Infant Formula Safety

In the April 12th issue of Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) reported on a fatal case of meningitis in an intensive care nursery in Tennessee.1 The infecting organism was Enterobacter sakazakii , an unusual but often fatal, invasive pathogen. In the fatal Tennessee case, the infection was traced to contaminated powdered infant formula. Other infants in the same nursery were screened for E sakazakii . Of 49 screened infants, 10 events were discovered (1 proven infection, 2 assumed infections, and 7 colonizations). E sakazakii has been reported to cause or be associated with bacteremia,2,3 necrotizing enterocolitis,4 meningitis,5,6 and colonization.7 There are also reports of E sakazakii contaminating infant formula8–10; however, this report detailed for the first time a direct link to an unopened product. The manufacturer voluntarily recalled the contaminated batch of powdered formula identified as the source. The editorial comment after the report, pointed out that powdered infant formula is not sterile. The CDC concluded its report with the following recommendations for the use of powdered infant formula in the neonatal intensive care unit (NICU): 1) use alternatives to powdered formula whenever possible, 2) use aseptic technique in the preparation of infant formula, 3) refrigerate prepared formula and discard any reconstituted formula stored for longer than 24 hours, 4) limit ambient temperature “hang time” to no >4 hours, and 5) have …