1
|
Lou X, Wu Y, Huang Z, Zhang W, Xiao X, Wu J, Li J, Fang Z. Biofilm formation and associated gene expression changes in Cronobacter from cereal related samples in China. Food Microbiol 2024; 118:104409. [PMID: 38049271 DOI: 10.1016/j.fm.2023.104409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/09/2023] [Accepted: 10/23/2023] [Indexed: 12/06/2023]
Abstract
Cronobacter is an important foodborne pathogen that can cause severe neonatal meningitis, necrotizing enterocolitis, and bacteremia. Currently, there is limited knowledge of biofilm formation in Cronobacter. In the present study, biofilm formation ability and associated gene expression changes in Cronobacter from cereal related samples was carried out systematically. Our results from 307 Cronobacter isolates analyzed for 48 h showed strong biofilm-forming ability in 14 strains (4.6%), moderate in 47 strains (15.3%), weak in 142 strains (46.2%), and no such ability in the remaining 104 strains (33.9%). Further studies on five strains with strong biofilm-forming ability showed that maximum biofilm formation in Cronobacter occurred after 24 h of cultivation, reaching a peak around 48 h-72 h, reducing gradually thereafter. Kyoto encyclopedia of genes and genomes (KEGG) analysis revealed that differentially expressed genes (DEGs) involved in flagellar assembly, oxidative phosphorylation, ribosome, photosynthesis, O-Antigen nucleotide sugar biosynthesis, citrate cycle (tricarboxylic acid cycle, TCA) and bacterial chemotaxis were enriched in biofilm forming cells. The genes involved these enrichment pathways were mostly downregulated when compared to planktonic cells. Several transcriptional regulator genes such as csrA and bolA, and the cell surface composition regulator gene glgS were significantly upregulated. 12 of 13 (92.3%) selected genes was found to be in agreement with the RNA-Seq of planktonic and biofilm cells by Quantitative real-time PCR analysis, thus increasing confidence in our data. Our research lays a sound theoretical basis for further studies on mechanisms regulating biofilm formation and provides a foundation for development of new food safety measures, clinical disease prevention and control.
Collapse
Affiliation(s)
- Xiuqin Lou
- Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, China
| | - Yue Wu
- Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, China
| | - Zhenzhou Huang
- Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, China
| | - Wei Zhang
- Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, China
| | - Xiao Xiao
- Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, China
| | - Jun Wu
- Lin'an Center for Disease Control and Prevention, Hangzhou, 311399, China
| | - Jun Li
- Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, China.
| | - Zhiguo Fang
- School of Environmental Science and Engineering, Zhejiang Gongshang University, Hangzhou, 310018, China.
| |
Collapse
|
2
|
Sahra S, Jahangir A, Mobarakai N, Glaser A, Jahangir A, Sharif MA. First case report of acute cholangitis secondary to Cronobacter sakazakii. BMC Infect Dis 2021; 21:493. [PMID: 34044785 PMCID: PMC8161626 DOI: 10.1186/s12879-021-06195-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Cronobacter sakazakii is an opportunistic Gram-negative, rod-shaped bacterium which may be a causative agent of meningitis in premature infants and enterocolitis and bacteremia in neonates and adults. While there have been multiple cases of C. sakazakii infections, there have been no acute cholangitis cases reported in humans. Case presentation An 81-year-old male with a past medical history of basal cell carcinoma, alcoholic liver cirrhosis, transjugular intrahepatic portosystemic shunt procedure, complicated by staphylococcus bacteremia, pituitary tumor, glaucoma, and hypothyroidism presented to the emergency room with the complaint of diffuse and generalized 10/10 abdominal pain of 1 day’s duration. There was a concern for pancreatitis, acute cholangitis, and possible cholecystitis, and the patient underwent a percutaneous cholecystostomy tube placement. Blood cultures from admission and biliary fluid cultures both grew C. sakazakii. The patient was treated with a carbapenem and clinically improved. Conclusions The case study described a patient with multiple medical comorbidities that presented with C. sakazakii bacteremia and cholangitis. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria is being documented to have caused acute cholangitis.
Collapse
Affiliation(s)
- Syeda Sahra
- Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA.
| | - Abdullah Jahangir
- Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA
| | - Neville Mobarakai
- Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA
| | - Allison Glaser
- Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA
| | | | | |
Collapse
|
3
|
Ohira S, Ikeda E, Kamijo K, Nagai T, Tsunemi K, Uchiyama N, Matsubara N, Tachibana R. Pyosalpinx due to Cronobacter sakazakii in an elderly woman. BMC WOMENS HEALTH 2021; 21:136. [PMID: 33794866 PMCID: PMC8017632 DOI: 10.1186/s12905-021-01283-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 03/25/2021] [Indexed: 11/16/2022]
Abstract
Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.
Collapse
Affiliation(s)
- Satoshi Ohira
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan.
| | - Eri Ikeda
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan
| | - Kyosuke Kamijo
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan
| | - Tomokuni Nagai
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan
| | - Koji Tsunemi
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan
| | - Natsuki Uchiyama
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan
| | - Naoki Matsubara
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan
| | - Ryota Tachibana
- Department of Obstetrics and Gynecology, Iida Municipal Hospital, 438 Yawatamachi, Iida, 395-8502, Japan
| |
Collapse
|
4
|
Jang H, Chase HR, Gangiredla J, Grim CJ, Patel IR, Kothary MH, Jackson SA, Mammel MK, Carter L, Negrete F, Finkelstein S, Weinstein L, Yan Q, Iversen C, Pagotto F, Stephan R, Lehner A, Eshwar AK, Fanning S, Farber J, Gopinath GR, Tall BD, Pava-Ripoll M. Analysis of the Molecular Diversity Among Cronobacter Species Isolated From Filth Flies Using Targeted PCR, Pan Genomic DNA Microarray, and Whole Genome Sequencing Analyses. Front Microbiol 2020; 11:561204. [PMID: 33101235 PMCID: PMC7545074 DOI: 10.3389/fmicb.2020.561204] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022] Open
Abstract
Cronobacter species are opportunistic pathogens capable of causing life-threatening infections in humans, with serious complications arising in neonates, infants, immuno-compromised individuals, and elderly adults. The genus is comprised of seven species: Cronobacter sakazakii, Cronobacter malonaticus, Cronobacter turicensis, Cronobacter muytjensii, Cronobacter dublinensis, Cronobacter universalis, and Cronobacter condimenti. Despite a multiplicity of genomic data for the genus, little is known about likely transmission vectors. Using DNA microarray analysis, in parallel with whole genome sequencing, and targeted PCR analyses, the total gene content of two C. malonaticus, three C. turicensis, and 14 C. sakazaki isolated from various filth flies was assessed. Phylogenetic relatedness among these and other strains obtained during surveillance and outbreak investigations were comparatively assessed. Specifically, microarray analysis (MA) demonstrated its utility to cluster strains according to species-specific and sequence type (ST) phylogenetic relatedness, and that the fly strains clustered among strains obtained from clinical, food and environmental sources from United States, Europe, and Southeast Asia. This combinatorial approach was useful in data mining for virulence factor genes, and phage genes and gene clusters. In addition, results of plasmidotyping were in agreement with the species identity for each strain as determined by species-specific PCR assays, MA, and whole genome sequencing. Microarray and BLAST analyses of Cronobacter fly sequence datasets were corroborative and showed that the presence and absence of virulence factors followed species and ST evolutionary lines even though such genes were orthologous. Additionally, zebrafish infectivity studies showed that these pathotypes were as virulent to zebrafish embryos as other clinical strains. In summary, these findings support a striking phylogeny amongst fly, clinical, and surveillance strains isolated during 2010–2015, suggesting that flies are capable vectors for transmission of virulent Cronobacter spp.; they continue to circulate among United States and European populations, environments, and that this “pattern of circulation” has continued over decades.
Collapse
Affiliation(s)
- Hyein Jang
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Hannah R Chase
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Jayanthi Gangiredla
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Christopher J Grim
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Isha R Patel
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Mahendra H Kothary
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Scott A Jackson
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Mark K Mammel
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Laurenda Carter
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Flavia Negrete
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Samantha Finkelstein
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Leah Weinstein
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - QiongQiong Yan
- WHO Collaborating Centre for Cronobacter, University College Dublin, Dublin, Ireland.,UCD Centre for Food Safety, School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Carol Iversen
- WHO Collaborating Centre for Cronobacter, University College Dublin, Dublin, Ireland.,UCD Centre for Food Safety, School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Franco Pagotto
- Food Directorate, Bureau of Microbial Hazards, Health Canada, Ottawa, ON, Canada
| | - Roger Stephan
- Institute for Food Safety and Hygiene, University of Zürich, Zurich, Switzerland
| | - Angelika Lehner
- Institute for Food Safety and Hygiene, University of Zürich, Zurich, Switzerland
| | - Athmanya K Eshwar
- Institute for Food Safety and Hygiene, University of Zürich, Zurich, Switzerland
| | - Seamus Fanning
- WHO Collaborating Centre for Cronobacter, University College Dublin, Dublin, Ireland.,UCD Centre for Food Safety, School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Jeffery Farber
- Department of Food Science, University of Guelph, Guelph, ON, Canada
| | - Gopal R Gopinath
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Ben D Tall
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD, United States
| | - Monica Pava-Ripoll
- Center of Food Safety and Applied Nutrition, U. S. Food & Drug Administration, College Park, MD, United States
| |
Collapse
|
5
|
Jang H, Gopinath GR, Eshwar A, Srikumar S, Nguyen S, Gangiredla J, Patel IR, Finkelstein SB, Negrete F, Woo J, Lee Y, Fanning S, Stephan R, Tall BD, Lehner A. The Secretion of Toxins and Other Exoproteins of Cronobacter: Role in Virulence, Adaption, and Persistence. Microorganisms 2020; 8:E229. [PMID: 32046365 PMCID: PMC7074816 DOI: 10.3390/microorganisms8020229] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/28/2020] [Accepted: 02/06/2020] [Indexed: 12/29/2022] Open
Abstract
: Cronobacter species are considered an opportunistic group of foodborne pathogenic bacteria capable of causing both intestinal and systemic human disease. This review describes common virulence themes shared among the seven Cronobacter species and describes multiple exoproteins secreted by Cronobacter, many of which are bacterial toxins that may play a role in human disease. The review will particularly concentrate on the virulence factors secreted by C. sakazakii, C. malonaticus, and C. turicensis, which are the primary human pathogens of interest. It has been discovered that various species-specific virulence factors adversely affect a wide range of eukaryotic cell processes including protein synthesis, cell division, and ion secretion. Many of these factors are toxins which have been shown to also modulate the host immune response. These factors are encoded on a variety of mobile genetic elements such as plasmids and transposons; this genomic plasticity implies ongoing re-assortment of virulence factor genes which has complicated our efforts to categorize Cronobacter into sharply defined genomic pathotypes.
