Underestimated Risks of Infantile Infectious Disease from the Caregiver’s Typical Handling Practices of Infant Formula

• Published in: Scientific reports 2019-07, Vol.9 (1), p.9799-12, Article 9799
• Main Authors: Cho, Tae Jin, Hwang, Ji Yeon, Kim, Hye Won, Kim, Yong Ki, Il Kwon, Jeong, Kim, Young Jun, Lee, Kwang Won, Kim, Sun Ae, Rhee, Min Suk
• Format: Article
• Language: English
• Subjects: 631/326/1762; 631/326/2522; 631/326/421; Baby foods; Bacterial Load; Caregivers; Communicable Diseases - epidemiology; Communicable Diseases - transmission; Contamination; Food Contamination; Food contamination & poisoning; Food Handling; Food Microbiology; Humanities and Social Sciences; Humans; Infant; Infant Formula - microbiology; Infant, Newborn; Infants; Infectious diseases; Microbial Viability; multidisciplinary; Pathogens; Public Health Surveillance; Risk Assessment; Risk Factors; Science; Science (multidisciplinary); Skin - microbiology; Survival; Utensils
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-46181-0

The impact on infant caregiver as a reservoir of pathogens has not been exploited with perspective to powdered infant formula (PIF). Here we reveal novel route of pathogen transfer through hand-spoon-PIF unexpectedly occurred by even typical practices of caregivers, handling of PIF and storage of feeding-spoon in PIF container. Hand-spoon-PIF contamination route was simulated to analyze the transfer and subsequent survival of pathogens. Major pathogens associated with infantile fatal diseases ( Cronobacter sakazakii , Salmonella enterica , Staphylococcus aureus ) were readily transmitted to PIF from skin (3−6 log CFU/hand) via spoons following long-term survival of transferred pathogens (3 weeks; use-by date of PIF) as the excessive level of infectious dose, highlighting direct onset of diseases. Low bacterial load on skin ( ca . 1 log CFU/hand) could prevent cross-contamination of PIF, however, at least 72 h survival of transferred pathogen on spoons demonstrated the probability on re-contamination of PIF. To our knowledge, this is the first study to investigate the cross-contamination of utensils in contact with powdered-foods. Bacterial load on hands is the key determinant of pathogen transfer and the extent of risk are species-dependent. These evidential results redefine risk of caregivers’ practices and facilitate incorporation of cross-contamination into risk-assessment as underestimated route of infection.