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      Riesgo de contaminación por Cronobacter Sakazakii en leches en polvo para la nutrición de lactantes Translated title: Risk of Cronobacter Sakazakii contamination in powdered milk for infant nutrition

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          Abstract

          Introducción: Cronobacter spp es un género bacteriano con 7 especies, siendo C. sakazakii la especie clínica más reportada y asociada a meningitis y septicemia en lactantes. Es transmitida por leche en polvo (LP) por lo que la OMS recomienda su ausencia en este producto. En Chile, el reglamento sanitario de los alimentos (RSA) no lo considera. Objetivo: Evaluar el riesgo por Cronobacter sakazakii en LP destinadas al consumo de lactantes. Metodología: Se analizaron 72 muestras de LP de 3 marcas y 3 países. El recuento de bacterias mesófilas (RAM), Enterobacteriaceae (ENT) y número más probable (NMP) se realizó con la metodología de Puch and Ito (2001). Se utilizó agar diferencial Cronobacter para aislamiento (DFI, Oxoid, England) y kit bioquímico ID32E (Biomeriux, Francia) para fenotipo. El patógeno fue identificado y genotipificado por multilocus sequence typing (MLST) utilizando criterios de http://www.pubmlst.org/cronobacter. Resultados: La medianas de RAM para LP etapa 1 y prematuros fueron 300 UFC/g (10-36 000) y 650 UFC/g (70-30 000), siendo mayor en las muestras de Chile (p=0,016). Para ENT de 75 UFC/g (10-1 060) y 200 UFC/g (30-1 000), no existiendo diferencias significativas por tipo, país o marca de LP (p>0,05). Dos cepas de 2 lotes diferentes características en agar DFI se identificaron como C. sakazaki con 0,23 y 2,3 NMP/g. Además de Franconibacter helveticus en otras 2 cepas, especie relacionada estrechamente con Cronobacter spp. Conclusiones: La prevalencia de C. sakazakii en todas las muestras fue de 2,7% y aisló sólo en LP de elaborados en Chile. La ausencia de Cronobacter spp en 25 g debe ser incorporado en el RSA de Chile.

          Translated abstract

          Introduction: Cronobacter spp. is a bacterial genus that includes 7 species; Cronobacter sakazakii is the clinical specie that is the most reported and associated with meningitis and septicemia in infants. Given that it is transmitted by powdered infant formula (PIF), the WHO recommends that this product be free of Cronobacter, whereas the Chilean Food Sanitary Regulation (RSA) does not consider it. Objective: To assess the risk of C. sakazakii in PIF for consumption by infants. Methodology: A total of 72 PIF samples were analyzed using three brands originating from three countries. Aerobic plate count (APC), Enterobacteriaceae (ENT), and most probable number (MPN) were performed using the methodology described by Puch and Ito (2001). Cronobacter differential agar was used to isolate strains (DFI, Oxoid, England), and the ID32E biochemical kit (Biomeriux, France) was used for phenotyping. The pathogen was identified and genotyped by multilocus sequence typing (MLST) based on the criteria found at http://www.pubmlst.org/cronobacter. Results: Median APC for step 1 and preterm PIF was 300 CFU/g (10-36 000) and 650 CFU (70-30 000), respectively and was higher in Chilean PIF (p=0.016). There were no significant differences for type, country or PIF brand in 75 CFU/g (10-36 000) and 200 CFU/g (10-1 000) ETN (p>0.05). Two strains from two different lots with characteristic strains in DFI agar were identified as C. sakazakii with 0.23 and 2.3 MPN/g. In addition, Franconibacter helveticus, specie closely related to Cronobacter spp, was found in two other strains. Conclusions: The prevalence of Cronobacter sakazakii in all the samples was 2.7% isolated only in PIFs manufactured in Chile. The absence of Cronobacter spp in 25 g must be included in the Chilean RSA.

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          Cronobacter condimenti sp. nov., isolated from spiced meat, and Cronobacter universalis sp. nov., a species designation for Cronobacter sp. genomospecies 1, recovered from a leg infection, water and food ingredients.