Collapse
Affiliation(s)
- Hyein Jang
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - Gopal R. Gopinath
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - Athmanya Eshwar
- Institute for Food Safety and Hygiene, University of Zurich, Zurich CH-8006 Zürich, Switzerland; (A.E.); (R.S.); (A.L.)
| | - Shabarinath Srikumar
- UCD-Centre for Food Safety, Science Centre South, University College Dublin, Dublin Belfield, Dublin 4, D04 V1W8, Ireland; (S.S.); (S.N.); (S.F.)
| | - Scott Nguyen
- UCD-Centre for Food Safety, Science Centre South, University College Dublin, Dublin Belfield, Dublin 4, D04 V1W8, Ireland; (S.S.); (S.N.); (S.F.)
| | - Jayanthi Gangiredla
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - Isha R. Patel
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - Samantha B. Finkelstein
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - Flavia Negrete
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - JungHa Woo
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - YouYoung Lee
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - Séamus Fanning
- UCD-Centre for Food Safety, Science Centre South, University College Dublin, Dublin Belfield, Dublin 4, D04 V1W8, Ireland; (S.S.); (S.N.); (S.F.)
| | - Roger Stephan
- Institute for Food Safety and Hygiene, University of Zurich, Zurich CH-8006 Zürich, Switzerland; (A.E.); (R.S.); (A.L.)
| | - Ben D. Tall
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, MD 20708, USA; (H.J.); (J.G.); (F.N.); (J.W.); (Y.L.)
| | - Angelika Lehner
- Institute for Food Safety and Hygiene, University of Zurich, Zurich CH-8006 Zürich, Switzerland; (A.E.); (R.S.); (A.L.)
| |
Collapse
|
6
|
Finkelstein S, Negrete F, Jang H, Gangiredla J, Mammel M, Patel IR, Chase HR, Woo J, Lee Y, Wang CZ, Weinstein L, Tall BD, Gopinath GR. Prevalence, Distribution, and Phylogeny of Type Two Toxin-Antitoxin Genes Possessed by Cronobacter Species where C. sakazakii Homologs Follow Sequence Type Lineages. Microorganisms 2019; 7:E554. [PMID: 31726673 PMCID: PMC6920972 DOI: 10.3390/microorganisms7110554] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/04/2019] [Accepted: 11/09/2019] [Indexed: 12/28/2022] Open
Abstract
Cronobacter species are a group of foodborne pathogenic bacteria that cause both intestinal and systemic human disease in individuals of all age groups. Little is known about the mechanisms that Cronobacter employ to survive and persist in foods and other environments. Toxin-antitoxin (TA) genes are thought to play a role in bacterial stress physiology, as well as in the stabilization of horizontally-acquired re-combinatorial elements such as plasmids, phage, and transposons. TA systems have been implicated in the formation of a persistence phenotype in some bacterial species including Escherichia coli and Salmonella. This project's goal was to understand the phylogenetic relatedness among TA genes present in Cronobacter. Preliminary studies showed that two typical toxin genes, fic and hipA followed species evolutionary lines. A local database of 22 TA homologs was created for Cronobacter sakazakii and a Python version 3 shell script was generated to extract TA FASTA sequences present in 234 C. sakazakii genomes previously sequenced as part of Center for Food Safety and Applied Nutrition's (CFSAN) GenomeTrakr project. BLAST analysis showed that not every C. sakazakii strain possessed all twenty-two TA loci. Interestingly, some strains contained either a toxin or an antitoxin component, but not both. Five common toxin genes: ESA_00258 (parDE toxin-antitoxin family), ESA_00804 (relBE family), ESA_01887 (relBE family), ESA_03838 (relBE family), and ESA_04273 (YhfG-Fic family) were selected for PCR analysis and the primers were designed to detect these genes. PCR analysis showed that 55 of 63 strains possessed three of these genes Sequence analysis identified homologs of the target genes and some of the strains were PCR-negative for one or more of the genes, pointing to potential nucleotide polymorphisms in those loci or that these toxin genes were absent. Phylogenetic studies using a Cronobacter pan genomic microarray showed that for the most part TAs follow species evolutionary lines except for a few toxin genes possessed by some C. malonaticus and C. universalis strains; this demonstrates that some TA orthologues share a common phylogeny. Within the C. sakazakii strains, the prevalence and distribution of these TA homologs by C. sakazakii strain BAA-894 (a powdered infant formula isolate) followed sequence-type evolutionary lineages. Understanding the phylogeny of TAs among the Cronobacter species is essential to design future studies to realize the physiological mechanisms and roles for TAs in stress adaptation and persistence of Cronobacter within food matrices and food processing environments.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Ben D. Tall
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, 8301 MuirKirk Rd, Laurel, MD 20708, USA; (S.F.); (F.N.); (H.J.); (J.G.); (M.M.); (I.R.P.); (H.R.C.); (J.W.); (Y.L.); (C.Z.W.); (L.W.); (G.R.G.)
| | | |
Collapse
|
7
|
|
8
|
Silva JN, Vasconcellos L, Forsythe SJ, de Filippis I, Luiz Lima Brandão M. Molecular and phenotypical characterization ofCronobacterspecies isolated with high occurrence from oats and linseeds. FEMS Microbiol Lett 2018; 366:5266300. [DOI: 10.1093/femsle/fny289] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/14/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Júlia Nunes Silva
- Laboratory of Food and Sanitizes, INCQS/Fiocruz, Av. Brasil, 4365. Manguinhos, Rio de Janeiro-RJ, Brazil, CEP:21040-900
| | - Luiza Vasconcellos
- Laboratory of Food and Sanitizes, INCQS/Fiocruz, Av. Brasil, 4365. Manguinhos, Rio de Janeiro-RJ, Brazil, CEP:21040-900
| | | | - Ivano de Filippis
- Laboratory of Reference Microorganisms, INCQS/Fiocruz, Av. Brasil, 4365. Manguinhos, Rio de Janeiro-RJ, Brazil, CEP:21040-900
| | - Marcelo Luiz Lima Brandão
- Laboratory of Food and Sanitizes, INCQS/Fiocruz, Av. Brasil, 4365. Manguinhos, Rio de Janeiro-RJ, Brazil, CEP:21040-900
| |
Collapse
|
9
|
Virvidaki IE, Nasios G, Kosmidou M, Giannopoulos S, Milionis H. Swallowing and Aspiration Risk: A Critical Review of Non Instrumental Bedside Screening Tests. J Clin Neurol 2018; 14:265-274. [PMID: 29504298 PMCID: PMC6031981 DOI: 10.3988/jcn.2018.14.3.265] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE The presence of dysphagia and aspiration in stroke patients is associated with increased mortality and morbidity. Early recognition and management of these two conditions via reliable, minimally invasive bedside procedures before complications arise remains challenging in everyday clinical practice. This study reviews the available bedside screening tools for detecting swallowing status and aspiration risk in acute stroke by qualitatively observing reference population study design, clinical flexibility, reliability and applicability to acute-care settings. METHODS The primary search was conducted using the PubMed, Embase, and Cochrane Library databases. The search was limited to papers on humans written in English and published from 1991 to 2016. Eligibility criteria included the consecutive enrollment of acute-stroke inpatients and the development of a protocol for screening aspiration risk during oral feeding in this population. RESULTS Of the 652 sources identified, 75 articles were reviewed in full however, only 12 fulfilled the selection criteria. Notable deficiencies in most of the bedside screening protocols included poor methodological designs and inadequate predictive values for aspiration risk which render clinicians to be more conservative in making dietary recommendations. CONCLUSIONS The literature is dense with screening methods for assessing the presence of dysphagia but with low predictive value for aspiration risk after acute stroke. A standard, practical, and cost-effective screening tool that can be applied at the bedside and interpreted by a wide range of hospital personnel remains to be developed. This need is highlighted in settings where neither trained personnel in evaluating dysphagia nor clinical instrumentation procedures are available.
