|FLORES, J. PARRA - University Of Bío-Bío|
|AGUIRRE, J. - Universidad De Chile|
|CRUZ-CORDOVA, ARIADNNA - Hospital Infantil De Mexico|
|SILVA-SANCHEZ, JESUS - National Institute Of Public Health (INSP)|
|FORSYTHE, STEPHEN - Foodmicrobecom|
|JACKSON, EMILY - Hospital Infantil De Mexico|
Submitted to: Frontiers in Microbiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/29/2018
Publication Date: 9/29/2018
Citation: Flores, J., Aguirre, J., Juneja, V.K., Cruz-Cordova, A., Silva-Sanchez, J., Forsythe, S. 2018. Virulence and antibiotic resistance profiles of Cronobacter sakazakii and Enterobacter spp. involved in the diarrheic hemorrhagic outbreak in Mexico. Frontiers in Microbiology. 9(2206). https://doi.org/10.3389/fmicb.2018.02206.
Interpretive Summary: Powdered infant formula (PIF) has been implicated as a vehicle of transmission of Cronobacter sakazakii and Enterobacter spp. in food poisoning outbreaks. Important aspects to be considered in the severity and prognosis of Cronobacter infection are the presence of antibiotic-resistance and virulence factors. We determined the pathogenicity and antibiotic resistance of several isolates from clinical cases as well as those from PIF and its processing environments. The findings should support regulatory and health authorities in their microbial surveillance measures and improve neonatal and infant health.
Technical Abstract: Cronobacter spp. are bacterial pathogens that cause neonatal meningitis, septicemia, and necrotizing enterocolitis in infants with a lethality rate of 40-80%. Powdered infant formulas (PIF) have been implicated as the main vehicles of transmission. The organism can also cause infection through contaminated expressed breast milk, and has been recovered from neonatal feeding tubes of neonates not fed reconstituted PIF. This study analysed Cronobacter sakazakii and Enterobacter spp. recovered from PIF, fecal matter, and the milk kitchen environment from an diarrheic hemorrhagic outbreak in 2011 in Mexico, with respect to their tissue virulence tests, and antibiotic resistance profiles. These strains had similar pathogenicity and antibiotic resistance profiles irrespective of isolation site. C. sakazakii strains isolated from PIF are significantly more invasive than Enterobacter spp. (p equal to 0.001) and 83% were resistant to more than one antibiotic. The findings can be used to complement existing information to better control Cronobacter and Enterobacter spp. contamination in PIF production, prevent its transmission, and improve infant food safety.