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Risk associated with Enterobacter sakazakii in powdered milk formula

Abstract:

Enterobacter sakazakii can cause a severe form of neonatal meningitis in infants with a mortality of 10 to 80%. Several cases were associated with the consumption of powdered milk formula. The Federal Food Agency in Belgium ordered a study to collect information with regard to the contamination level, growth, survival characteristics and infective dose of E. sakazakii in powdered milk formula. Following this study recommendations were developed regarding the conditions for preparation, storage and feeding procedure. The production process of milk powder does not guarantee an absolute sterile product and low levels of E. sakazakii (< 1 cfu per 10 g) may occasionaly be present. Despite appropriate hygienic conditions during preparation, it is recommended that the prepared powdered milk formula is cooled down to 5°C in less than 2 hours and that refrigerated storage is limited to a maximum of 24 h. Warming up again to 37°C and feeding should not take more than one hour in order to keep a safety margin between the numbers of E. sakazakii cells potentially present and its infective dose. If the above mentioned guidelines for preparation, storage and feeding of powdered milk formula are respected, the risk of a neonatal E. sakazakii-infection (and infections caused by other pathogenic micro-organisms) could be dramatically reduced.