Collapse
Affiliation(s)
- Ioanna Eleni Virvidaki
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
- Department of Neurology, School of Medicine, University of Ioannina, Ioannina, Greece.
| | - Grigorios Nasios
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Maria Kosmidou
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Sotirios Giannopoulos
- Department of Neurology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Haralampos Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| |
Collapse
|
10
|
Gopinath GR, Chase HR, Gangiredla J, Eshwar A, Jang H, Patel I, Negrete F, Finkelstein S, Park E, Chung T, Yoo Y, Woo J, Lee Y, Park J, Choi H, Jeong S, Jun S, Kim M, Lee C, Jeong H, Fanning S, Stephan R, Iversen C, Reich F, Klein G, Lehner A, Tall BD. Genomic characterization of malonate positive Cronobacter sakazakii serotype O:2, sequence type 64 strains, isolated from clinical, food, and environment samples. Gut Pathog 2018; 10:11. [PMID: 29556252 PMCID: PMC5845375 DOI: 10.1186/s13099-018-0238-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/02/2018] [Indexed: 02/06/2023] Open
Abstract
Background Malonate utilization, an important differential trait, well recognized as being possessed by six of the seven Cronobacter species is thought to be largely absent in Cronobacter sakazakii (Csak). The current study provides experimental evidence that confirms the presence of a malonate utilization operon in 24 strains of sequence type (ST) 64, obtained from Europe, Middle East, China, and USA; it offers explanations regarding the genomic diversity and phylogenetic relatedness among these strains, and that of other C. sakazakii strains. Results In this study, the presence of a malonate utilization operon in these strains was initially identified by DNA microarray analysis (MA) out of a pool of 347 strains obtained from various surveillance studies involving clinical, spices, milk powder sources and powdered infant formula production facilities in Ireland and Germany, and dried dairy powder manufacturing facilities in the USA. All ST64 C. sakazakii strains tested could utilize malonate. Zebrafish embryo infection studies showed that C. sakazakii ST64 strains are as virulent as other Cronobacter species. Parallel whole genome sequencing (WGS) and MA showed that the strains phylogenetically grouped as a separate clade among the Csak species cluster. Additionally, these strains possessed the Csak O:2 serotype. The nine-gene, ~ 7.7 kbp malonate utilization operon was located in these strains between two conserved flanking genes, gyrB and katG. Plasmidotyping results showed that these strains possessed the virulence plasmid pESA3, but in contrast to the USA ST64 Csak strains, ST64 Csak strains isolated from sources in Europe and the Middle East, did not possess the type six secretion system effector vgrG gene. Conclusions Until this investigation, the presence of malonate-positive Csak strains, which are associated with foods and clinical cases, was under appreciated. If this trait was used solely to identify Cronobacter strains, many strains would likely be misidentified. Parallel WGS and MA were useful in characterizing the total genome content of these Csak O:2, ST64, malonate-positive strains and further provides an understanding of their phylogenetic relatedness among other virulent C. sakazakii strains. Electronic supplementary material The online version of this article (10.1186/s13099-018-0238-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Gopal R Gopinath
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Hannah R Chase
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Jayanthi Gangiredla
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Athmanya Eshwar
- 2Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland
| | - Hyein Jang
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Isha Patel
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Flavia Negrete
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Samantha Finkelstein
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Eunbi Park
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - TaeJung Chung
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - YeonJoo Yoo
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - JungHa Woo
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - YouYoung Lee
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Jihyeon Park
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Hyerim Choi
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Seungeun Jeong
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Soyoung Jun
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Mijeong Kim
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Chaeyoon Lee
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - HyeJin Jeong
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| | - Séamus Fanning
- 3UCD Centre for Food Safety, School of Public Health, Physiotherapy & Population Science, University College, Dublin & WHO Collaborating Centre for Cronobacter, Belfield, Dublin 4, Ireland
| | - Roger Stephan
- 2Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland
| | - Carol Iversen
- 2Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland.,3UCD Centre for Food Safety, School of Public Health, Physiotherapy & Population Science, University College, Dublin & WHO Collaborating Centre for Cronobacter, Belfield, Dublin 4, Ireland
| | - Felix Reich
- 4Institute for Food Quality and Safety, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173 Hannover, Germany
| | - Günter Klein
- 4Institute for Food Quality and Safety, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173 Hannover, Germany
| | - Angelika Lehner
- 2Institute for Food Safety and Hygiene, University of Zurich, Zurich, Switzerland
| | - Ben D Tall
- 1Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708 USA
| |
Collapse
|
11
|
Abstract
There has been considerable concern related to Cronobacter spp. in foods, especially due to their highlighted association with neonatal infections through the ingestion of reconstituted powdered infant formula (PIF). This concern resulted in improved microbiological criteria recommendations by the Codex Alimentarius Commission and revised WHO advice on the preparation of infant feeds. In recent years, the diversity of the genus has been well described, and various detection and typing methods have been developed. This review considers our current knowledge of the genus and how DNA-sequence-based methods have contributed considerably to research into improved detection methods and more reliable identification procedures, genotyping schemes, and genomic analysis. The broader occurrence of Cronobacter in food ingredients, finished products, and food manufacturing environments is covered. This review also highlights the significance of clonal lineages in microbial source tracking and the use of CRISPR-cas array profiling.
Collapse
Affiliation(s)
- Stephen J Forsythe
- foodmicrobe.com, Adams Hill, Keyworth, Nottinghamshire, NG12 5GY, United Kingdom;
| |
Collapse
|
12
|
Characterisation of Cronobacter strains isolated from hospitalised adult patients. Antonie van Leeuwenhoek 2017; 111:1073-1085. [PMID: 29270766 DOI: 10.1007/s10482-017-1008-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/15/2017] [Indexed: 10/18/2022]
Abstract
Bacteria belonging to the genus Cronobacter are opportunistic pathogens known for causing rare but serious infections in neonates, including meningitis, necrotising enterocolitis and sepsis. Cronobacter infections occur also in adult populations, however, they generally have milder manifestations and their prevalence is uncertain. In this study, the presence of Cronobacter strains from adult patients in the University Hospital in Bratislava was investigated and overall 18 confirmed isolates from 321 patients (5.3%) were recovered. No Cronobacter positive sample was detected in 215 sputum samples from outpatients. The highest occurrence of Cronobacter strains was observed from stroke patients and this may be associated with an abnormal swallowing ability. The isolated strains belonged to the species Cronobacter sakazakii and Cronobacter malonaticus. In silico genotyping (MLST, CRISPR-cas array profiling) of whole genome sequences assigned the strains to three different MLST clones. The majority (12/18) of the isolated strains were sequence type ST513 or single locus variants ST514 and ST515, thereby being members of C. sakazakii pathovar clonal complex CC4. However, according to core genome MLST analysis the ST513-ST515 strains created a unique cluster substantially different from other CC4 strains. The isolated strains were susceptible to 18 tested antibiotics. All strains possess a genomic island encoding for increased thermal tolerance. As Cronobacter strains are frequently present in dried foods of plant origin, spread of a specific clone within a hospital may be caused by food transmission and may be facilitated by its tolerance to environmental stresses such as desiccation and temperature.
Collapse
|
13
|
Brandão MLL, Umeda NS, Jackson E, Forsythe SJ, de Filippis I. Isolation, molecular and phenotypic characterization, and antibiotic susceptibility of Cronobacter spp. from Brazilian retail foods. Food Microbiol 2017; 63:129-138. [DOI: 10.1016/j.fm.2016.11.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
|
14
|
Tall BD, Gangiredla J, Grim CJ, Patel IR, Jackson SA, Mammel MK, Kothary MH, Sathyamoorthy V, Carter L, Fanning S, Iversen C, Pagotto F, Stephan R, Lehner A, Farber J, Yan QQ, Gopinath GR. Use of a Pan-Genomic DNA Microarray in Determination of the Phylogenetic Relatedness among Cronobacter spp. and Its Use as a Data Mining Tool to Understand Cronobacter Biology. MICROARRAYS 2017; 6:microarrays6010006. [PMID: 28273858 PMCID: PMC5374366 DOI: 10.3390/microarrays6010006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/08/2017] [Accepted: 02/21/2017] [Indexed: 11/24/2022]
Abstract
Cronobacter (previously known as Enterobacter sakazakii) is a genus of Gram-negative, facultatively anaerobic, oxidase-negative, catalase-positive, rod-shaped bacteria of the family Enterobacteriaceae. These organisms cause a variety of illnesses such as meningitis, necrotizing enterocolitis, and septicemia in neonates and infants, and urinary tract, wound, abscesses or surgical site infections, septicemia, and pneumonia in adults. The total gene content of 379 strains of Cronobacter spp. and taxonomically-related isolates was determined using a recently reported DNA microarray. The Cronobacter microarray as a genotyping tool gives the global food safety community a rapid method to identify and capture the total genomic content of outbreak isolates for food safety, environmental, and clinical surveillance purposes. It was able to differentiate the seven Cronobacter species from one another and from non-Cronobacter species. The microarray was also able to cluster strains within each species into well-defined subgroups. These results also support previous studies on the phylogenic separation of species members of the genus and clearly highlight the evolutionary sequence divergence among each species of the genus compared to phylogenetically-related species. This review extends these studies and illustrates how the microarray can also be used as an investigational tool to mine genomic data sets from strains. Three case studies describing the use of the microarray are shown and include: (1) the determination of allelic differences among Cronobacter sakazakii strains possessing the virulence plasmid pESA3; (2) mining of malonate and myo-inositol alleles among subspecies of Cronobacter dublinensis strains to determine subspecies identity; and (3) lastly using the microarray to demonstrate sequence divergence and phylogenetic relatedness trends for 13 outer-membrane protein alleles among 240 Cronobacter and phylogenetically-related strains. The goal of this review is to describe microarrays as a robust tool for genomics research of this assorted and important genus, a criterion toward the development of future preventative measures to eliminate this foodborne pathogen from the global food supply.
