Issue 3 Jan 2004

A bacterium that can be dangerous to premature babies and young infants could be more widespread in the environment than previously thought, suggest authors of a research letter in this week's issue of THE LANCET.

Enterobacter sakazakii occasionally causes illness among premature babies and infants. In some previously described outbreaks, infant formula-contaminated during factory production or bottle preparation-was recognised as a source for bacterial colonisation; however the degree of wider environmental contamination is unknown.

Chantal Kandhai from Wageningen University, The Netherlands, and colleagues used a refined isolation and detection method to investigate the presence of E. sakazakii in various food factories and households. Environmental samples from eight of nine food factories and from a third of households (five of 16) contained the bacterium. The investigators comment that appreciation of the widespread nature of this micro-organism needs to be taken into account when designing preventive control measures.

In an accompanying Commentary (p 5), Jeffrey M. Farber from Health Canada concludes: "Current industry efforts to reduce the occurrence of E sakazakii have focused on improving hygiene practices, coupled with environmental monitoring and end-product testing for the organism. Since powdered infant formula is not sterile and there is the potential risk of contamination during preparation, there is a need for care when preparing and handling reconstituted powdered infant formulas. Health-care professionals should follow recommendations provided by public-health officials and organisations such as the American Dietetic Association, and be alert to possiblemodifications."

Please remember to cite THE LANCET.

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