Cronobacter sakazakii is a germ that can live in very dry places. Cronobacter has been found in dry foods, like powdered infant formula, powdered milk, herbal teas, and starches. It has also been found in wastewater.
Cronobacter infections are often very serious for babies; they can die. Cronobacter infection can also be very serious for older people and people whose bodies have trouble fighting germs, like people with HIV, organ transplants, or cancer.
Typically, the CDC is informed of about 2–4 cases of Cronobacter illness in infants each year, but reporting isn’t required in the US, except for in Minnesota. As a result, rates of Cronobacter infection in the United States are not well understood.
Sicknesses from Cronobacter look different depending on the person.
Cronobacter, which used to be called Enterobacter sakazakii, is a germ that can live in very dry places. Cronobacter has been found in dry foods, like powdered infant formula, powdered milk, herbal teas, and starches. It has also been found in sewer water.
Sometimes powdered formula gets germs in it while it is being made at the factory. Other times, Cronobacter can get into powdered infant formula after it is opened at home or somewhere else.
Since Cronobacter germs live in the environment, there might be other ways babies can catch it. We do not know if Cronobacter infection can be spread from one person to another, but other types of bacteria spread this way, especially in hospitals if people do not wash their hands well.
Powdered infant formula is not sterile. Manufacturers report that, using current methods, it is not possible to produce sterile powdered infant formula. At the factory, Cronobacter could get into formula powder if contaminated raw materials are used to make the formula, or if the formula powder touches a contaminated surface in the manufacturing environment.
Powdered infant formula can also be contaminated at home or elsewhere after the container is opened. For example, Cronobacter could get into the formula if formula lids or scoops are placed on contaminated surfaces and later touch the formula, or if the formula is mixed with contaminated water or in a contaminated bottle.
Cronobacter infection is diagnosed by a laboratory culture.
If a Cronobacter infection is diagnosed by a laboratory culture in an infant, CDC encourages physicians, hospitals, and laboratories to inform their local or state health department.
Infants suspected of having Cronobacter sepsis or meningitis should undergo a full clinical evaluation for sepsis, including blood culture, urine culture, and cerebrospinal fluid culture, and should be given empiric therapy for sepsis immediately.
Antimicrobial sensitivity patterns of Cronobacter isolates should be determined because multidrug-resistant strains have been reported. Brain imaging studies of infants with meningitis can help detect brain abscesses and other complications. People with urinary tract infections or serious wound infections should also be treated with antibiotics. If a patient is colonized, rather than infected, with Cronobacter, treatment is not needed.
STOP is currently appealing to the FDA, the CDC, and the
Council of State and Territorial Epidemiologists to add
Cronobacter sakazakii to the Nationally Reportable Disease List.
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and expedited response.
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