Collapse
Affiliation(s)
- Ben D Tall
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Jayanthi Gangiredla
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Christopher J Grim
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Isha R Patel
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Scott A Jackson
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
- Complex Microbial Systems Group Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA.
| | - Mark K Mammel
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Mahendra H Kothary
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Venugopal Sathyamoorthy
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Laurenda Carter
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| | - Séamus Fanning
- UCD Centre for Food Safety, School of Public Health, Physiotherapy & Population Science, University College, Dublin, Belfield, Dublin D04 N2E5, Ireland.
| | - Carol Iversen
- College of Life Sciences, University of Dundee, Dundee, DD1 5EH Scotland, UK.
| | - Franco Pagotto
- Food Directorate, Bureau of Microbial Hazards, Health Canada, Ottawa, ON K1A 0K9, Canada.
| | - Roger Stephan
- Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstr. 272, CH-8057 Zurich, Switzerland.
| | - Angelika Lehner
- Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstr. 272, CH-8057 Zurich, Switzerland.
| | - Jeffery Farber
- Department of Food Science, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Qiong Q Yan
- UCD Centre for Food Safety, School of Public Health, Physiotherapy & Population Science, University College, Dublin, Belfield, Dublin D04 N2E5, Ireland.
| | - Gopal R Gopinath
- Center of Food Safety and Applied Nutrition, U. S. Food and Drug Administration, Laurel, MD 20708, USA.
| |
Collapse
|
15
|
Abstract
The Cronobacter group of pathogens, associated with severe and potentially life-threatening diseases, until recently were classified as a single species, Enterobacter sakazakii. The group was reclassified in 2007 into the genus Cronobacter as a member of the Enterobacteriaceae. This chapter outlines the history behind the epidemiology, analyzes how our understanding of these bacteria has evolved, and highlights the clinical significance the Cronobacter spp. have for neonatal and elderly patient populations and treatment of the associated infections.
Collapse
|
16
|
Temmam S, Davoust B, Chaber AL, Lignereux Y, Michelle C, Monteil-Bouchard S, Raoult D, Desnues C. Screening for Viral Pathogens in African Simian Bushmeat Seized at A French Airport. Transbound Emerg Dis 2016; 64:1159-1167. [PMID: 26876732 PMCID: PMC7169774 DOI: 10.1111/tbed.12481] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Indexed: 11/27/2022]
Abstract
Illegal bushmeat traffic is an important threat to biodiversity conservation of several endangered species and may contribute to the emergence and spread of infectious diseases in humans. The hunting, manipulation and consumption of wildlife‐based products, especially those of primate origin, may be a threat to human health; however, few studies have investigated the role of bushmeat trade and consumption as a potential source of human infections to date. In this study, we report the screening of viral pathogens in African simian game seized by French customs at Toulouse Blagnac Airport. Epifluorescence microscopy revealed the presence of virus‐like particles in the samples, and further metagenomic sequencing of the DNA and RNA viromes confirmed the presence of sequences related to the Siphoviridae, Myoviridae and Podoviridae bacteriophage families; some of them infecting bacterial hosts that could be potentially pathogenic for humans. To increase the sensitivity of detection, twelve pan‐generic PCRs targeting several viral zoonoses were performed, but no positive signal was detected. A large‐scale inventory of bacteria, viruses and parasites is urgently needed to globally assess the risk for human health of the trade, manipulation and consumption of wildlife‐related bushmeat.
Collapse
Affiliation(s)
- Sarah Temmam
- URMITE UM63, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine de la Timone, Aix-Marseille Université, Marseille, France
| | - Bernard Davoust
- URMITE UM63, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine de la Timone, Aix-Marseille Université, Marseille, France
| | - Anne-Lise Chaber
- Research Unit of Epidemiology and Risk Analysis applied to veterinary sciences (UREAR-ULg), Fundamental and Applied Research for Animals and Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Liège, Belgium.,Wildlife Consultant L.L.C, Al Ain, United Arab Emirates
| | - Yves Lignereux
- National Veterinary School, INP, Toulouse Cedex 03, France.,Natural History Museum, Toulouse, France
| | - Caroline Michelle
- URMITE UM63, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine de la Timone, Aix-Marseille Université, Marseille, France
| | - Sonia Monteil-Bouchard
- URMITE UM63, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine de la Timone, Aix-Marseille Université, Marseille, France
| | - Didier Raoult
- URMITE UM63, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine de la Timone, Aix-Marseille Université, Marseille, France
| | - Christelle Desnues
- URMITE UM63, CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine de la Timone, Aix-Marseille Université, Marseille, France
| |
Collapse
|
17
|
Odeyemi OA, Sani NA. The prevention of Cronobacter infections in hospital neonatal intensive care units. J Infect Public Health 2016; 9:110-2. [DOI: 10.1016/j.jiph.2015.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 06/04/2015] [Accepted: 06/23/2015] [Indexed: 11/27/2022] Open
|
18
|
Tamigniau A, Vanhaecke J, Saegeman V. Cronobacter sakazakii bacteremia in a heart transplant patient with polycystic kidney disease. Transpl Infect Dis 2015; 17:921-5. [PMID: 26436411 DOI: 10.1111/tid.12466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/01/2015] [Accepted: 09/06/2015] [Indexed: 11/27/2022]
Abstract
Infections with Cronobacter sakazakii are mainly described among neonates and infants, with contaminated powdered infant formulas most often incriminated as the cause. We describe here a case of C. sakazakii bacteremia secondary to a suspected cyst infection in a heart-and-kidney transplant patient with polycystic kidney disease.
Collapse
Affiliation(s)
- A Tamigniau
- Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium
| | - J Vanhaecke
- Cardiology, Department of Cardiovascular Sciences, UZ Leuven, Leuven, Belgium
| | - V Saegeman
- Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium
| |
Collapse
|
19
|
Sivamaruthi BS, Madhumita R, Balamurugan K, Rajan KE. Cronobacter sakazakii infection alters serotonin transporter and improved fear memory retention in the rat. Front Pharmacol 2015; 6:188. [PMID: 26388777 PMCID: PMC4560023 DOI: 10.3389/fphar.2015.00188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 08/19/2015] [Indexed: 12/15/2022] Open
Abstract
It is well established that Cronobacter sakazakii infection cause septicemia, necrotizing enterocolitis and meningitis. In the present study, we tested whether the C. sakazakii infection alter the learning and memory through serotonin transporter (SERT). To investigate the possible effect on SERT, on postnatal day-15 (PND-15), wistar rat pups were administered with single dose of C. sakazakii culture (infected group; 107 CFU) or 100 μL of Luria-Bertani broth (medium control) or without any treatment (naïve control). All the individuals were subjected to passive avoidance test on PND-30 to test their fear memory. We show that single dose of C. sakazakii infection improved fear memory retention. Subsequently, we show that C. sakazakii infection induced the activation of toll-like receptor-3 and heat-shock proteins-90 (Hsp-90). On the other hand, level of serotonin (5-hydroxytryptamine) and SERT protein was down-regulated. Furthermore, we show that C. sakazakii infection up-regulate microRNA-16 (miR-16) expression. The observed results highlight that C. sakazakii infections was responsible for improved fear memory retention and may have reduced the level of SERT protein, which is possibly associated with the interaction of up-regulated Hsp-90 with SERT protein or miR-16 with SERT mRNA. Taken together, observed results suggest that C. sakazakii infection alter the fear memory possibly through SERT. Hence, this model may be effective to test the C. sakazakii infection induced changes in synaptic plasticity through SERT and effect of other pharmacological agents against pathogen induced memory disorder.
Collapse
Affiliation(s)
- Bhagavathi S Sivamaruthi
- Department of Animal Science, School of Life Sciences, Bharathidasan University , Tiruchirappalli, India
| | - Rajkumar Madhumita
- Department of Animal Science, School of Life Sciences, Bharathidasan University , Tiruchirappalli, India
| | | | - Koilmani E Rajan
- Department of Animal Science, School of Life Sciences, Bharathidasan University , Tiruchirappalli, India
| |
Collapse
|
20
|
Alsonosi A, Hariri S, Kajsík M, Oriešková M, Hanulík V, Röderová M, Petrželová J, Kollárová H, Drahovská H, Forsythe S, Holý O. The speciation and genotyping of Cronobacter isolates from hospitalised patients. Eur J Clin Microbiol Infect Dis 2015; 34:1979-88. [PMID: 26173692 PMCID: PMC4565866 DOI: 10.1007/s10096-015-2440-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 06/26/2015] [Indexed: 12/01/2022]
Abstract
The World Health Organization (WHO) has recognised all Cronobacter species as human pathogens. Among premature neonates and immunocompromised infants, these infections can be life-threatening, with clinical presentations of septicaemia, meningitis and necrotising enterocolitis. The neurological sequelae can be permanent and the mortality rate as high as 40-80%. Despite the highlighted issues of neonatal infections, the majority of Cronobacter infections are in the elderly population suffering from serious underlying disease or malignancy and include wound and urinary tract infections, osteomyelitis, bacteraemia and septicaemia. However, no age profiling studies have speciated or genotyped the Cronobacter isolates. A clinical collection of 51 Cronobacter strains from two hospitals were speciated and genotyped using 7-loci multilocus sequence typing (MLST), rpoB gene sequence analysis, O-antigen typing and pulsed-field gel electrophoresis (PFGE). The isolates were predominated by C. sakazakii sequence type 4 (63%, 32/51) and C. malonaticus sequence type 7 (33%, 17/51). These had been isolated from throat and sputum samples of all age groups, as well as recal and faecal swabs. There was no apparent relatedness between the age of the patient and the Cronobacter species isolated. Despite the high clonality of Cronobacter, PFGE profiles differentiated strains across the sequence types into 15 pulsotypes. There was almost complete agreement between O-antigen typing and rpoB gene sequence analysis and MLST profiling. This study shows the value of applying MLST to bacterial population studies with strains from two patient cohorts, combined with PFGE for further discrimination of strains.