          A re-evaluation of the taxonomic position of five strains, one assigned to Cronobacter sakazakii (strain 1330(T), isolated from spiced meat purchased in Slovakia), two previously assigned to Cronobacter genomospecies 1 (strains NCTC 9529(T) and 731, isolated from water and a leg infection, respectively) and two previously assigned to Cronobacter turicensis (strains 96 and 1435, isolated from onion powder and rye flour, respectively) was carried out. The analysis included phenotypic characterization, 16S rRNA gene sequencing and multilocus sequence analysis (MLSA) of seven housekeeping genes (atpD, fusA, glnS, gltB, gyrB, infB, ppsA; 3036 bp). 16S rRNA gene sequence analysis and MLSA showed that strain 1330(T) formed an independent phylogenetic lineage in the MLSA, with Cronobacter dublinensis LMG 23823(T) as the closest neighbour. DNA-DNA reassociation and phenotypic analysis revealed that strain 1330(T) represented a novel species, for which the name Cronobacter condimenti sp. nov. is proposed (type strain 1330(T) = CECT 7863(T) = LMG 26250(T)). Strains NCTC 9529(T), 731, 96 and 1435 clustered together within an independent phylogenetic lineage, with C. turicensis LMG 23827(T) as the closest neighbour in the MLSA. DNA-DNA reassociation and phenotypic analysis confirmed that these strains represent a novel species, for which the name Cronobacter universalis sp. nov. is proposed (type strain NCTC 9529(T) = CECT 7864(T) = LMG 26249(T)).
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            Enterobacter sakazakii infections among neonates, infants, children, and adults. Case reports and a review of the literature.

            Samuel Lai (2001)
            Enterobacter sakazakii can cause serious infections especially among the very young and the elderly. It continues to be more common among neonates and infants than adults. Its tropism for the central nervous system in neonates and infants remains a mystery. Among neonates and infants, E. sakazakii has a propensity to cause meningitis resulting in ventriculitis, brain abscess or cyst formation, and development of hydrocephalus requiring ventricular-peritoneal shunt. Computed tomography of the head is therefore useful in following patients with E. sakazakii meningitis. Mortality and morbidity of E. sakazakii meningitis is high, and virtually all patients recovering from the central nervous system infection suffered mental and physical developmental delays. The case-fatality rate decreased among patients with meningitis treated with the third-generation cephalosporins. Most adults with E. sakazakii infection had serious underlying diseases and 50% of the adults with the infection had malignancies. However there has never been a known case of meningitis. Increasing antibiotic resistance among Enterobacter species should lead one to consider using the carbapenems or the newer cephalosporins in combination with a second agent such as an aminoglycoside. Limited data suggest that trimethoprim-sulfamethoxazole may be a useful agent in the treatment of infections caused by the Enterobacter species, especially in view of the production of extended-spectrum beta-lactamases capable of inactivating the cephalosporins and extended-spectrum penicillin.
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              Predominance of Cronobacter sakazakii Sequence Type 4 in Neonatal Infections

              A 7-loci (3,036 nt) multilocus sequence typing scheme was applied to 41 clinical isolates of Cronobacter sakazakii. Half (20/41) of the C. sakazakii strains were sequence type (ST) 4, and 9/12 meningitis isolates were ST4. C. sakazakii ST4 appears to be a highly stable clone with a high propensity for neonatal meningitis.
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                Author and article information

                Journal
                rchnut
                Revista chilena de nutrición
                Rev. chil. nutr.
                Sociedad Chilena de Nutrición, Bromatología y Toxicología (Santiago, , Chile )
                0717-7518
                March 2015
                : 42
                : 1
                : 83-89
                Affiliations
                [04] Nottingham orgnameNottingham Trent University orgdiv1School of Science and Technology orgdiv2Pathogen Research Centre UK
                [03] Concepción orgnameUniversidad de Concepción orgdiv1Escuela de Medicina Chile
                [02] Chillan orgnameUniversidad del Bío-Bío Chile
                [01] Chillan orgnameUniversidad del Bío-Bío orgdiv1Departamento de Nutrición y Salud Pública Chile
                Article
                S0717-75182015000100011 S0717-7518(15)04200100011
                10.4067/S0717-75182015000100011
                c72940e0-77d0-44a3-908f-8a519e7f8284

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 25 January 2015
                : 09 December 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 7
                Product

                SciELO Chile

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                ARTÍCULOS ORIGINALES

                infants,Cronobacter sakazakii,leche en polvo,lactantes,powdered infant formula

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