Development of an immobilization and detection method of Enterobacter sakazakii from powdered infant formula

Enterobacter sakazakii is an emerging opportunistic pathogen that is associated with rare but life-threatening cases of meningitis, necrotizing enterocolitis, and sepsis in premature and full-term infants. In the present study, a procedure was developed for immobilization of E. sakazakii with zirconium hydroxide coupled with detection by a species-specific duplex PCR, based on 16s-23s rDNA internal transcribed spacer (ITS) and ompA gene. Specificity of duplex PCR was tested against two-type strains, six isolates of E. sakazakii and other eight non-E. sakazakii species. When pure culture of E. sakazakii was used for immobilization, total recovery rate ranged from 79.4% to 99.6% of input bacteria, and the detection limit of duplex PCR was 3x10(5)CFU/ml. Different levels of E. sakazakii were inoculated into 90ml reconstituted powdered infant formula (PIF), and detection limit of duplex PCR was 3x10(0)CFU/ml with 24-30h enrichment after immobilization. When the experiment was performed in the presence of 10(2)CFU/ml Salmonella typhimurium, the detection limit of duplex PCR was not affected after enrichment. Seven out of 13 commercial PIF were detected positive by duplex PCR after immobilization, while only three were positive by biological methods. This study demonstrates that the combination of immobilization method with duplex PCR is easy, rapid, and efficient, and may have applications for the detection of E. sakazakii in more PIF samples.     

The presence of endotoxin in powdered infant formula milk and the influence of endotoxin and Enterobacter sakazakii on bacterial translocation in the infant rat

Lipopolysaccharide (LPS) is a heat stable endotoxin that persists during the processing of powdered infant formula milk (IFM). Upon ingestion it may increase the permeability of the neonatal intestinal epithelium and consequently bacterial translocation from the gut. To determine the level of endotoxin present in IFM, 75 samples were collected from seven countries (representing 31 brands) and analysed for endotoxin using the kinetic colorimetric Limulus amoebocyte lysate (LAL) assay. The endotoxin levels ranged from 40 to 5.5 x 10(4) endotoxin units (EU) per gram and did not correlate with the number of viable bacteria. The neonate rat model was used to address the risk of endotoxin-induced bacterial translocation from the gut. Purified Escherichia coli LPS was administered to rat pups followed by inoculation with Enterobacter sakazakii ATCC 12868. Bacteria were isolated from the mesentery, spleen, blood and cerebral spinal fluid (CSF) of endotoxin-treated rats due to enhanced gut and blood brain barrier penetration. Histological analysis of the colon showed marked distension of the mucosal and muscular layers. It is plausible that the risk of neonatal bacteraemia and endotoxemia, especially in neonates with immature innate immune systems, may be raised due to ingestion of IFM with high endotoxin levels.     

Survival of Enterobacter sakazakii in infant cereal as affected by composition, water activity, and temperature

Enterobacter sakazakii infections in preterm neonates and infants have been epidemiologically associated with consumption of reconstituted powdered infant formula. The bacterium has been isolated from grain, infant cereals, and cereal factory environments. A study was done to determine the survival characteristics of E. sakazakii initially at populations of 0.31 and 5.03 logCFU/g of infant rice cereal (a(w) 0.30, 0.45-0.46, and 0.68-0.69). Cereal was stored at 4, 21, and 30 degrees C and populations were monitored for up to 12 months. Survival of the pathogen in infant rice, barley, oatmeal, and mixed grain cereals (a(w) 0.63-0.66, 0.76, or 0.82-0.83) initially containing a population of 4.93-5.64 logCFU/g and held at 4, 21, and 30 degrees C up to 24 weeks was determined. Populations decreased significantly (p < or = 0.05) in all cereals stored at 21 and 30 degrees C regardless of a(w). Increases in a(w) or storage temperature accelerated the rate of death of E. sakazakii in dry infant cereals. However, at an initial population of 0.31 logCFU/g, E. sakazakii survived in rice cereal (a(w) 0.30-0.69) for up to 12 months at all storage temperatures. Survival of E. sakazakii was not affected by the composition of dry infant rice, barley, mixed grain, and oatmeal cereals (initial a(w) 0.63-0.83) stored for up to 24 weeks at 4, 21, or 30 degrees C. This study demonstrated that E. sakazakii can survive for up to 12 months in infant cereals having a wide range of a(w) when storage is at temperatures simulating those to which they may be exposed during distribution, at retail, and in the home.     