Collapse
Affiliation(s)
- A Alsonosi
- Pathogen Research Group, School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS, UK
| | - S Hariri
- Pathogen Research Group, School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS, UK
| | - M Kajsík
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - M Oriešková
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - V Hanulík
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - M Röderová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - J Petrželová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - H Kollárová
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| | - H Drahovská
- Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - S Forsythe
- Pathogen Research Group, School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS, UK.
| | - O Holý
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Olomouc, Czech Republic
| |
Collapse
|
21
|
Mohammed MA, Sallam KI, Tamura T. Prevalence, identification and molecular characterization of Cronobacter sakazakii isolated from retail meat products. Food Control 2015. [DOI: 10.1016/j.foodcont.2015.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
22
|
Singh N, Goel G, Raghav M. Prevalence and Characterization of Cronobacter spp. from Various Foods, Medicinal Plants, and Environmental Samples. Curr Microbiol 2015; 71:31-8. [PMID: 25855303 DOI: 10.1007/s00284-015-0816-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/26/2015] [Indexed: 11/26/2022]
Abstract
Dairy or non-dairy based products were explored to determine the prevalence, molecular characterization, and antibiotic susceptibility of Cronobacter spp. The isolation was done as per ISO 22964:2006 on chromogenic media followed by further confirmation by biochemical- and 16S rRNA-based identification. From 219 samples, the chromogenic agar assay and biochemical tests yielded presumptive 45 isolates. Among them, only 36 isolates showed 282 bp band amplified from ITS-G gene confirming as Cronobacter sakazakii. The Cronobacter spp. prevalence was highest in herbs and spices (34 %) while environmental samples had contamination rates of 23 % indicating plants as a possible reservoir of this pathogen. All the isolates were resistant to β-lactam derivatives (68 %), macrolides (88.6 %), and aminoglycosides (79.9 %) but susceptible to phenicoles (31.6 %) and tetracyclines (15 %) derivatives. The results emphasize the screening of plant materials before their incorporation in food matrices.
Collapse
MESH Headings
- Anti-Bacterial Agents/pharmacology
- Bacterial Typing Techniques
- Cluster Analysis
- Cronobacter/classification
- Cronobacter/drug effects
- Cronobacter/genetics
- Cronobacter/isolation & purification
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- DNA, Ribosomal/chemistry
- DNA, Ribosomal/genetics
- DNA, Ribosomal Spacer/chemistry
- DNA, Ribosomal Spacer/genetics
- Environmental Microbiology
- Food Microbiology
- Microbial Sensitivity Tests
- Phylogeny
- Plants, Medicinal/microbiology
- Prevalence
- RNA, Ribosomal, 16S/genetics
- Sequence Analysis, DNA
Collapse
Affiliation(s)
- Niharika Singh
- Department of Biotechnology and Bioinformatics, Jaypee University of Information Technology, Waknaghat, Solan, 173234, India
| | | | | |
Collapse
|
23
|
A proposed harmonized LPS molecular-subtyping scheme for Cronobacter species. Food Microbiol 2015; 50:38-43. [PMID: 25998813 DOI: 10.1016/j.fm.2015.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/06/2015] [Accepted: 03/09/2015] [Indexed: 11/23/2022]
Abstract
Cronobacter are opportunistic pathogens, which cause infections in all age groups. To aid the characterization of Cronobacter in foods and environments a harmonized LPS identification scheme for molecular serotyping is needed. To this end, we studied 409 Cronobacter isolates representing the seven Cronobacter species using two previously reported molecular serotyping schemes, described here as Mullane-Jarvis (M-J) and Sun schemes. PCR analysis revealed many overlapping results that were obtained when independently applying the two serotyping schemes. There were complete agreements between the two PCR schemes for Cronobacter sakazakii (Csak) O:1, Csak O:3, and Csak O:7 serotypes. However, only thirty-five of 41 Csak O:4 strains, identified using the M-J scheme, were PCR-positive with the Sun scheme primers. Also the Sun scheme Csak O:5 primers failed to identify this serotype in any of the C. sakazakii strains tested, but did recognize seven Cronobacter turicensis strains, which were identified as Ctur O:3 using the M-J scheme. Similarly, the Sun scheme Csak O:6 primers recognized 30 Cronobacter malonaticus O:2 strains identified with the M-J scheme, but failed to identify this serotype in any C. sakazakii strain investigated. In this report, these findings are summarized and a harmonized molecular-serotyping scheme is proposed which is predicated on the correct identification of Cronobacter species, prior to serotype determination. In summary, fourteen serotypes were identified using the combined protocol, which consists of Csak O:1-O:4, and Csak O:7; Cmal O:1-O:2; Cdub O:1-O:2, Cmuy O:1-O:2, Cuni O:1, as well as Ctur O:1 and Ctur O:3.
Collapse
|
24
|
A Cronobacter turicensis O1 antigen-specific monoclonal antibody inhibits bacterial motility and entry into epithelial cells. Infect Immun 2014; 83:876-87. [PMID: 25534937 DOI: 10.1128/iai.02211-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cronobacter turicensis is an opportunistic foodborne pathogen that can cause a rare but sometimes lethal infection in neonates. Little is known about the virulence mechanisms and intracellular lifestyle of this pathogen. In this study, we developed an IgG monoclonal antibody (MAb; MAb 2G4) that specifically recognizes the O1 antigen of C. turicensis cells. The antilipopolysaccharide antibody bound predominantly monovalently to the O antigen and reduced bacterial growth without causing cell agglutination. Furthermore, binding of the antibody to the O1 antigen of C. turicensis cells caused a significant reduction of the membrane potential which is required to energize flagellar rotation, accompanied by a decreased flagellum-based motility. These results indicate that binding of IgG to the O antigen of C. turicensis causes a direct antimicrobial effect. In addition, this feature of the antibody enabled new insight into the pathogenicity of C. turicensis. In a tissue culture infection model, pretreatment of C. turicensis with MAb 2G4 showed no difference in adhesion to human epithelial cells, whereas invasion of bacteria into Caco-2 cells was significantly inhibited.
Collapse
|
25
|
Possible reservoir and routes of transmission of Cronobacter (Enterobacter sakazakii) via wheat flour. Food Control 2014. [DOI: 10.1016/j.foodcont.2014.03.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
26
|
Xu F, Li P, Ming X, Yang D, Xu H, Wu X, Shah NP, Wei H. Detection of Cronobacter species in powdered infant formula by probe-magnetic separation PCR. J Dairy Sci 2014; 97:6067-75. [PMID: 25108865 DOI: 10.3168/jds.2014-8287] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 06/24/2014] [Indexed: 11/19/2022]
Abstract
Cronobacter species are opportunistic foodborne pathogens associated with serious infections in preterm neonates and infants. Based on the epidemiological research, infant formula products are considered to be the main source of infections from this organism. Therefore, accurate methods are required for detection of Cronobacter species. In this study, the specific probe and primers for detection of this organism were designed and verified. The probe-magnetic beads were prepared for sequence capture, followed by PCR assay to detect the target gene. This probe-magnetic separation PCR assay could detect as few as 10(3) cfu/mL of Cronobacter in artificially contaminated infant formulas in less than 4 h. The combination of magnetic beads and PCR showed the potential for the detection of Cronobacter in infant formulas and may have applications in the dairy industry.
Collapse
Affiliation(s)
- Feng Xu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P. R. China
| | - Peng Li
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P. R. China
| | - Xing Ming
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P. R. China
| | - Dong Yang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P. R. China
| | - Hengyi Xu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P. R. China
| | - Xiaoli Wu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Nagendra P Shah
- Food and Nutritional Science, School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong.
| | - Hua Wei
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P. R. China.
| |
Collapse
|
27
|
Cui J, Du X, Liu H, Hu G, Lv G, Xu B, Yang X, Li W, Cui Z. The genotypic characterization of Cronobacter spp. isolated in China. PLoS One 2014; 9:e102179. [PMID: 25029018 PMCID: PMC4100892 DOI: 10.1371/journal.pone.0102179] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/16/2014] [Indexed: 11/20/2022] Open
Abstract
Cronobacter spp. (Enterobacter sakazakii) is an important pathogen contaminating powdered infant formula (PIF). To describe the genotypic diversity of Cronobacter isolated in China, we identified the isolates using fusA allele sequencing, and subtyped all of the isolates using pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST), and multiple-locus variable-number tandem-repeat analysis (MLVA). A total of 105 isolates were identified, which included C. sakazakii (58 isolates), C. malonaticus (30 isolates), C. dublinensis (11 isolates), C. turicensis (5 isolates), and C. muytjensii (1 isolate). These isolates were showed to have 85 PFGE-patterns, 71 sequence types (STs), and 55 MLVA-patterns. Comparisons among the three molecular subtyping methods revealed that the PFGE method was the most distinguishable tool in identifying clusters of Cronobacter spp. through DNA fingerprinting, and MLST method came second. However, ESTR-1, ESTR-2, ESTR-3, and ESTR-4 were not effective loci for subtyping Cronobacter spp. such that the MLVA method requires further improvement.
Collapse
Affiliation(s)
- Jinghua Cui
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoli Du
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Liu
- Jinan Municipal Center for Disease Control and Prevention, Jinan, China
| | - Guangchun Hu
- Jinan Municipal Center for Disease Control and Prevention, Jinan, China
| | - Guoping Lv
- Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang, China
| | - Baohong Xu
- Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang, China
| | - Xiaorong Yang
- Sichuan Province Center for Disease Control and Prevention, Chengdu, China
| | - Wei Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhigang Cui
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail:
| |
Collapse
|
28
|
Jaradat ZW, Al Mousa W, Elbetieha A, Al Nabulsi A, Tall BD. Cronobacter spp.--opportunistic food-borne pathogens. A review of their virulence and environmental-adaptive traits. J Med Microbiol 2014; 63:1023-1037. [PMID: 24878566 DOI: 10.1099/jmm.0.073742-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The genus Cronobacter consists of a diverse group of Gram-negative bacilli and comprises seven species: Cronobacter sakazakii, Cronobacter malonaticus, Cronobacter muytjensii, Cronobacter turicensis, Cronobacter dublinensis, Cronobacter universalis and Cronobacter condimenti. Cronobacter are regarded as opportunistic pathogens, and have been implicated in newborn and infant infections, causing meningitis, necrotizing enterocolitis and bacteraemia or sepsis. Cronobacter virulence is believed to be due to multiple factors. Some strains were found to produce diarrhoea or cause significant fluid accumulation in suckling mice. Two iron acquisition systems (eitCBAD and iucABCD/iutA), Cronobacter plasminogen activator gene (cpa), a 17 kb type VI secretion system (T6SS), and a 27 kb filamentous haemagglutinin gene (fhaBC) and associated putative adhesins locus are harboured on a family of RepFIB-related plasmids (pESA3 and pCTU1), suggesting that these are common virulence plasmids; 98% of 229 tested Cronobacter strains possessed these plasmids. Even though pESA3 and pCTU1 share a common backbone composed of the repA gene and eitCBAD and iucABCD/iutA gene clusters, the presence of cpa, T6SS and FHA loci depended on species, demonstrating a strong correlation with the presence of virulence traits, plasmid type and species. Other factors were observed, in that Cronobacter form biofilms, and show unusual resistance to heat, dry and acid stress growth conditions. The outer-membrane protein A is probably one of the best-characterized virulence markers of Cronobacter. Furthermore, it was reported that Cronobacter employ phosphatidylinositide 3-kinase/Akt signalling, which activates protein kinase C-α and impairs the host cell's mitogen-activated protein kinase pathway, in order to invade cells. Cronobacter can also use immature dendritic cells and macrophages to escape the immune response. This review addresses the various virulence and environmental-adaptive characteristics possessed by members of the genus Cronobacter.
