Infection of Cronobacter sakazakii ST1 Producing SHV-12 in a Premature Infant Born from Triplet Pregnancy

Abstract

Cronobacter sakazakii can cause severe life-threatening invasive infections in neonates, with a high mortality rate mostly associated with powdered infant formula consumption. The study describes a fatal C. sakazakii infection in premature infant fed only with expressed human milk. Despite the identification of etiological factor from patient’s blood, the epidemiological investigation, including mother’s skin, hospital surfaces, milk expressing devices, and milk samples, did not show bacterial contamination. The infection was caused by C. sakazakii ST1, being one of the leading genotypes reported in invasive infections. The phylogenetic analysis of the international collection of the ST1 organisms allowed us to identify the isolate as a member of the main cluster. The pathogenic potential of the isolate was augmented by the presence of IncFIB-like molecule representing virulence plasmids of pESA-3 family. Isolate presented ESBL phenotype associated with blaSHV-12 gene harboured by IncX3 plasmid. The described case gave valuable information to genetics of Cronobacter, and also urges the need of wider whole-genome sequencing implementation as a part of diagnostic procedure.

Emerging of Multidrug-Resistant Cronobacter sakazakii Isolated from Infant Supplementary Food in China

“…Furthermore, virulence genes located on the IncFIB plasmids in C. sakazakii were reported ( 14 , 32 ). In this study, virulence genes, including cpa and iucABCD , which could support bacterial growth in human hosts and which were detected in isolates from clinical cases of C. sakazakii infection ( 51 – 54 ), were also found in the IncFIB plasmids of both MDR isolates’ genes. All the virulence genes detected in both MDR C. sakazakii isolates implied a potential infection risk for infants upon consuming food contaminated by these strains.…”

Antimicrobial resistance determinants in silage

“…In line with our results, this gene has recently been mentioned to appear in Cronobacter spp. in a case report 23 . E. hormaechei deriving aadA2 and sul1 , a sulfonamide resistant dihydropteroate synthase gene that is described to appear in Gram-negative bacteria 21 have been reported to appear in the genom of Enterobacter spp.…”

Characterization of Cronobacter sakazakii and Cronobacter malonaticus Strains Isolated from Powdered Dairy Products Intended for Consumption by Adults and Older Adults

“…The two strains of C. sakazakii ST1 that we evaluated carried plasmids homologous to pESA3, which have been previously reported due to their association with clinical cases caused by C. sakazakii ST1 [81]. Franco et al [16] reported that plasmid pESA3 encodes a replication origin gene similar to RepFIB (incompatibility class) both unique and shared (repA), as well as virulence genes for iron acquisition, a siderophore aerobactin, a type VI secretion system, and the cpa-producing gene, a protease capable of degrading host serum, found only in C. sakazakii strains.…”