AUTHOR=Jason Janine 

TITLE=The Roles of Epidemiologists, Laboratorians, and Public Health Agencies in Preventing Invasive Cronobacter Infection

JOURNAL=Frontiers in Pediatrics

VOLUME=3

YEAR=2015

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2015.00110

DOI=10.3389/fped.2015.00110

ISSN=2296-2360

ABSTRACT=<sec id="ST1"><title>Background</title><p><italic>Cronobacter</italic> can cause severe, invasive infection in very young infants. These bacteria can also colonize or cause insignificant infections in immunocompromised, elderly, and/or hospitalized adults.</p></sec><sec id="ST2"><title>Methods</title><p>This editorial review highlights key points addressed in the Frontiers Research Topic on <italic>Cronobacter</italic>, discusses the clinical presentation and epidemiology of <italic>Cronobacter</italic> infections, and examines the responses of public health agencies to this problem.</p></sec><sec id="ST3"><title>Results</title><p><italic>Cronobacter</italic> is rarely isolated from hospitalized, immunocompromised and/or elderly adults and does not cause significant disease in those patients. Certain species and strains, especially of <italic>Cronobacter sakazakii</italic>, can cause invasive illness in previously healthy infants &lt;2 months of age. Multilocus sequence type 4 and clonal complex 4 (ST4/MLST 4) <italic>C. sakazakii</italic> are the predominant cause of <italic>Cronobacter</italic> meningitis, which occurs only in infants. These infections and this strain type are strongly linked to powdered infant formulas (PIF), which can also be contaminated with other <italic>Cronobacter</italic> strains. End-product testing is not intended to guarantee the absence of these organisms. WHO has made recommendations that can help decrease but will not eliminate the risk of this infection.</p></sec><sec id="ST4"><title>Conclusion</title><p>To further define the spectrum of <italic>Cronobacter</italic>-associated disease, all isolates should be genetically typed using every currently available method, typing results should be linked to the associated epidemiologic and clinical data, and these data should be analyzed in a scientifically sound manner. Based on currently available information, more can be done now to prevent cause invasive infection in young infants. This includes encouragement of exclusive breastfeeding and/or use of commercially sterile ready-to-feed formulas in the first 2 months of life.</p></sec>