Collapse
Affiliation(s)
- Ziad W Jaradat
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan
| | - Waseem Al Mousa
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan
| | - Ahmed Elbetieha
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan
| | - Anas Al Nabulsi
- Department of Nutrition and Food Technology, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan
| | - Ben D Tall
- Food and Drug Administration, Center for Food Safety and Applied Nutrition, Division of Virulence Assessment, 8301 Muirkirk Road, Laurel, MD 20708, USA
| |
Collapse
|
29
|
|
30
|
Complete Genome Sequence of Cronobacter sakazakii Strain CMCC 45402. GENOME ANNOUNCEMENTS 2014; 2:2/1/e01139-13. [PMID: 24435860 PMCID: PMC3894274 DOI: 10.1128/genomea.01139-13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cronobacter sakazakii is considered to be an important pathogen involved in life-threatening neonatal infections. Here, we report the annotated complete genome sequence of C. sakazakii strain CMCC 45402, obtained from a milk sample in China. The major findings from the genomic analysis provide a better understanding of the isolates from China.
Collapse
|
31
|
Tall BD, Chen Y, Yan Q, Gopinath GR, Grim CJ, Jarvis KG, Fanning S, Lampel KA. Cronobacter: an emergent pathogen causing meningitis to neonates through their feeds. Sci Prog 2014; 97:154-72. [PMID: 25108996 PMCID: PMC10365370 DOI: 10.3184/003685014x13994743930498] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The recognition of Cronobacter as a public health concern was raised when powdered infant formula (PIF) was linked to several neonatal meningitis outbreaks. It is an opportunistic pathogen that causes necrotising enterocolitis, infantile septicaemia, and meningitis which carries a high mortality rate among neonates. It has been also linked with cases of infection in adults and elderly. Over the past decade, much focus has been made on developing sensitive and specific characterisation, detection, and isolation methods to ascertain the quality of foods, notably contamination of PIF with Cronobacter and to understand its ability to cause disease. Whole genome sequencing has unveiled several putative virulence factors, yet the full capacity of the pathogenesis of Cronobacter has not yet been elucidated.
Collapse
Affiliation(s)
- Ben D. Tall
- Center for Food Safety and Applied Nutrition, Food and Drug Administration in Laurel, Maryland
| | - Yi Chen
- FDA in College Park, Maryland
| | | | - Gopal R. Gopinath
- Center for Food Safety and Applied Nutrition, FDA, in Laurel, Maryland
| | | | - Karen G. Jarvis
- Center for Food Safety and Applied Nutrition, FDA, in Laurel, Maryland
| | | | | |
Collapse
|
32
|
El-Sharoud WM, Darwish MS, Batt CA. A real-time PCR-based microfluidics platform for the detection of Cronobacter sakazakii in reconstituted milks. Int Dairy J 2013. [DOI: 10.1016/j.idairyj.2013.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
33
|
Yan Q, Power KA, Cooney S, Fox E, Gopinath GR, Grim CJ, Tall BD, McCusker MP, Fanning S. Complete genome sequence and phenotype microarray analysis of Cronobacter sakazakii SP291: a persistent isolate cultured from a powdered infant formula production facility. Front Microbiol 2013; 4:256. [PMID: 24032028 PMCID: PMC3759002 DOI: 10.3389/fmicb.2013.00256] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 08/13/2013] [Indexed: 11/13/2022] Open
Abstract
Outbreaks of human infection linked to the powdered infant formula (PIF) food chain and associated with the bacterium Cronobacter, are of concern to public health. These bacteria are regarded as opportunistic pathogens linked to life-threatening infections predominantly in neonates, with an under developed immune system. Monitoring the microbiological ecology of PIF production sites is an important step in attempting to limit the risk of contamination in the finished food product. Cronobacter species, like other microorganisms can adapt to the production environment. These organisms are known for their desiccation tolerance, a phenotype that can aid their survival in the production site and PIF itself. In evaluating the genome data currently available for Cronobacter species, no sequence information has been published describing a Cronobacter sakazakii isolate found to persist in a PIF production facility. Here we report on the complete genome sequence of one such isolate, Cronobacter sakazakii SP291 along with its phenotypic characteristics. The genome of C. sakazakii SP291 consists of a 4.3-Mb chromosome (56.9% GC) and three plasmids, denoted as pSP291-1, [118.1-kb (57.2% GC)], pSP291-2, [52.1-kb (49.2% GC)], and pSP291-3, [4.4-kb (54.0% GC)]. When C. sakazakii SP291 was compared to the reference C. sakazakii ATCC BAA-894, which is also of PIF origin, the annotated genome data identified two interesting functional categories, comprising of genes related to the bacterial stress response and resistance to antimicrobial and toxic compounds. Using a phenotypic microarray (PM), we provided a full metabolic profile comparing C. sakazakii SP291 and the previously sequenced C. sakazakii ATCC BAA-894. These data extend our understanding of the genome of this important neonatal pathogen and provides further insights into the genotypes associated with features that can contribute to its persistence in the PIF environment.
Collapse
Affiliation(s)
- Qiongqiong Yan
- UCD Centre for Food Safety, WHO Collaborating Centre for Research, Reference and Training on Cronobacter, School of Public Health, Physiotherapy and Population Science, University College Dublin Dublin, Ireland
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Cronobacter: an emerging opportunistic pathogen associated with neonatal meningitis, sepsis and necrotizing enterocolitis. J Perinatol 2013; 33:581-5. [PMID: 23538645 DOI: 10.1038/jp.2013.26] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 01/24/2013] [Accepted: 02/11/2013] [Indexed: 11/08/2022]
Abstract
Members of the genus Cronobacter are an emerging group of opportunist Gram-negative pathogens. This genus was previously thought to be a single species, called Enterobacter sakazakii. Cronobacter spp. typically affect low-birth-weight neonates, causing life-threatening meningitis, sepsis and necrotizing enterocolitis. Outbreaks of disease have been associated with contaminated infant formula, although the primary environmental source remains elusive. Advanced understanding of these bacteria and better classification has been obtained by improved detection techniques and genomic analysis. Research has begun to characterize the virulence factors and pathogenic potential of Cronobacter. Investigations into sterilization techniques and protocols for minimizing the risk of contamination have been reviewed at national and international forums. In this review, we explore the clinical impact of Cronobacter neonatal and pediatric infections, discuss virulence and pathogenesis, and review prevention and treatment strategies.
Collapse
|
35
|
Surveillance and characterisation of Cronobacter spp. in Czech retail food and environmental samples. Folia Microbiol (Praha) 2013; 59:63-8. [DOI: 10.1007/s12223-013-0266-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 06/28/2013] [Indexed: 10/26/2022]
|
36
|
Gopinath G, Hari K, Jain R, Mammel M, Kothary M, Franco A, Grim C, Jarvis K, Sathyamoorthy V, Hu L, Datta A, Patel I, Jackson S, Gangiredla J, Kotewicz M, LeClerc J, Wekell M, McCardell B, Solomotis M, Tall B. The Pathogen-annotated Tracking Resource Network (PATRN) system: A web-based resource to aid food safety, regulatory science, and investigations of foodborne pathogens and disease. Food Microbiol 2013; 34:303-18. [DOI: 10.1016/j.fm.2013.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 12/23/2012] [Accepted: 01/07/2013] [Indexed: 01/14/2023]
|
37
|
Hannawi Y, Hannawi B, Rao CPV, Suarez JI, Bershad EM. Stroke-associated pneumonia: major advances and obstacles. Cerebrovasc Dis 2013; 35:430-43. [PMID: 23735757 DOI: 10.1159/000350199] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 02/14/2013] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Stroke-associated pneumonia (SAP) has been implicated in the morbidity, mortality and increased medical cost after acute ischemic stroke. The annual cost of SAP during hospitalization in the United States approaches USD 459 million. The incidence and prognosis of SAP among intensive care unit (ICU) patients have not been thoroughly investigated. We reviewed the pathophysiology, microbiology, incidence, risk factors, outcomes and prophylaxis of SAP with special attention to ICU studies. METHODS To determine the incidence, risk factors and prognosis of acute SAP, PubMed was searched using the terms 'pneumonia' AND 'neurology intensive unit' and the MeSH terms 'stroke' AND 'pneumonia'. Non-English literature, case reports and chronic SAP studies were excluded. Studies were classified into 5 categories according to the setting they were performed in: neurological intensive care units (NICUs), medical intensive care units (MICUs), stroke units, mixed studies combining more than one setting or when the settings were not specified and rehabilitation studies. RESULTS The incidences of SAP in the following settings were: NICUs 4.1-56.6%, MICUs 17-50%, stroke units 3.9-44%, mixed studies 3.9-23.8% and rehabilitation 3.2-11%. The majority of NICU and MICU studies were heterogeneous including different neurovascular diseases, which partly explains the wide range of SAP incidence. The higher incidence in the majority of ICU studies compared to stroke units or acute floor studies is likely explained by the presence of mechanical ventilation, higher stroke severity causing higher rates of aspiration and stroke-induced immunodepression among ICU patients. The short-term mortality of SAP was increased among the mixed and stroke unit studies ranging between 10.1 and 37.3%. SAP was associated with worse functional outcome in the majority of stroke unit and floor studies. Mortality was less consistent among NICU and MICU studies. This difference could be due to the heterogeneity of ICU studies and the effect of small sample size or other independent risk factors for mortality such as the larger neurological deficit, mechanical ventilation, and age, which may simultaneously increase the risk of SAP and mortality confounding the outcomes of SAP itself. The pathophysiology of SAP is likely explained by aspiration combined with stroke-induced immunodepression through complex humeral and neural pathways that include the hypothalamic-pituitary-adrenal axis, parasympathetic and sympathetic systems. CONCLUSIONS A unified definition of SAP, strict inclusion criteria, and the presence of a long-term follow-up need to be applied to the future prospective studies to better identify the incidence and prognosis of SAP, especially among ICU patients.
