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Cronobacter sakazakii  is an opportunistic pathogen that causes severe infections in neonates and infants through contaminated powdered infant formula (PIF). Therefore, the aim of this study was a large-scale study on determine the prevalence, molecular characterization and antibiotic susceptibility of  C. sakazakii  isolates from PIF purchased from Chinese retail markets. Two thousand and twenty PIF samples were collected from different institutions. Fifty-six  C. sakazakii  strains were isolated, and identified using  fusA  sequencing analysis, giving a contamination rate of 2.8%. Multilocus sequence typing (MLST) was more discriminatory than other genotyping methods. The  C. sakazakii  isolates were divided into 14 sequence types (STs) by MLST, compared with only seven clusters by  ompA  and  rpoB  sequence analysis, and four  C. sakazakii  serotypes by PCR-based O-antigen serotyping.  C. sakazakii  ST4 (19/56, 33.9%), ST1 (12/56, 21.4%), and ST64 (11/56, 16.1%) were the dominant sequence types isolated.  C. sakazakii  serotype O2 (34/56, 60.7%) was the primary serotype, along with o mpA 6 and  rpoB 1 as the main allele profiles, respectively. Antibiotic susceptibility testing indicated that all  C. sakazakii  isolates were susceptible to ampicillin-sulbactam, cefotaxime, ciprofloxacin, meropenem, tetracycline, piperacillin-tazobactam, and trimethoprim-sulfamethoxazole. The majority of  C. sakazakii  strains were susceptible to chloramphenicol and gentamicin (87.5 and 92.9%, respectively). In contrast, 55.4%  C. sakazakii  strains were resistant to cephalothin. In conclusion, this large-scale study revealed the prevalence and characteristics of  C. sakazakii  from PIF in Chinese retail markets, demonstrating a potential risk for neonates and infants, and provide a guided to effective control the contamination of  C. sakazakii  in production process.

frontiers in microbiology

Prevalence, Molecular Characterization, and Antibiotic Susceptibility of Cronobacter sakazakii Isolates from Powdered Infant Formula Collected from Chinese Retail Markets