Individual cell lag time distributions of Cronobacter (Enterobacter sakazakii) and impact of pooling samples on its detection in powdered infant formula

Cells of six strains of Cronobacter were subjected to dry stress and stored for 2.5 months at ambient temperature. The individual cell lag time distributions of recovered cells were characterized at 25 °C and 37 °C in non-selective broth. The individual cell lag times were deduced from the times taken by cultures from individual cells to reach an optical density threshold. In parallel, growth curves for each strain at high contamination levels were determined in the same growth conditions. In general, the extreme value type II distribution with a shape parameter fixed to 5 (EVIIb) was the most effective at describing the 12 observed distributions of individual cell lag times. Recently, a model for characterizing individual cell lag time distribution from population growth parameters was developed for other food-borne pathogenic bacteria such as Listeria monocytogenes. We confirmed this model’s applicability to Cronobacter by comparing the mean and the standard deviation of individual cell lag times to populational lag times observed with high initial concentration experiments. We also validated the model in realistic conditions by studying growth in powdered infant formula decimally diluted in Buffered Peptone Water, which represents the first enrichment step of the standard detection method for Cronobacter. Individual lag times and the pooling of samples significantly affect detection performances.     

婴幼儿配方食品中阪崎肠杆菌的计数结果不确定度评定

[目的] 了解专项抽查的婴儿配方食品中的阪崎肠杆菌指标状况,并探讨阪崎肠杆菌的计数结果的不确定度评定方法。[方法] 按照GB 4789.1-2010 《食品微生物学检验 总则》和GB 4789.40-2016 《食品微生物学检验 阪崎肠杆菌检验》进行了抽样和检测, 依据JJF1059.1-2012 《测量不确定度评定与表示》及贝塞尔统计学方法对计数结果进行不确定度评定。[结果]22批次婴儿配方食品中有1批次检出阪崎肠杆菌,检出率为4.55%, 该批次样品中阪崎肠杆菌平均计数为25.5MPN/100g,计数结果扩展标准不确定度为2.72MPN/100g。[结论] 本次评估依据阪崎肠杆菌检计数检验国家标准,对4次保温培养节点进行了分析,结果表明固液混合过程,酵液取样体积,阪崎肠杆菌显色平板上可疑菌落选择和MPN法重复计数的四个不确定度较大,是记数检验过程中的重要环节。     

Isolation of Enterobacter sakazakii and other Enterobacteriaceae from powdered infant formula milk and related products

The presence of Enterobacter sakazakii and other Enterobacteriaceae was surveyed in 82 powdered infant formula milk (IFM) and 404 other food products. The presence of Ent. sakazakii was detected using the conventional method (growth on violet red bile glucose agar plus yellow pigment production on TSA) and a new chromogenic medium (Druggan–Forsythe–Iversen agar, DFI) which enables results to be obtained 2 days earlier than the conventional method. Ent. sakazakii was isolated from 2/82 powdered IFM, 5/49 dried infant foods, 3/72 milk powder, 2/62 cheese products and various dry food ingredients, especially herbs and spices (40/122). Ent. sakazakii was isolated from 67 samples using the DFI medium, however only 19 of the samples were positive following the conventional method. The largest difference in isolation between the two methods was with dry food ingredients.Although Enterobacteriaceae were enumerated from one powdered IFM sample (Klebsiella ozaenae, 200 cfu/g), 7/82 had detectable Enterobacteriaceae after enrichment in EE broth. Using the ISO 6579 2002 method and immuno-magnetic separation technique no Salmonella serovars were isolated from powdered IFM, dried infant foods or milk samples. Therefore hygienic production of powdered IFM and milk production as monitored by control of Salmonella and enumeration of Enterobacteriaceae did not control Ent. sakazakii.     