Collapse
Affiliation(s)
- Yousef Hannawi
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA. yousefhannawi @ yahoo.com
| | | | | | | | | |
Collapse
|
38
|
Grim CJ, Kotewicz ML, Power KA, Gopinath G, Franco AA, Jarvis KG, Yan QQ, Jackson SA, Sathyamoorthy V, Hu L, Pagotto F, Iversen C, Lehner A, Stephan R, Fanning S, Tall BD. Pan-genome analysis of the emerging foodborne pathogen Cronobacter spp. suggests a species-level bidirectional divergence driven by niche adaptation. BMC Genomics 2013; 14:366. [PMID: 23724777 PMCID: PMC3680222 DOI: 10.1186/1471-2164-14-366] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 05/24/2013] [Indexed: 11/24/2022] Open
Abstract
Background Members of the genus Cronobacter are causes of rare but severe illness in neonates and preterm infants following the ingestion of contaminated infant formula. Seven species have been described and two of the species genomes were subsequently published. In this study, we performed comparative genomics on eight strains of Cronobacter, including six that we sequenced (representing six of the seven species) and two previously published, closed genomes. Results We identified and characterized the features associated with the core and pan genome of the genus Cronobacter in an attempt to understand the evolution of these bacteria and the genetic content of each species. We identified 84 genomic regions that are present in two or more Cronobacter genomes, along with 45 unique genomic regions. Many potentially horizontally transferred genes, such as lysogenic prophages, were also identified. Most notable among these were several type six secretion system gene clusters, transposons that carried tellurium, copper and/or silver resistance genes, and a novel integrative conjugative element. Conclusions Cronobacter have diverged into two clusters, one consisting of C. dublinensis and C. muytjensii (Cdub-Cmuy) and the other comprised of C. sakazakii, C. malonaticus, C. universalis, and C. turicensis, (Csak-Cmal-Cuni-Ctur) from the most recent common ancestral species. While several genetic determinants for plant-association and human virulence could be found in the core genome of Cronobacter, the four Cdub-Cmuy clade genomes contained several accessory genomic regions important for survival in a plant-associated environmental niche, while the Csak-Cmal-Cuni-Ctur clade genomes harbored numerous virulence-related genetic traits.
Collapse
|
39
|
Müller A, Stephan R, Fricker-Feer C, Lehner A. Genetic diversity of Cronobacter sakazakii isolates collected from a Swiss infant formula production facility. J Food Prot 2013; 76:883-7. [PMID: 23643134 DOI: 10.4315/0362-028x.jfp-12-521] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this study, 141 Cronobacter isolates that were collected based on a hygienic monitoring program performed in a powdered infant formula production facility in Switzerland between September 2011 and October 2012 were further characterized. Isolates were identified to the species level by molecular methods, and strains of Cronobacter sakazakii were further subtyped by applying PCR-based O-antigen serotyping, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). C. sakazakii was the most prevalent species identified (93.6%). Among this collection of isolates, representatives of all but one O-antigen serotype (serotype O5) were recognized. MLST analysis of 19 selected isolates revealed that most of the typeable isolates belonged to sequence type (ST) 4. Correlations between ST4 and serotype O2 and between ST83 and serotype O7 were observed. PFGE analysis revealed clusters with multiple isolates, including strains from samples collected at different time points and sampling sources. Generally, the observed heterogeneity among strains collected over the 13 months of the monitoring program was high, suggesting a constant flux among strains rather than a selection for persisting organisms.
Collapse
Affiliation(s)
- Andrea Müller
- Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | | | | |
Collapse
|
40
|
Multiplex PCR assay targeting a diguanylate cyclase-encoding gene, cgcA, to differentiate species within the genus Cronobacter. Appl Environ Microbiol 2012; 79:734-7. [PMID: 23144142 DOI: 10.1128/aem.02898-12] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a comparison to the widely used Cronobacter rpoB PCR assay, a highly specific multiplexed PCR assay based on cgcA, a diguanylate cyclase gene, that identified all of the targeted six species among 305 Cronobacter isolates was designed. This assay will be a valuable tool for identifying suspected Cronobacter isolates from food-borne investigations.
Collapse
|
41
|
Kilonzo-Nthenge A, Rotich E, Godwin S, Nahashon S, Chen F. Prevalence and antimicrobial resistance of Cronobacter sakazakii isolated from domestic kitchens in middle Tennessee, United States. J Food Prot 2012; 75:1512-7. [PMID: 22856579 DOI: 10.4315/0362-028x.jfp-11-442] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cronobacter sakazakii is an emerging opportunistic pathogen that has been implicated in cases of severe meningitis, sepsis, and necrotizing enterocolitis in premature and full-term infants. In this study, the prevalence of C. sakazakii was estimated in selected domestic kitchens in middle Tennessee. Antimicrobial resistance patterns of these C. sakazakii isolates were examined for points of public health significance. A total of 234 contact sites in 78 domestic kitchens were tested for C. sakazakii. Consumers' used dishcloths and cleaning sponges were also tested. Antimicrobial susceptibility of the identified C. sakazakii isolates was determined for 10 antimicrobial drugs by means of the disk diffusion method. C. sakazakii was recovered from 26.9% of domestic kitchens visited. Multidrug resistance was observed; the highest resistance was to penicillin (76.1% of isolates) followed by tetracycline (66.6%), ciprofloxacin (57.1%), and nalidixic acid (47.6%). None of the C. sakazakii isolates were resistant to gentamicin. These results suggest that antibiotic-resistant C. sakazakii could be present at various sites in domestic kitchens.
Collapse
Affiliation(s)
- A Kilonzo-Nthenge
- Department of Family and Consumer Sciences, Tennessee State University, 3500 John A. Merritt Boulevard, Nashville, TN 37209-1561, USA.
| | | | | | | | | |
Collapse
|
42
|
Yan QQ, Condell O, Power K, Butler F, Tall BD, Fanning S. Cronobacter species (formerly known as Enterobacter sakazakii) in powdered infant formula: a review of our current understanding of the biology of this bacterium. J Appl Microbiol 2012; 113:1-15. [PMID: 22420458 DOI: 10.1111/j.1365-2672.2012.05281.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cronobacter species (formerly known as Enterobacter sakazakii) are opportunistic pathogens that can cause necrotizing enterocolitis, bacteraemia and meningitis, predominantly in neonates. Infection in these vulnerable infants has been linked to the consumption of contaminated powdered infant formula (PIF). Considerable research has been undertaken on this organism in the past number of years which has enhanced our understanding of this neonatal pathogen leading to improvements in its control within the PIF production environment. The taxonomy of the organism resulted in the recognition of a new genus, Cronobacter, which consists of seven species. This paper presents an up-to-date review of our current knowledge of Cronobacter species. Taxonomy, genome sequencing, current detection protocols and epidemiology are all discussed. In addition, consideration is given to the control of this organism in the manufacturing environment, as a first step towards reducing the occurrence of this pathogen in PIF.
Collapse
Affiliation(s)
- Q Q Yan
- UCD Centre for Food Safety, WHO Collaborating Centre for Research, Reference & Training on Cronobacter, School of Public Health, Physiotherapy & Population Science, University College Dublin, Dublin, Ireland
| | | | | | | | | | | |
Collapse
|
43
|
Lam OL, McGrath C, Li LS, Samaranayake LP. Effectiveness of oral hygiene interventions against oral and oropharyngeal reservoirs of aerobic and facultatively anaerobic gram-negative bacilli. Am J Infect Control 2012; 40:175-82. [PMID: 21719150 DOI: 10.1016/j.ajic.2011.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/04/2011] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Aerobic and facultatively anaerobic gram-negative bacilli (AGNB) are opportunistic pathogens and continue to cause a large number of hospital-acquired infections. AGNB residing in the oral cavity and oropharynx have been linked to nosocomial pneumonia and septicemia. Although AGNB are not considered members of the normal oral and oropharyngeal flora, medically compromised patients have been demonstrated to be susceptible to AGNB colonization. METHODS A literature search was conducted to retrieve articles that evaluated the effectiveness of oral hygiene interventions in reducing the oral and oropharyngeal carriage of AGNB in medically compromised patients. RESULTS Few studies have documented the use of mechanical oral hygiene interventions alone against AGNB. Although a number of studies have employed oral hygiene interventions complemented by antiseptic agents such as chlorhexidine and povidone iodine, there appears to be a discrepancy between their in vitro and in vivo effectiveness. CONCLUSION With the recognition of the oral cavity and oropharynx as a reservoir of AGNB and the recent emergence of multidrug and pandrug resistance in hospital settings, there is a pressing need for additional high-quality randomized controlled trials to determine which oral hygiene interventions or combination of interventions are most effective in eliminating or reducing AGNB carriage.
