Cronobacter

• Cronobacter, which used to be called Enterobacter sakazakii, is a bacterium 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. 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.

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Cronobacter (Enterobacter sakazakii)

Signs and Symptoms

• Cronobacter illness is very rare, but it is often deadly in young infants.
• It usually occurs in the first days or weeks of life.
• Typically, CDC is informed of about 4­–6 cases of Cronobacter illness in infants each year, but reporting isn’t required. Cronobacter bacteria can cause severe blood infections (sepsis) or meningitis (an inflammation of the membranes that protect the brain and spine).

Risk factors

• Infants 2 months of age and younger are the infants that are most likely to develop meningitis if they are infected with Cronobacter bacteria.
• Infants born prematurely and those with weakened immune systems are also at risk for severe illness.
• 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.

Signs and symptoms

Sicknesses from Cronobacter look different depending on the person.

• Babies (less than 1 year old) - In babies, especially babies less than 2 months old, Cronobacter germs usually get in the blood or make the lining of the brain and spine swell (meningitis).
• Sickness from Cronobacter in babies will usually start with a fever and poor feeding, crying, or very low energy. Some babies may also have seizures. Babies with these symptoms should be taken to a doctor.
• Babies with meningitis may develop serious, long-lasting problems in their brains. Up to 4 out of 10 babies with meningitis from Cronobacter can die.
• People of all ages - Cronobacter can cause problems in cuts, scrapes, or places where people have had surgeries.
• Cronobacter can also get into your urinary tract.
• Older people and people with weakened immune systems (for example, people being treated with immune-suppressing drugs for cancer, organ transplants, or other illnesses, or those with HIV infection or genetic conditions that affect the immune system) may also get Cronobacter in their blood.

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Bacterial lawn

Testing and Treatment

• Babies whose blood might have Cronobacter need to go to a doctor or hospital right away so they can get germ-fighting medicine called antibiotics.
• Babies who have meningitis from Cronobacter usually need special tests to look at the brain and spinal fluid.
• Adults are treated with antibiotics, too.
• Cronobacter infection is diagnosed by a laboratory culture.
• If a Cronobacter infection is diagnosed by a laboratory culture in an infant, CDC encourages clinicians and laboratories to inform their local or state health department.

Transmission

• 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.

How Cronobacter is spread

• 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.

Risks from factories and homes

• Powdered infant formula is not germ-free. Formula manufacturers report that it is not possible to remove all germs from powdered infant formula. At the factory, Cronobacter could get into formula powder from ingredients used to make the formula or if the formula powder touches a Cronobacter-covered surface in the factory.
• At home, Cronobacter could get into the formula if formula lids or scoops are placed on Cronobacter-covered surfaces and later touch the formula or if the formula is mixed with water or in a bottle that has Cronobacter in it.

Prevention & Control

• Cronobacter growing in a laboratory.
• Getting sick with Cronobacter is rare, but infections in babies can be fatal.
• When a source of a baby’s Cronobacter infection has been found, nearly all have been associated with consumption of reconstituted powdered infant formula. Powdered infant formula is not sterile.
• Manufacturers report that, using current methods, it is not possible to eliminate all germs from powdered infant formula in the factory.
• In some investigations, Cronobacter was found in powdered infant formula that had been contaminated in the factory.
• In other investigations, Cronobacter was found in opened containers of powdered infant formula that might have been contaminated at home or elsewhere

Cronobacter Resources
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