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FAO/WHO Findings on E. sakazakii

FAO/WHO has published key findings that included an assessment of the at-risk age groups.  ‘E. sakazakii has caused disease in all age groups.  From the age distribution of reported cases it is deduced that infants (children less than 1 year old) are at particular risk.  Among infants those greatest at risk for Enterobacter sakazakii infection are neonates (up to 4 weeks of age), particularly pre-term infants, low-birth-weight infants or immunocompromised infants.  Infants of HIV-positive mothers are also at risk both because they may specifically require infant formula and may be more susceptible to infection.  This, and low weight, may be of particular concern for some developing countries, where the proportion of such infants is higher than in developed countries’.

E. sakazakii is a rare cause of infections in adults. Since 1961 only about 60 cases of infections have been reported.  The majority of these cases have occurred in neonates that were pre-term and/or low birth weight.  Powdered infant formula has been linked to E. sakazakii infections in some neonate cases.  In neonates and infants, E. sakazakii is known to cause sepsis and meningitis and has resulted in the death of 33% of the reported neonatal cases.  Neonates that recover often have mental retardation or developmental delays (15%).  All affected infants recovered and only one reported developmental delays.

E. sakazakii infections amongst children and adults are very rare and have never been linked to food.  These individuals often have serious underlying diseases.  None of the child or adult cases have resulted in meningitis.  All child cases recovered, and the four adults that died suffered from other serious diseases.

Age breakdown of E. sakazakii infections

* Fourteen of the neonates died, 28 recovered (9 reported recovery with no developmental problems and 6 reported recovery with mental retardation or developmental delays).  There are some other infections or colonisations (~15) reported with insufficient information to include in the analysis.

Iversen C., Forsythe S.  (2003).  Risk profile of Enterobacter sakazakii, an emergent pathogen associated with infant milk formula.  Trends in Food Science and Technology, 14, 443-454.

Lai K. K.  (2001).  Enterobacter sakazakii infections among neonates, infants, children, and adults.  Case reports and a review of the literature.  Medicine 80,