Collapse
|
44
|
Healy B, Cooney S, O'Brien S, Iversen C, Whyte P, Nally J, Callanan JJ, Fanning S. Cronobacter (Enterobacter sakazakii): an opportunistic foodborne pathogen. Foodborne Pathog Dis 2010; 7:339-50. [PMID: 19958103 DOI: 10.1089/fpd.2009.0379] [Citation(s) in RCA: 196] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Cronobacter spp. (Enterobacter sakazakii) are a recently described genus that is comprised of six genomospecies. The classification of these organisms was revised based on a detailed polyphasic taxonomic study. Cronobacter spp. are regarded as ubiquitous organisms having been isolated from a wide variety of foods. These bacteria are opportunistic pathogens and are linked with life-threatening infections in neonates. Clinical symptoms of Cronobacter infection include necrotizing enterocolitis, bacteremia, and meningitis, with case fatality rates of 50-80% being reported. Contaminated powdered infant formula has been epidemiologically linked with infections. Recently, infections among immunocompromised adults, mainly the elderly, have also been reported. A high tolerance to osmotic stress and elevated temperatures contribute to the survival of Cronobacter spp. in dried foods such as powdered infant formula. Controlling the organism in the production environment, thereby reducing dissemination, necessitates the provision of suitable diagnostic tools. Studies demonstrated that a high degree of variability exists amongst the phenotypic-based methods used to identify Cronobacter spp. However, advances in molecular detection and subtyping techniques have significantly improved the identification and characterization of Cronobacter spp. The dose required to induce infection has yet to be determined. In vitro virulence studies have shown that Cronobacter spp. may survive in macrophage cells and efficiently attach to and invade epithelial cell lines. The production of exopolysaccharide may contribute to the formation of biofilm and active efflux pumps promote resistance to antimicrobial agents such as bile salts and disinfectants. A holistic approach combining techniques such as comparative genome analysis, proteomics, and in vivo challenges could help unravel the complex interactions between this pathogen and its host. These data would help identify those properties in Cronobacter spp. which enable the bacterium to survive in the production environment and infect vulnerable neonates via the food chain.
Collapse
Affiliation(s)
- Brendan Healy
- Centres for Food Safety and Foodborne Zoonomics, School of Agriculture, Food Science, and Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Healy B, Huynh S, Mullane N, O'Brien S, Iversen C, Lehner A, Stephan R, Parker C, Fanning S. Microarray-based comparative genomic indexing of the Cronobacter genus (Enterobacter sakazakii). Int J Food Microbiol 2009; 136:159-64. [DOI: 10.1016/j.ijfoodmicro.2009.07.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 06/09/2009] [Accepted: 07/03/2009] [Indexed: 10/20/2022]
|
46
|
Teramoto S. Novel preventive and therapuetic strategy for post-stroke pneumonia. Expert Rev Neurother 2009; 9:1187-200. [PMID: 19673607 DOI: 10.1586/ern.09.72] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Pneumonia is a significant complication of ischemic stroke that increases mortality. Post-stroke pneumonia is defined as newly developed pneumonia following stroke onset. Clinically and chronologically, post-stroke pneumonia is divided into two types of aspiration pneumonia. First, acute-onset post-stroke pneumonia occurs within 1 month after stroke. Second, insidious or chronic-onset post-stroke pneumonia occurs 1 month after the stroke. The mechanisms of pneumonia are apparent aspiration and dysphagia-associated microaspiration. Stroke and the post-stroke state are the most significant risk factors for aspiration pneumonia. The preventive and therapeutic strategies have been developed thoroughly and appropriate antibiotic use, and both pharmacological and nonpharmacological approaches for the treatment of post-stroke pneumonia have been studied rigorously. Increases in substance P levels, oral care, and swallowing rehabilitation are necessary to improve swallowing function in post-stroke patients, resulting in a reduction in the incidence of post-stroke pneumonia in a chronic stage. The stroke must be a cause of aspiration pneumonia.
Collapse
Affiliation(s)
- Shinji Teramoto
- Department of Pulmonary Medicine, National Hospital Organization, Tokyo National Hospital, Kiyose, Tokyo, 204-8585, Japan.
| |
Collapse
|
47
|
Epidemiology of invasive neonatal Cronobacter (Enterobacter sakazakii) infections. Eur J Clin Microbiol Infect Dis 2009; 28:1297-304. [PMID: 19662446 DOI: 10.1007/s10096-009-0779-4] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
Abstract
About 120-150 neonatal Cronobacter spp. (Enterobacter sakazakii) infections have been described. An analysis of current case numbers, epidemiological measures and risk factors is warranted. Data of microbiologically confirmed cases, published between 2000 and 2008, have been analysed statistically. More than 100 neonatal Cronobacter infections have been reported in this period. The overall lethality of the 67 invasive infections was 26.9%. The lethality of Cronobacter meningitis, bacteraemia and necrotising enterocolitis (NEC) was calculated to be 41.9% (P < 0.0001), <10% and 19.0% (P < 0.05), respectively. Logistic regression models (P < 0.0001) revealed a higher gestational age at birth and parentage not from Europe as significant factors for a higher reporting probability of neonatal Cronobacter meningitis. Neonates with Cronobacter meningitis not originating from North America have a higher risk for lethal outcome than other neonatal Cronobacter infections (P < 0.0001). Continental differences of risk factors for Cronobacter meningitis and for the lethal outcome of neonatal meningitis should be elucidated. Neonatal Cronobacter infections are mainly associated with the contamination of infant formula and of the relevant cleaning and preparation equipment. Eleven neonatal Cronobacter infections, not caused by contaminated infant formula, have been retrieved. Other environmental sources of infection should be considered. Consistent and sufficiently informative data of invasive neonatal Cronobacter infections should be recorded in a centralized reporting system.
Collapse
|
48
|
El-Sharoud WM, O'Brien S, Negredo C, Iversen C, Fanning S, Healy B. Characterization of Cronobacter recovered from dried milk and related products. BMC Microbiol 2009; 9:24. [PMID: 19187534 PMCID: PMC2640398 DOI: 10.1186/1471-2180-9-24] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Accepted: 02/02/2009] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cronobacter is a recently proposed genus consisting of six genomospecies that encompass the organisms previously identified as Enterobacter sakazakii. Cronobacter are opportunistic pathogens and are known to cause serious infections in infants, particularly neonates. High case fatality rates have been associated with infections and acute sequelae can occur in survivors with severe ramifications on neurological development. Infant formula has been identified as one route of transmission for infection in infants. However, the primary reservoirs for subsequent contamination of foods with Cronobacter remain undefined due to the ubiquitous nature of these organisms. More recently, infections in adults have been reported, especially amongst the elderly and patients who are immunocompromised. To help prevent the transmission of infection, it is important to identify the main food sources for Cronobacter. The aim of this study was to identify and characterize Cronobacter isolated from dried-milk and related products available in an Egyptian food market. RESULTS In total sixteen Cronobacter strains were isolated from 152 dairy-based products. These were identified and characterized using pheno- and genotyping experiments. Real-time PCR confirmed the detection of Cronobacter. Following antibiotic susceptibility tests, 3 strains showed resistance to trimethoprim and/or neomycin. Phenotype profiles were generated based on key biochemical distinguishing tests. Pulsed-field gel electrophoresis (PFGE) identified 8 PFGE types amongst the collection of strains. Repetitive sequence based PCR (rep-PCR) analysis identified 3 rep-PCR types amongst the collection of strains. Sequencing of the recN gene was used to differentiate among the recently described species of Cronobacter. CONCLUSION This study identified the presence of Cronobacter in dried milk and related products sourced from the Nile-Delta region of Egypt. Although the majority of the strains were susceptible to the antibiotics tested, resistance was observed in three isolates, highlighting the risks associated with Cronobacter contamination in foods. Phenotype and genotype analysis should be applied to further characterize Cronobacter spp. and prevent its transmission into food products.
Collapse
Affiliation(s)
- Walid M El-Sharoud
- Food Safety and Microbial Physiology Laboratory, Dairy Department, Faculty of Agriculture, Mansoura University, Mansoura, Egypt.
| | | | | | | | | | | |
Collapse
|
49
|
Hunter CJ, Petrosyan M, Ford HR, Prasadarao NV. Enterobacter sakazakii: an emerging pathogen in infants and neonates. Surg Infect (Larchmt) 2009; 9:533-9. [PMID: 18687047 DOI: 10.1089/sur.2008.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Enterobacter sakazakii (ES) is an emerging pathogen associated with the ingestion of contaminated reconstituted formula that causes necrotizing enterocolitis, sepsis, and meningitis in low-birth-weight preterm neonatal infants. Necrotizing enterocolitis remains the most common gastrointestinal surgical emergency in these infants. In recent years, the International Commission on Microbiological Specifications for Foods has ranked ES a "severe hazard for restricted populations." Because of its resistance to certain antibiotics, better understanding of ES pathogenesis is needed to aid in the development of new preventive strategies. METHODS Review of pertinent English-language literature. RESULTS Neonatal and older infants appear to be at the highest risk, although adult ES infections have been reported. We discuss the origins of ES, the detection and pathogenesis of the disease, and potential prevention strategies. CONCLUSIONS The precise pathogenesis of ES remains a mystery. Appropriate measures by parents, infant formula manufacturers, and health care providers, as well as understanding of the pathogenesis, are important in the prevention of ES-related infections.
Collapse
Affiliation(s)
- Catherine J Hunter
- Department of Surgery, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California 90027, USA.
| | | | | | | |
Collapse
|
50
|
Improving Stroke Outcomes. Am J Nurs 2007. [DOI: 10.1097/01.naj.0000298069.65467.f6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|