Evaluation of different methods for the detection and identification of Enterobacter sakazakii isolated from South African infant formula milks and the processing environment

Enterobactersakazakii is an emerging pathogen associated with life-threatening neonatal infections resulting from the consumption of contaminated powdered infant formula milk (IFM). Recent taxonomic analyses have determined that E. sakazakii comprises a number of genomospecies, and it has been proposed that E. sakazakii be reclassified as a novel genus, "Cronobacter". Accurate methods are required for the rapid detection and identification of this group of micro-organisms, since even low cell numbers have been reported to cause disease. The aim of this study was to evaluate various E. sakazakii detection methods in order to ascertain the most suitable method for detection and identification of these pathogenic agents. Samples from IFM and the environment were evaluated for the presence of E. sakazakii using the isolation steps (pre-enrichment, enrichment and selection) described in the Food and Drug Administration (FDA) method for E. sakazakii detection. Sixty-four isolates (50 from IFM and 14 from the environment) were selected from tryptone soy agar (TSA), regardless of colony appearance, and these isolates were identified by 16S ribosomal DNA (rDNA) sequencing. Thereafter, different culture-dependent and culture-independent methods were evaluated to accurately detect and identify the E. sakazakii isolates. These methods included the assessment of yellow pigment production on TSA, typical colonies on chromogenic Druggan-Forsythe-Iversen (DFI) and Chromocult(R) Enterobacter sakazakii (CES) media and polymerase chain reaction (PCR) using six different species-specific primer pairs described in the literature. Identification of E. sakazakii using yellow pigment production was demonstrated to have a low sensitivity, specificity and accuracy (87%, 71% and 74%, respectively), which lowers the suitability of the FDA method. Chromogenic DFI and CES media were sensitive, specific and accurate (100%, 98% and 98%, respectively) for the detection of E. sakazakii. The specificity of the PCR amplifications ranged from 8% to 92%, emphasising the need for rigorous primer testing against closely related species. Of the primer pairs evaluated, Esakf/Esakr were the most suitable for E. sakazakii detection and identification. The detection limit of Esakf/Esakr was found to be 10(4) CFU/ml. This study demonstrated that no single method was capable of unambiguously confirming the presence and identity of E. sakazakii isolates, that each method had inherent advantages and disadvantages, and that in most cases several methods were required for accurate detection and identification. Further, it was demonstrated that the current FDA method for E. sakazakii detection should be revised in the light of the availability of more sensitive, specific and accurate detection methods.     

Enterobacter sakazakii: biological properties and significance in dried infant milk formula (IMF) powder†

Enterobacter sakazakii is an emerging opportunistic pathogen associated with rare but life‐threatening cases of meningitis, necrotizing enterocolitis and sepsis in premature infants. The bacterium has been isolated at low levels from dried infant milk formulas and is a cause of concern to all manufacturers. The threat posed by E. sakazakii is further compounded by a paucity of knowledge in key areas, specifically its ecology and physiology. This organism now represents a serious challenge to all those involved in the manufacture of infant formula products.     

中国安徽阜阳劣质婴儿配方粉中阪崎肠杆菌的污染

2004年中国安徽阜阳劣质婴儿配方粉事件引起了我国政府的高度重视.为了调查婴儿配方粉中阪崎肠杆菌的污染状况,根据美国FDA和加拿大实验室的方法,建立了婴儿配方粉中阪崎肠杆菌的分离鉴定技术.从87份阜阳劣质奶粉样品中检测到11份阪崎肠杆菌阳性样品,污染阳性率为12.6%.用API 20E和Qualicon BAX(R)系统鉴定了11株阪崎肠杆菌.这是国内首次从婴儿配方粉中分离到阪崎肠杆菌菌株.     

Development of multiplex real-time PCR with Internal amplification control for simultaneous detection of Salmonella and Cronobacter in powdered infant formula

Contamination of powdered infant formula (PIF) by the bacteria Cronobacter spp. and Salmonella enterica was deemed a matter of great concern by the World Health Organization and the Food and Agriculture Organization of the United Nations in 2004. Therefore, we developed a rapid and sensitive multiplex real-time PCR assay for the simultaneous detection of Cronobacter and Salmonella in PIF. In addition, an internal amplification control (IAC) was also included for exclusion of false negative results in this study. The quantitative detection range for pure cultures in this optimized multiplex real-time PCR assay was 10³ to 10⁸ CFU/ml for both Salmonella and Cronobacter. When our established multiplex real-time PCR system was applied to artificially contaminated PIF, the detection limit was 10³ CFU/ml for Salmonella and Cronobacter without enrichment. The commercial PIF was then inoculated with Salmonella and Cronobacter at 10, 1 and 0.1 CFU per gram of formula and the single enrichment broth samples were analyzed by multiplex real-time PCR after enrichment for 9, 12, and 24 h. At 12 h post-enrichment, we could detect Salmonella and Cronobacter at initial inoculation levels of approximately 0.1 CFU/g in PIF. Additionally, stable fluorescent IAC signals could be assessed between 29 and 34 cycles of PCR amplification. Results from this study showed that the multiplex real-time PCR assay is an effective method for the rapid and simultaneous detection and quantification of Cronobacter and Salmonella in PIF.     

