Bacillus cereus and severe intestinal infections in preterm neonates: Putative role of pooled breast milk

Background Bacillus cereus is an environmental pathogen whose spores resist the usual cleaning procedure applied by the food industry and hospitals. We reported a cluster of severe intestinal infections due to B cereus in 2 very low birth weight neonates from a neonatal intensive care unit. Methods...

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Bibliographic Details
Published in:American journal of infection control 2013-10, Vol.41 (10), p.918-921
Main Authors: Decousser, Jean-Winoc, PharmD, PhD, Ramarao, Nalini, PhD, Duport, Claudine, BS, Dorval, Marie, BS, Bourgeois-Nicolaos, Nadège, PharmD, PhD, Guinebretière, Marie-Hélène, PhD, Razafimahefa, Hasini, MD, Doucet-Populaire, Florence, PharmD, PhD
Format: Article
Language:English
Subjects:
Bacillus cereus - classification
Bacillus cereus - genetics
Bacillus cereus - isolation & purification
Bacterial diseases
Bacterial sepsis
Biological and medical sciences
Breastfeeding & lactation
Cross Infection - diagnosis
Cross Infection - microbiology
Diseases of mother, fetus and pregnancy
DNA, Bacterial - genetics
Drug resistance
Environmental Microbiology
Epidemiology. Vaccinations
Food and Nutrition
Foodborne Diseases - diagnosis
Foodborne Diseases - microbiology
Foodborne outbreak
General aspects
Gram-positive bacteria
Gram-Positive Bacterial Infections - diagnosis
Gram-Positive Bacterial Infections - microbiology
Gynecology. Andrology. Obstetrics
Human bacterial diseases
Human health and pathology
Humans
Infant, Newborn
Infant, Premature
Infection Control
Infectious Disease
Infectious diseases
Intensive care
Life Sciences
Medical sciences
Milk, Human - microbiology
Neonatal care
Neonatal sepsis
Nosocomial infection
Nosocomial infections
Pasteurization
Polymerase Chain Reaction
Pregnancy. Fetus. Placenta
Virulence
Virulence Factors - genetics
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Summary:Background Bacillus cereus is an environmental pathogen whose spores resist the usual cleaning procedure applied by the food industry and hospitals. We reported a cluster of severe intestinal infections due to B cereus in 2 very low birth weight neonates from a neonatal intensive care unit. Methods Environmental sampling and bacteriological analysis of pooled breast milk (PBM) were performed. Practices for preparation and administration of milk were observed and additional laboratory experiments performed. Strains were typed using M13-polymerase chain reaction and their virulence tested using cellular and insect models. Results B cereus strains were exclusively isolated from intestinal tracts and PBM. No environmental culture yielded any viable B cereus . Although genotypically diverse, both clinical and food strains exhibited high virulence potency. These findings pointed out the pathogenic potency of B cereus in neonates; the putative role of PBM as a reservoir for pathogenic B cereus and the triggered effect of a defective care procedure, which allowed the growth of bacteria in pasteurized PBM. Well described from dried formula, the presence of pathogenic B cereus strains in PBM was not previously reported. Conclusions Careful monitoring of conditions during collection, conservation, and administration of PBM should be implemented in high-risk populations such as premature neonates.
ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2013.01.043