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- Title
RIESGO DE ENFERMAR POR Cronobacter sakazakii ASOCIADO AL CONSUMO DE LECHES EN POLVO EN NIÑOS CHILENOS MENORES DE 2 AÑOS.
- Authors
PARRA-FLORES, Julio; RODRIGUEZ FERNÁNDEZ, Alejandra; CONTRERAS^FERNÁNDEZ, Alejandra; AGUIRRE GARCÍA, Juan
- Abstract
Background: Cronobacter is a bacterial genus with seven species; Cronobacter sakazakii is the species most related to meningitis and septicemia in infants. Its transmission is associated with powdered infant formula (PIF) and the WHO recommends PIF to be free of this species. It is not included in the Chilean food sanitary regulation. Objectives: Evaluate the risk of illness by C. sakazakii in PIF sold in Chile for infants. Methods: From 2013 to 2015, 128 samples of three types of PIF were analyzed: Premature (PIFP), Phase 1 (PIF1), and Phase 2 (PIF2), four brands, and five countries (Chile, Mexico, Holland, Brazil, USA). The aerobic plate count (APC) and Enterobacteriaceae (ENT) count were performed with official norms NCh 2659 and 2676 (2002). Druggan-Forsythe-Iversen (DFI) agar was used for Cronobacter and an ID32E biochemical kit for the phenotype. The antibiotic resistance profile was in accordance with CLSI norms. The pathogen was quantified (MPN), identified, and genotyped by PCR (rpoB), multilocus sequence typing (MLST), and BLAST (NCBI). The risk of illness was calculated with an exponential model Pill=1-exp(-rdc), which considered variability, PIF consumption dose, water rehydration temperature with 1 to 50 cells. Results: The median of APC for PIFP, PIF1, and PIF2 were: 2x104 CFU g-1 (70- 5x106), 530 CFU g-1 (10-3x105), and 5x104 CFU g-1 (3x103-16x105); it was higher in PMP (p<0.0001) from Holland (p<0.001) in brand 4 (p<0.00001). For ENT in PIF, PIF1, and PIF2, medians were 30 CFU g-1 (10-1x103), 60 CFU g-1 (10-2x104), and 10 CFU g-1 (10-27x102) with significant differences in brand 1 (p=0.041). Six characteristic strains of Cronobacter in DFI agar were identified as C. sakazaki by ID32E, PCR, MLST, and BLAST with 0.023 to 2.3 MPN/g. All the strains were resistant to cefotaxime and 60% were resistant to cefepime. Furthermore, E. cloacae, E. asburiae, E. hormaechei, and K. pneumoniae were identified. Conclusions: The prevalence of C. sakazakii in PIF was 4.6%; it was 12.2% in the Chilean samples. The probability of illness was 0.2 and 0.7 with 1 and 50 cells, respectively, with an estimated risk of 0.000062 for 1 case in 100 000 newborns who consume PIF.
- Publication
Vitae (01214004), 2016, Vol 23, pS62
- ISSN
0121-4004
- Publication type
Article