Foodborne Illness

A resource for foodborne illness.

Cronobacter sakazakii

Cronobacter sakazakii is a bacterium that causes a rare but often fatal infection of the bloodstream and central nervous system. Infants with weakened immune systems, particularly premature infants, are most likely to contract an Cronobacter infection, although the bacteria have caused illnesses in all age groups.

Cronobacter sakazakii in Infant Formula

Most cases of Cronobacter sakazakii come from powdered infant formula contaminated with the bacterium. However, this type of infection is still very rare. High temperatures reached in preparing the formula usually kill the bacteria, but they are known to survive even after preparation.

Powdered infant formula is most likely contaminated after production, since the pasteurization process is normally adequate to kill Cronobacter sakazakii bacteria. However, if the powder is produced using the dry blending process, and not heated, Cronobacter bacteria can survive in the formula.

Symptoms of Cronobacter Infection

Cronobacter symptoms usually include the following in infants:

  • Poor feeding response

IrritabilityJaundiceGrunting while breathingUnstable body temperature

An Cronobacter sakazakii infection can also turn lead to meningitis, an inflammation of the membranes surrounding the brain and spinal cord. Signs of meningitis in newborns include:

  • High fever

Constant cryingExcessive sleepiness or irritabilitySluggishnessPoor feedingA bulge in the soft spot on the top of the headStiffness of the body and neckSeizures

Around 50 percent of infants who have an Cronobacter sakazakii die, and those who survive may experience neurological impairment.

Treatment for Cronobacter sakazakii

A Cronobacter sakazakii infection is usually treatable with antibiotics, although some antibiotic-resistant strains have recently been discovered. If a newborn exhibits any of the above symptoms, consult a doctor to see whether the infant might need treatment.

How to Prevent a Cronobacter sakazakii Infection

The CDC recommends the following steps for preventing an Cronobacter infection:

  • Use hot water to make baby milk from infant formula powder—Water should reach a heat of 158°F (70°C)

Choose an alternative to a powdered form of baby milk. Liquid formula is usually sterile.Follow the manufacturer’s instructions for preparing baby milk from powdered formula

  • Throw out prepared formula if you don’t use it within 24 hours of preparing it
  • Limit “hang time” for continuous feeding via tube to four hours
Outside References

Mayo Clinic. (2010). Meningitis. Available at sakazakii(Cronobacter Spp.). Available at

Clostridium Botulinum (Botulism)

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