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11 - Cronobacter Flashcards

1
Q

What is the older name of Cronobacter (before 2007)

A

Enterobacter Sakazakii

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2
Q

Cronobacter typical outbreak:

A
  • infant fed on PIF
  • neck rigidity
  • rehydration
  • seizure-lie activity
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3
Q

How is Cronobacter often reported after autopsy in infants?

A

It is often reported as SIDS (sudden infant death syndrome) as the cause of death

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4
Q

Cronobacter is recognized as a _________________ coliform

A

yellow-pigmented

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5
Q

There are now ___ recognizes species of Cronobacter

A

11

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6
Q

Which Cronobacter species have been involved in neonatal infection (3):

A
  • C.sakazakii
  • C.turicensis
  • C.malonaticus
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7
Q

Give me the Cronobacter characteristics (gram, etc)

A
  • Gram negative
  • non-spore forming
  • straight
  • rod-shape bacteria
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8
Q

Cronobacter has a ________ is ________________ (nonhalophilic/halophilic), and _____________ anaerobic and grows from ______ to _____

A

flagellum
nonhalophilic
facultatively
6-45C

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9
Q

T or F: Originally described as a yellow-pigmented coliform, the yellow pigment as well as well as the cell morphology may be lost or change upon repeated sub-culturing.

A

T

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10
Q

T or F: Cronobacter is an emerging pathogen

A

T

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11
Q

In 1990 Cronobacter was linked to ___________

A

powdered infant formula (PIF)

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12
Q

T or F: There is a year to year increase of Cronobacter

A

T

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13
Q

There have been approximately __ recorded cases of Cronobacter in adults

A

20

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14
Q

Epidemiology of Cronobacter (describe it)

A

low number of cases but high number of deaths

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15
Q

What group is at the most risk for Cronobacter?

A

PIF fed infants less than 1 year of age

Immunocompromised and neonates younger than 28 days old are at the greatest risk

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16
Q

T or F: Low birth-weight neonates could possibly be at higher risk

A

T

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17
Q

T or F: Cases are higher in the developed world than in the developing

A

T

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18
Q

Why premature infants born at less than 37 weeks are at particular risK?

A
  • they should be fed breast milk
  • they secrete less gastric acid than older infants, and this may be important in the long-term survival of Cronobacter
  • HIV positive mothers cannot breast feed
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19
Q

Infants infected with Cronobacter often suffer from:

A
  • Necrotizing enterocolitis (NEC)
  • Septicemia
  • Meningitis
20
Q

Neurological sequelae are common and include:

A
  • Brain abscess
  • Necrosis of brain tissue
  • Liquefaction of white cerebral matter
21
Q

Name food products that are not linked to illness but have been found to harbor Cronobacter:

A
  • Milk powder
  • Cheese
  • Herbs
  • Spices
  • Rice
22
Q

___________________ is the most associated vehicle for transmission of the pathogen, being an intrinsic or extrinsic contaminant during manufacturing under poor good manufacturing practices (GMP) or reconstitution of PIF

A

Reconstituted PIF

23
Q

T or F: Voluntary recalls of PIF contaminated with Cronobacter in the United States, Europe and Asia-Pacific region suggested the need of a collective effort among PIF manufacturers, health-care facilities and governing bodies to develop hygienic practices and maintain higher microbiological standards

24
Q

Why is the PIF form used over liquid form?

A

Because it is better in terms of cost and storage

25
The _______ form is sterile and the ________ form may contain low levels of microorganisms
liquid | PIF
26
T or F: Current processing technology is able to completely eliminate the potential for microbial contamination without affecting organoleptic and nutritional requirements
F
27
Based on current knowledge sterilization of PIF seems to only be possible using __________
irradiation *however, the doses that are required to kill all Cronobacter are not feasible do to organoleptic deterioration
28
What are the other approaches that are currently being researched to kill Cronobacter:
- magnetic fields | - ultrahigh pressure
29
In terms of virulence factors. how much is known about Cronobacter pathogenesis?
Little is known about Cronobacter pathogenesis
30
Name some virulence factors of Cronobacter sakazakii
- apical attachment - apical invasion - disruption of tight and adherens junction - basolateral invasion
31
What are the outer membrane proteins (OMPs) genes involved in invasion of epithelial cells, involved in BBB
ompX, ompA
32
What is a gene associated with outer membrane protease ?
cpa, provides protection from the immune system
33
_________________ are of particular interest, owing to their cell-surface exposure and contribution in export of virulence factors, and in anchoring the structures that mediate adhesion and motility
Outer membrane proteins
34
______ helps cells adhere to GI epithelial cells
OmpA
35
Only __________ Cronobacter breech the blood brain barrier
OmpA positive
36
______ helps invasion on the apical side of GI epithelial cells, but also helps Cronobacter survive the basolateral side as well
OmpX
37
A study on C. sakazakii reported the presence of a plasmid ______ encoding an outer membrane proteases (cpa)
pESA3
38
The cpa protease has an ability to :
- render serum resistance by cleaving complement components - activates a plasminogen - inactivate a plasmin inhibitor
39
The pESA3 plasmid also encodes a ________________ and some adhesion factors
type 6 secretion system
40
Sialic acid is found in human milk and in infant formulae in the form of ____________________.
sialyloligosaccharides.
41
The sialyoligosaccharides remain ________ in neonates and infants, therefore the intestinal microvilli of neonates have increased sialic acid levels
undigested
42
It is plausible that there is a linkage between sialic acid __________ of C. sakazakii as it is the only Cronobacter species possessing the _______ gene cluster encoding for sialic acid utilization
pathogenicity | nanAKT
43
the nanAKT gene cluster encodes for ____________
sialic acid utilization
44
What are some things you can do to prevent Cronobacter sakazakii?
- refrigerate prepared infant formula to 4C within 1 hour of preparation - prepare only small volumes of PIF to reduce the hang time at room temperature before consumption (hang time should never exceed 4 hours) - use only chilled, sterile water for IF preparation - discard any IF remaining in the bottle after feeding - Use PIF within 4 weeks of opening the can - Sterilize bottles prior to reconstitution
45
T or F: there are 11 species of Cronobacter
T
46
Mortality rates associated with Cronobacter infection are _______ and even survivors will likely have permanent developmental damage
very high
47
Cronibacter infections are probably ________ due to being diagnosed as SIDS
underreported

Fpathogens (23 decks)

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