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Cronobacter Infection

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  • Cronobacter Infection

    Cronobacter Infection

    Pathophysiology

    Cronobacter multi-species complex (formerly Enterobacter sakazakii) is a group of gram-negative bacteria that exists in the environment and which can survive in very dry conditions. The natural habitat for Cronobacter is not known. It has been found in a variety of dry foods, including powdered infant formula, skimmed milk powder, herbal teas, and starches. It has also been found in wastewater. Cronobacter illnesses are rare, but they are frequently lethal for infants and can be serious among people with immunocompromising conditions and the elderly.

  • Cronobacter Infection

    Treatment

    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.

  • Cronobacter Infection

    Major research on disease

    Current research on E. sakazakii focuses on the elimination of this coliform from PIF. Investigations into thermal resistance, osmotic tolerance, exopolysaccharide production, and pathogenicity, among others, have been performed, and attempts have been made to identify environmental reservoirs. Only 1 study has suggested the possible existence of an enterotoxin produced by E. sakazakii on the basis of an animal model. Other virulence factors remain to be identified. Furthermore, why infection can occur in all age groups but is more frequent among full-term infants and neonates remains to be understood.

  • Cronobacter Infection

    Statistics

    According to the Statistics of Food Poisoning published by the Food Safety Division, the Ministry of Health, Labour and Welfare (MHLW), the incidents peaked at 2,620 involving 36,337 cases in 1998, and the decreasing tendency continued until 2007, during which time cases counted at 9,666, below 10,000, in 2006. Food poisoning due to Vibrio parahaemolyticus or Salmonella was on the marked decrease and that due to pathogenic E. coli was also decreasing. In contrast, incidents of Campylobacter jejuni/coli food poisoning have increased largely due to the increasing reports of single-case incidents after 1997 without accompanying such marked increase in cases. Cases of Staphylococcus aureus food poisoning suddenly increased due to a large-scale outbreak occurring in 2000, after then kept on a level of 1,000-2,000 without large increase in incidents. Although there were increase and decrease in cases of EHEC, Clostridium perfringens and Bacillus cereus food poisoning, no marked increase was seen in incidents. However, notified cases of EHEC infections based on the Infectious Diseases Control Law largely outnumbered EHEC food poisoning cases every year. In many incidents, identification of incriminated food item was difficult and single-case incidents may not have been notified as food poisoning.

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