Detergent and sanitizer stresses decrease the thermal resistance of Enterobacter sakazakii in infant milk formula

ABSTRACT:  This study determined the effect of acid, alkaline, chlorine, and ethanol stresses on the thermal inactivation of Enterobacter sakazakii in infant milk formula. Unstressed or stressed cells were mixed with reconstituted powdered infant milk formula (PIMF) at temperatures between 52 and 58 °C for various time periods or mixed with PIMF prior to reconstitution with hot water between 50 and 100 °C. D - and z -values were determined using liner regression analysis. In general, detergent and sanitizer stresses decreased the thermal resistance of E. sakazakii in infant milk formula. The results of this study may be of use to regulatory agencies, manufacturers, and infant caregivers to design heating processes to eliminate E. sakazakii .     

The phenotypic and genotypic characterization of Enterobacter sakazakii strains from infant formula milk

Enterobacter sakazakii is an emerging foodborne pathogen associated with severe diseases in neonates. Infant formula milk (IFM) has been identified as one of the major contaminated sources and a transmission vehicle. To determine the phenotypic and genotypic characterization of this pathogen, 22 E. sakazakii strains isolated from IFM by an FDA-recommended method and PCR on the α-glucosidase gene were subtyped by random amplified polymorphic DNA (RAPD)-PCR, enterobacterial repetitive intergenic consensus (ERIC)-PCR, and antibiotic resistance patterns. At a similarity threshold of 80%, 16 ERIC-PCR fingerprint types were identified with a discriminatory power (D) of 0.933, and 18 RAPD-PCR types were identified with D of 0.973. Resistance to 9 antibiotics tested by disk diffusion assay revealed 6 antibiotic resistance patterns with D of 0.749. The comparison of characterization indicated that RAPD-PCR and ERIC-PCR have high discriminatory power showing genetic diversity of E. sakazakii isolates, and ERIC-PCR patterns showed a closer correlation than RAPD-PCR patterns to phenotypic characterization and the brands of IFM. Overall, the ERIC-PCR typing method could be used for tracing sources of E. sakazakii isolates in the food chain.     

Inactivation of Cronobacter sakazakii by manothermosonication in buffer and milk

The inactivation of Cronobacter sakazakii by heat and ultrasound treatments under pressure at different temperatures [manosonication (MS) and manothermosonication (MTS)] was studied in citrate-phosphate pH 7.0 buffer and rehydrated powdered milk. The inactivation rate was an exponential function of the treatment time for MS/MTS treatments (35−68 °C; 200 kPa of pressure; 117 μm of amplitude of ultrasonic waves) in both media, and for thermal treatments alone when buffer was used as heating media. Survival curves of C. sakazakii during heating in milk had a concave downward profile. Up to 50 °C, the lethality of ultrasound under pressure treatments was independent of the treatment temperature in both media. At temperatures greater than 64 °C in buffer and 68 °C in milk, the inactivating effect of MTS was equivalent to that of the thermal treatments alone at the same temperature. Between 50 and 64 ºC for buffer and 50 and 68 °C for milk, the lethality of MTS was the result of a synergistic effect, where the total lethal effect was higher than the lethal effect of heat added to that of ultrasound under pressure at room temperature. The maximum synergism was found at 60 °C in buffer and at 56 °C in milk. A heat treatment of 12 min (60 °C) or 4 min of an ultrasound under pressure at room temperature treatment (35 °C; 200 kPa; 117 μm) would be necessary to guarantee the death of 99.99% of C. sakazakii cells suspended in milk. The same level of C. sakazakii inactivation can be achieved with 1.8 min of a MTS treatment (60 °C; 200 kPa; 117 μm). Damaged cells were detected after heat treatments and after ultrasound under pressure treatments at lethal but not at non-lethal temperatures.     

