efforts are in place to improve health care. Considered as an opportunistic pathogen, Cronobacter causes severe illness in neonates, such as necrotizing enterocolitis, bacteremia, and meningitis, often in low-birth-weight preterm infants [5]. Infections due to Cronobacter in normal and immunocompromised adults have also been noted, but these are less severe. Based on partial 16S rRNA and hsp60 sequencing, four cluster groups of C. sakazakii have been identified among this diverse group of pathogens [6]. The bacterium can be found in a variety of foods, including dairy-based foods (cheese), dried meats, and rice. Furthermore, it was also detected in environmental sources such as soil, livestock facilities, and food preparation units. Compared to other Enterobacteriaceae family members, Cronobacter is highly resistant to heat, dryness, and acidic conditions [7]. It also forms biofilms that function as a protective barrier to withstand environmental stress and obviate immune surveillance of the host.
The application of bacteriophage to control Cronobacter sakazakii planktonic and biofilm growth in infant formula milk
Published in Biofouling, 2021
Hyung Suk Kim, Md. Ashrafudoulla, Bo-Ram Kim, Md. Furkanur Rahaman Mizan, Soo-Jin Jung, Mohammad Sadekuzzaman, Si Hong Park, Sang-Do Ha
Accordingly, C. sakazakii has gradually gained the attention of the governing agencies because of its potential impact on human health (Chang et al. 2009). Cronobacter spp. are universal and have been isolated from various types of foods of animal or vegetable origin, including ready-to-eat, fermented, and cooked food products. In addition, beverages and water, owing to the steps involved in their processing and preparation could be other possible sources of contamination, colonization or infection (Friedemann 2007; Iversen and Forsythe 2003).
Invasive Cronobacter species infection in infants and children admitted to a rural Kenyan hospital with a high prevalence of malnutrition
Published in Paediatrics and International Child Health, 2018
Joe D. Piper, Salim Mwarumba, Moses Ngari, Benedict Mvera, Susan Morpeth, James A. Berkley
Analysis of the proportion of cultures that were positive for by age and nutritional status (Tables 1 and 2) demonstrated a low Enterobacter burden in children with malnutrition, with no increase in detection after the introduction of RUTF and RUSF in 2007. The clinical details of the two cases identified with Cronobacter infection are as follows.