Enterobacter sakazakii in infants: novel phenomenon in India

Area of Science:

• Neonatal infections
• Microbiology
• Public Health

Background:

• _Cronobacter sakazakii_ (*E. sakazakii*) is a pathogen associated with severe neonatal infections like necrotizing enterocolitis, bloodstream infections, and central nervous system infections.
• Mortality rates for *E. sakazakii* infections can range from 40% to 80%.

Observation:

• This report details two distinct cases of E. sakazakii infection in India: a preterm, very low birth weight neonate with meningitis and a two-month-old infant with bacteremia.
• The first infant, fed powdered infant formula, presented with sepsis and meningitis and unfortunately succumbed to the infection.
• The second infant, who was breastfed, developed nosocomial E. sakazakii bacteremia and responded to treatment.

Findings:

• These cases represent the first documented instances of E. sakazakii meningitis and bacteremia in neonates and infants in India.
• The contrasting outcomes underscore the potential severity of E. sakazakii infections and the importance of timely and appropriate therapeutic interventions.
• The association of powdered infant formula with the fatal case raises concerns about potential contamination routes and infant feeding practices.

Implications:

• This study emphasizes the need for increased awareness and surveillance of E. sakazakii infections in Indian neonatal units.
• It highlights the critical importance of stringent hygiene and safety protocols in the preparation and handling of infant formula to prevent neonatal infections.
• Further research into the epidemiology and prevention of E. sakazakii in the Indian context is warranted to reduce infant morbidity and mortality.