Inactivation of Cronobacter sakazakii by ultrasonic waves under pressure in buffer and foods

The objective of this research was to characterize the resistance of Cronobacter sakazakii to ultrasonic waves under pressure (manosonication, MS). The D_MS value (decimal reduction time value) of C. sakazakii in standard conditions (35 °C, 117 μm, 200 kPa, citrate-phosphate buffer pH 7.0) was 0.41 min. This value was higher than that of Yersinia enterocolitica (D_MS = 0.19 min) and lower than those of Salmonella enterica serovar Enteritidis (D_MS = 0.61 min), Listeria monocytogenes (D_MS = 0.86 min), and Enterococcus faecium (D_MS = 1.2 min). Strain studied (ATCC 29544, NCTC 8155, 9238, and 9529), growth temperature (10, 20, 30, and 37 °C), and pH of the treatment media (4.0, 5.0, 6.0, and 7.0) did not significantly change C. sakazakii MS resistance. Conversely, entry into stationary growth phase, decreasing water activity of the treatment media (0.98, 0.96, and 0.94), and treatment in food products (apple and orange juices, chicken and vegetable soups, and rehydrated powdered milk) resulted in up to a 1.6-, 3.9-, and 2.5-fold maximum change in D_MS values, respectively. Whereas an exponential relationship between the amplitude of ultrasonic waves and D_MS values was found, the relationship between static pressure and D_MS values was better described by a quadratic equation. The energy transferred into the medium determined the lethality of the ultrasonic waves regardless of the combination of pressure (0, 50, 100, 200 and 300 kPa) and amplitude (34, 62, 90, 117 and 145 μm) applied. There was an exponential relationship between D_MS values and the power input: an increase of 134 W increased the inactivation rate ten times regardless of the treatment medium. No C. sakazakii cells with sublethally injured cytoplasmic membrane or with sublethal oxidative damage occurred after MS treatments, but the results indicated that damage to the outer membrane preceded microbial death.     

Effect of desiccation, starvation, heat, and cold stresses on the thermal resistance of Enterobacter sakazakii in rehydrated infant milk formula

Enterobacter sakazakii is an opportunistic foodborne pathogen that has been isolated from powdered infant milk formula. This study determined the effect of desiccation, starvation, heat and cold stresses on the thermal inactivation of E. sakazakii in rehydrated infant milk formula (RIMF). Stressed cells were mixed with RIMF at 52, 54, 56, and 58 degrees C for various time periods. The D- and z-values were determined by using linear regression analysis. D-values for unstressed E. sakazakii at 52, 54, 56, and 58 degrees C were 15.33, 4.53, 2, and 0.53 min, respectively. Desiccation and heat stresses, but not starvation or cold stress, caused significant (P < 0.05) reduction in D-values. The z-values of desiccated, starved, heat stressed, and cold stressed E. sakazakii were not significantly different from unstressed cells (4.22 degrees C). Thermal resistance of E. sakazakii in RIMF is affected by the environmental stresses; that is, desiccation and heat stresses that may surround the bacterium prior to the contamination of infant formula. The results of this study may be of use to regulatory agencies, infant milk producers, and infant caregivers to design heating processes to eliminate E. sakazakii that may be present in infant milk formula.     

Effect of dehydrated storage on the survival of Francisella tularensis in infant formula

Francisella tularensis is a Gram-negative bacterium that can cause gastrointestinal or oropharyngeal tularemia in humans from ingestion of contaminated food or water. Despite the potential for accidental or intentional contamination of foods with F. tularensis, there are few studies on the long-term survivability of this organism in food matrices. Infant formula has previously been implicated as a vehicle for the transmission of a variety of bacterial pathogens in infants. In this study, we investigated the survival of F. tularensis in dehydrated infant formula under various storage conditions. F. tularensis was stored for up to 12 weeks in dehydrated infant formula in an ambient air, dry or nitrogen atmosphere. Viable counts of fresh F. tularensis at 12 weeks in infant formula revealed a 4.15, 3.37 and 3.72-log decrease in ambient air, dry and nitrogen atmosphere, respectively. D-values were calculated (in weeks) as 3.99, 4.68 and 4.47 in air, dry and nitrogen atmosphere, respectively.     

