Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Is Cronobacter sakazakii infection possible in an exclusively breastfed premature neonate in the neonatal intensive care unit?

Journal of Perinatology volume 34, pages 408–409 (2014)Cite this article

Subjects

Abstract

Cronobacter species are Gram-negative rods that may cause life-threatening infections in neonates and infants. They belong to the family of Enterobacteriaceae. The first case was published in 1961 in England and about 150 cases have been reported thus far in the literature. The worst form of infection results in meningitis, leaving survivors with devastating neurological sequelae. We present the case of a premature neonate who was exclusively gavage fed with non-fortified breast milk and developed culture positive sepsis for Cronobacter sakazakii with clinical signs of meningitis at 18 days of life. She had a very traumatic course and survived the illness, but questions remain as to how she obtained this infection and her future neurodevelopmental outcomes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Urmenyi AM, Franklin AW . Neonatal death from pigmented coliform infection. Lancet 1961; 1: 313–315.

    Article  CAS  Google Scholar 

  2. Yan QQ, Condell O, Power K, Butler F, Tall BD, Fanning S . Cronobacter species (formerly known as Enterobacter sakazakii) in powdered infant formula: a review of our current understanding of the biology of this bacterium. J Appl Microbiol 2012; 113: 1–15.

    Article  CAS  Google Scholar 

  3. Iversen C, Lehner A, Mullane N, Bidlas E, Cleenwerck I, Marugg J . The taxonomy of Enterobacter sakazakii: proposal of a new genus Cronobacter gen. nov. and descriptions of Cronobacter sakazakii comb. nov. Cronobacter sakazakii subsp. sakazakii, comb. nov., Cronobacter sakazakii subsp. malonaticus subsp. nov., Cronobacter turicensis sp. nov., Cronobacter muytjensii sp. nov., Cronobacter dublinensis sp. nov. and Cronobacter genomospecies 1. BMC Evol Biol 2007; 7: 64.

    Article  Google Scholar 

  4. Cetinkaya E, Joseph S, Ayhan K, Forsythe S . Comparison of methods for the microbilogical identification and profiling of Cronobacter species from ingredients used in the preparation of infant formula. Mol Cell Probes 2013; 27: 60–64.

    Article  CAS  Google Scholar 

  5. Nazarowec-White M, Farber JM . Enterobacter sakazakii: a review. Int J Food Microbiol 1997; 34: 103–113.

    Article  CAS  Google Scholar 

  6. Hunter CJ, Bean JF . Cronobacter: an emerging opportunistic pathogen associated with neonatal meningitis, sepsis and necrotizing enterocolitis. J Perinatol 2013; 33: 581–585.

    Article  CAS  Google Scholar 

  7. Friedemann M . Epidemiology of invasive neonatal Cronobacter (Enterobacter sakazakii) infections. Eur J Clin Microbiol Infect Dis 2009; 28: 1297–1304.

    Article  CAS  Google Scholar 

  8. FDA. Investigation of Cronobacter Bacteria Illness in Infants [cited] Available from http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm285401.htm 2011.

  9. Stoll BJ, Hansen N, Fanaroff AA, Lemons JA . Enterobacter sakazakii is a rare cause of neonatal septicemia or meningitis in VLBW infants. J Pediatr 2004; 144: 821–823.

    PubMed  Google Scholar 

  10. Bowen AB, Braden CR . Invasive Enterobacter sakazakii disease in infants. Emerg Infect Dis 2006; 12: 1185–1189.

    Article  Google Scholar 

  11. Lenati RF, O’Connor DL, Hebert KC, Farber JM, Pagotto FJ . Growth and survival of Enterobacter sakazakii in human breast milk with and without fortifiers as compared to powdered infant formula. Int J Food Microbiol 2008; 122: 171–179.

    Article  CAS  Google Scholar 

  12. Hurrell E, Kucerova E, Loughlin M, Caubilla-Barron J, Hilton A, Armstrong R . Neonatal enteral feeding tubes as loci for colonisation by members of the Enterobacteriaceae. BMC Infect Dis 2009; 9: 146.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, East Carolina University, Greenville, NC, USA

    S Ravisankar, P Garg & J Higginson

  2. Department of Pediatrics, East Carolina University, Vidant Medical Center, Greenville, NC, USA

    S S Syed

Authors
  1. S Ravisankar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S S Syed
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P Garg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J Higginson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S S Syed.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ravisankar, S., Syed, S., Garg, P. et al. Is Cronobacter sakazakii infection possible in an exclusively breastfed premature neonate in the neonatal intensive care unit?. J Perinatol 34, 408–409 (2014). https://doi.org/10.1038/jp.2014.14

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2014.14

Keywords

This article is cited by

Search

Advanced search

Quick links