TOPIC CRONOBACTER INFECTIONS LINKED TO POWDERED INFANT FORMULA

HO CHI MINH CITY UNIVERSITY OF

TECHNOLOGY AND EDUCATION

FACULTY OF CHEMICAL AND FOOD TECHNOLOGY

SUBJECT: FOOD SAFETY

TOPIC:

CRONOBACTER INFECTIONS

LINKED TO POWDERED INFANT FORMULA

Instructor: Dr. Trương Quang Bình

Group’s Member:

1. Nguyễn Tr n Hoàng Anh 19116012 ầ

2. Trần Tiểu Phụng 19116053

3. Nguyễn Th Qu ị ỳnh Trân 19116013

4. Nguyễn Hoàng H ng Th m 19116049 ồ ắ

HO CHI MINH CITY, JUNE 2022

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MEMBER’S WORK

Member’s name Work Completed or not

Nguyễn Tr n Hoàng Anh ầ (Leader) 1; 3.2; 6 Completed

Trần Ti u Ph ể ụng 2.1; 3.1 Completed

Nguyễn Thị Quỳnh Trân 2.2; 4 Completed

Nguyễn Hoàng H ng Th m ồ ắ 4;5 Completed

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Table of Contents

1. Introduction .......................................................................................................... 1

2. Overview of Powdered infant formula ............................................................... 2

2.1. Powdered infant formula ............................................................................. 2

2.2. Processing of powdered infant formula ...................................................... 3

2.2.1. Preparation of the mix: ......................................................................... 6

2.2.2. Homogenisation and emulsification: .................................................... 8

2.2.3. Heat treatment: ...................................................................................... 8

2.2.4. Evaporation: ........................................................................................... 8

2.2.5. Spray drying: .......................................................................................... 9

2.2.6. Packaging:.............................................................................................10

3. illnesses linked powdered infant formula Cronobacter ..................................10

3.1. Cronobacter sakazakii ..................................................................................10

3.2. Some reported cases of Cronobacter spp. infections related to powdered

infant formula (PIF) ..........................................................................................16

4. Reasons for the Cronobacter infection in powdered infant formula ............25

5. Recommended solutions ....................................................................................28

5.1. Control in manufacturing environment ...................................................29

5.1.1. Biocides to control Cronobacter ..........................................................29

5.1.2. Essential oils .........................................................................................31

5.1.3. Polyphenols ...........................................................................................32

5.1.4. Prebiotics...............................................................................................33

5.1.5. Risk analysis .........................................................................................33

5.2. Control in the home ....................................................................................37

5.2.1. Reducing the level of contamination through heating reconstituted

PIF prior to use ..............................................................................................37

5.2.2. Minimizing the chance of contamination of reconstituted formula

during preparation .........................................................................................37

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5.2.3. Minimizing the growth of following reconsti C. sakazakii tution

prior to consumption .....................................................................................38

5.2.4. Guidelines from Centers for Disease Control and Prevention - U.S.

Department of Health & Human Services ...................................................38

6. Conclusion ...........................................................................................................42

References ...............................................................................................................45

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1

1. Introduction

Breastfeeding of young newborns is undeniably preferable to ensure a healthy

child's development. Nevertheless, it is not always feasible to breastfeed. Powdered

infant formula (PIF) is designed to be a supplement to breast milk and can be used

as a substitute if mothers are unable to breastfeed their children[1].

PIF is a low water activity non-sterile product. Therefore, it might contain a

range of bacteria that can grow rapidly following reconstitution[2]. Cronobacter spp.

(formerly ) is one of the most concerns in powdered Enterobacter sakazakii infant

formula.

The Cronobacter spp. infections cause neonatal meningitis or necrotizing

enterocolitis and bacteremia, which results in an alarming mortality rate has been

reported [3]. Many cases of infections have been re Cronobacter spp. searched that

is linked epidemiologically to powdered infant formula (PIF) [4].

Cronobacter infections are uncommon, but they can be fatal to neonates.

Although the amount of has been found only 3 cfu/g Cronobacter sakazakii in

powdered infant formula [5], time-temperature abuse of prepared formula allows

modest quantities of pollutants to rise, potentially causing illness. Low populations,

on the other hand, have been found to induce sickness even in the absence of abuse

after preparation [6]. According to FAO/WHO in 2008 [7], there were at least 120

reported cases of neonatal and infant . infections Cronobacter spp and 27 fatalities

worldwide. This might be an underestimation due to unreported and misidentified

instances [2] [8].

In particular, most recently, in 2022, there were 4 cases of Cronobacter illness

with 2 deaths believed to be linked to powdered milk. When the source of the

infection was thought to be related to Abbott's powdered infant formula, the incident

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