Two novel analytical methods based on polyclonal and monoclonal antibodies for the rapid detection of Cronobacter spp.: Development and application in powdered infant formula

Cronobacter spp. are opportunistic pathogens, and infections are associated with a high mortality rate. In the current study, monoclonal antibodies (mAbs) and polyclonal antibodies (pAbs) were generated using heat-inactivated C. sakazakii strain ATCC29544 as the immunogen. Following assay optimization, an indirect enzyme-linked immunosorbent assay (ELISA) based on pAbs and a sandwich ELISA based on mAbs and pAbs were established for the detection of Cronobacter spp. The indirect ELISA detected all species of Cronobacter assayed, and the limit of detection (LOD) was established as 10⁵ cfu/mL. In contrast, the sandwich ELISA was specific for C. sakazakii and had greater sensitivity than the indirect ELISA (LOD of 2 × 10⁴ cfu/mL). Following 10 h of enrichment, Cronobacter spp. were detected using either of the two analytical methods in samples inoculated with 1 cfu/100 g powdered infant formula (PIF). The results from this study demonstrated that both of these novel ELISAs were specific, sensitive, and rapid assays for the screening of pathogenic Cronobacter spp. in PIF.     

Growth inhibition of Cronobacter spp. strains in reconstituted powdered infant formula acidified with organic acids supported by natural stomach acidity

Cronobacter is associated with outbreaks of rare, but life-threatening cases of meningitis, necrotizing enterocolitis, and sepsis in newborns. This study was conducted to determine the effect of organic acids on growth of Cronobacter in laboratory medium and reconstituted powdered infant formula (PIF) as well as the bacteriostatic effect of slightly acidified infant formula when combined with neonatal gastric acidity. Inhibitory effect of seven organic acids on four acid sensitive Cronobacter strains was determined in laboratory medium with broth dilution method at pH 5.0, 5.5 and 6.0. Acetic, butyric and propionic acids were most inhibitive against Cronobacter in the laboratory medium. The killing effect of these three acids was partially buffered in reconstituted PIF. Under neonatal gastric acid condition of pH 5.0, the slightly acidified formula which did not exert inhibition effect solely reduced significantly the Cronobacter populations. A synergistic effect of formula moderately acidified with organic acid combined with the physiological infant gastric acid was visible in preventing the rapid growth of Cronobacter in neonatal stomach. The study contributed to a better understanding of the inhibitory effect of organic acids on Cronobacter growth in different matrixes and provided new ideas in terms of controlling bacteria colonization and translocation by acidified formula.     

婴幼儿配方乳粉和发酵乳中沙门氏菌检验方法的比对研究

目的 筛选针对婴幼儿配方乳粉、发酵乳以及环境样品中沙门氏菌污染最灵敏的检测方法.方法 对20种血清型沙门氏菌进行平行检测,对比美国食品与药品管理局/微生物分析手册(Food and Drug Adminis tration/Bacteriological Analytical Manual,FDA/BAM)Chapte...     

PCR detection of Klebsiella pneumoniae in infant formula based on 16S-23S internal transcribed spacer

A PCR detection based on 16S-23S rDNA internal transcribed spacer (ITS) of Klebsiella pneumoniae was developed in the present study. Nineteen different ITS sequences were amplified from 6 strains of K. pneumoniae by universal primers. By sequencing and alignment of these sequences to the other homologous in GenBank, species-specific primers of K. pneumoniae, Pf/Pr1 and Pf/Pr2, were designed for amplification of the ITS sequence from the operon containing tDNA(Ala) and tDNA(Ile). Ten type strains and 21 isolates of K. pneumoniae were positive to the PCR detection, and all of the non-K. pneumoniae reference strains (79 strains) were negative. The enrichment was performed in this procedure with a modified growth media to enrich K. pneumoniae from 1.5 CFU/100 g infant formula to about 10(5) CFU/ml in 900 ml of the media. Combination of the enrichment, with the PCR assay can detect 1.5 CFU/100 g infant formula of K. pneumoniae within 48 h. Furthermore, K. pneumoniae strains KPE050803 and KPE 050830 were identified by this method in 63 infant formula samples.