Cronobacter Support
06-19-2009, 07:18 PM
Posted from ftp.fao.org/docrep/fao/007/y5502e/y5502e00.pdf
Summary of recommendations
The expert meeting made recommendations to FAO, WHO, Codex, their member countries, NGOs and the scientific community. These are summarized below.
• In situations where infants are not breastfed, caregivers, particularly of infants at high risk, should be regularly alerted that powdered infant formula is not a sterile product and can be contaminated with pathogens that can cause serious illness; they should be provided with information that can reduce the risk.
• In situations where infants are not breastfed, caregivers of high-risk infants, should be encouraged to use, whenever possible and feasible, commercially sterile liquid formula or formula which has undergone an effective point-of-use decontamination procedure (e.g. use of boiling water to reconstitute or by heating reconstituted formula).3
• Guidelines should be developed for the preparation, use and handling of infant formula to minimize risk.
• The infant food industry should be encouraged to develop a greater range of commercially sterile alternative formula products for high-risk groups.
• The infant food industry should be encouraged to reduce the concentration and prevalence of E. sakazakii in both the manufacturing environment and powdered infant formula. To this end, the infant food industry should consider implementing an effective environmental monitoring programme and the use of Enterobacteriaceae rather than coliform testing as an indicator of hygienic control in factory production lines.
• In revising its code of practice, Codex should better address the microbiological risks of powdered infant formula and, if deemed necessary, include the establishment of appropriate microbiological specifications for E. sakazakii in powdered infant formula.
• FAO/WHO should address the particular needs of some developing countries and establish effective measures to minimize risk in situations where breastmilk substitutes may be used in exceptionally difficult circumstances, e.g. feeding infants of HIV-positive mothers or low-birthweight infants.
• The use of internationally validated detection and molecular typing methods for E. sakazakii and other relevant microorganisms should be promoted.
• Investigation and reporting of sources and vehicles, including powdered infant formula, of infection by E. sakazakii and other Enterobacteriaceae should be encouraged. This could include the establishment of a laboratory-based network.
• Research should be promoted to gain a better understanding of the ecology, taxonomy, virulence and other characteristics of E. sakazakii and of ways to reduce its levels in reconstituted powdered infant formula.
3 Nutritional and other factors need to be considered, e.g. alteration of nutritional content, risk from burns due to handling boiling or hot water/formula, and potential for germination of bacterial spores. The formula should thereafter be cooled and handled appropriately.
Summary of recommendations
The expert meeting made recommendations to FAO, WHO, Codex, their member countries, NGOs and the scientific community. These are summarized below.
• In situations where infants are not breastfed, caregivers, particularly of infants at high risk, should be regularly alerted that powdered infant formula is not a sterile product and can be contaminated with pathogens that can cause serious illness; they should be provided with information that can reduce the risk.
• In situations where infants are not breastfed, caregivers of high-risk infants, should be encouraged to use, whenever possible and feasible, commercially sterile liquid formula or formula which has undergone an effective point-of-use decontamination procedure (e.g. use of boiling water to reconstitute or by heating reconstituted formula).3
• Guidelines should be developed for the preparation, use and handling of infant formula to minimize risk.
• The infant food industry should be encouraged to develop a greater range of commercially sterile alternative formula products for high-risk groups.
• The infant food industry should be encouraged to reduce the concentration and prevalence of E. sakazakii in both the manufacturing environment and powdered infant formula. To this end, the infant food industry should consider implementing an effective environmental monitoring programme and the use of Enterobacteriaceae rather than coliform testing as an indicator of hygienic control in factory production lines.
• In revising its code of practice, Codex should better address the microbiological risks of powdered infant formula and, if deemed necessary, include the establishment of appropriate microbiological specifications for E. sakazakii in powdered infant formula.
• FAO/WHO should address the particular needs of some developing countries and establish effective measures to minimize risk in situations where breastmilk substitutes may be used in exceptionally difficult circumstances, e.g. feeding infants of HIV-positive mothers or low-birthweight infants.
• The use of internationally validated detection and molecular typing methods for E. sakazakii and other relevant microorganisms should be promoted.
• Investigation and reporting of sources and vehicles, including powdered infant formula, of infection by E. sakazakii and other Enterobacteriaceae should be encouraged. This could include the establishment of a laboratory-based network.
• Research should be promoted to gain a better understanding of the ecology, taxonomy, virulence and other characteristics of E. sakazakii and of ways to reduce its levels in reconstituted powdered infant formula.
3 Nutritional and other factors need to be considered, e.g. alteration of nutritional content, risk from burns due to handling boiling or hot water/formula, and potential for germination of bacterial spores. The formula should thereafter be cooled and handled appropriately.