Two Cases of Multi-antibiotic Resistant Cronobacter spp. Infections of Infants in China

Area of Science:

• Microbiology
• Infectious Diseases
• Genomics

Background:

• Cronobacter species infections are a serious threat to infants, potentially causing neonatal meningitis, bacteremia, and necrotizing enterocolitis.
• These bacteria often exhibit resistance to common antibiotics like beta-lactam derivatives, macrolides, and aminoglycosides, with multi-resistant strains increasingly detected.
• China reports a high isolation rate of Cronobacter from powdered infant formula (PIF) and follow-up formula (FUF), yet clinical cases remain underreported.

Observation:

• This study details two clinical cases of Cronobacter infection identified at a children's hospital in Wuhan, China.
• Genomic analysis and antibiotic resistance profiling were performed on the isolated Cronobacter strains.
• The identified strains demonstrated resistance to third-generation cephalosporins, aminoglycosides, and trimethoprim-sulfamethoxazole.

Findings:

• Whole genome sequencing of the Cronobacter isolates revealed the presence of multiple genes associated with antibiotic resistance.
• The specific genes conferring resistance were identified, although their functional activity requires further investigation.
• The study confirms the presence of antibiotic-resistant Cronobacter strains in clinical settings in China.

Implications:

• The findings underscore the critical public health issue of antibiotic resistance in Cronobacter species, particularly concerning infant health.
• Increased clinical vigilance and surveillance for Cronobacter infections are necessary, especially in regions with high formula contamination rates.
• Further research is crucial to understand the functionality of identified resistance genes and to develop effective treatment and prevention strategies.