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    Investigation of Extended Spectrum Β-Lactamases (ESBL)-Producing Enterobacteriaceae and Cronobacter Spp in Infant Formulas and Cereal-Based Foods for Children
    (İstanbul Gelişim Üniversitesi Yayınları / Istanbul Gelisim University Press, 2017-04-26) Cava Gümüş, Pınar; Tekiner, İsmail Hakkı; Çakmak, Burcu; Tacer Caba, Zeynep; Özpınar, Haydar
    Aim: The extended spectrum ?-lactamase (ESBL) producing Enterobacteriaceae have attracted attention due to their ability of delaying or cancelling antimicrobial therapy. The foods for infants and children may occasionally contain pathogens such as ESBLproducing Enterobacteriaceae, including Cronobacter spp., because of inappropriate production, storage and handling conditions. This situation leads to a greatest risk of infection to infants and children through their consumption. The objective of this study was to investigate the occurrence of ESBL-producing Enterobacteriaceae, including Cronobacter spp., from a total of 115 samples of various foods from different brands for infants and children sold in Istanbul, Turkey (20 locally produced infant formula, 20 imported infant formula, 20 starch, 20 rice flour, 20 semolina, and 15 milk powder). Methods: For isolation of Enterobacteriaceae ISO 21528-2:2004 was followed. The isolated colonies were identified by Mass Spectrometer. The identified colonies were then exposed to pre-enrichment at 35-370C for 18-24 hours, the suspension was transferred to a Chromogenic ESBL selective media, and allowed for an incubation at 35-370C for 18-24 hours again. The presumptive ESBL producers were subjected to ESBL screening test using a combination of ceftazidime, cefotaxime, and cefpodoxime ± clavulanic acid. Finally, MIC values for ESBL confirmation were conducted by Merlin Micronaut-S betalactamase VII kit, the readings were automatically evaluated by Sifin Software integrated with a spectrometer. All procedures were performed according to the Guidelines of CLSI (2013). Results: Of 18 ESBL suspected isolates (7 P. agglomerans, 1 E. aerogenes, 3 E. cloacae/asburiae, 2 K. oxytoca, 2 L. adecarboxylata, and 3 C. sakazakii), 5 isolates (3 P. agglomerans, 1 E. cloacae/ asburiae, and 1 E. aerogenes) were positive for ESBLproduction, whereas none of C. sakazakii isolates was ESBL-producers. Discussion and Conclusion: Some of the analysed infant formulas and cereal-based foods for children (locally produced infant formulas, rice flour, and starch) were determined to be posing a serious health risk for the infants and children due to contamination by ESBL-producing Enterobacteriaceae, except for C. sakazakii isolates. Keywords: Cereal-based food, children, cronobacter spp., enterobacteriaceae, esbl, infant formula.