About Cronobacter Infection

Key points

  • Cronobacter are bacteria that can contaminate dry foods like powdered infant formula, herbal teas, and starches, as well as feeding items like breast pump equipment.
  • Cronobacter infections are rare but can be deadly for infants, especially newborns.
  • If you think your baby might have a Cronobacter, infection take them to a medical provider as soon as possible.
Parent feeding infant a bottle of formula

What It Is

Cronobacter sakazakii (or "Cronobacter") and other species are bacteria found naturally in the environment. Cronobacter can live in dry foods, such as powdered infant formula. It has also been found on contaminated feeding items like breast pump equipment.

Getting sick from Cronobacter does not happen often, but infections in infants can be deadly. Infants less than 2 months old are most likely to develop meningitis (an inflammation of the membranes that protect the brain and spine) if they are infected with Cronobacter bacteria.

Signs and symptoms

In infants under 1 year old, Cronobacter usually starts with a fever and poor feeding, excessive crying, or very low energy. Some babies may also have seizures.

When to seek emergency care

Babies with these symptoms should be taken to a medical provider as soon as possible.

Cronobacter infection can lead to serious illness, including

  • Bloodstream infections (sepsis)
  • Swelling of the lining surrounding the brain and spine (meningitis)
  • Urinary tract infections
  • Infection in wounds like cuts, scrapes, or places where people have had surgeries

Babies with meningitis may develop serious, long-lasting problems in their brains.

People at risk

Anyone can get a Cronobacter infection, but newborns are at highest risk of serious illness. Although rare, Cronobacter infections can be life-threatening for newborns because of the risk for sepsis and meningitis. Infections in infants usually occur in the first days or weeks of life.

Infants who are more likely to get sick include:

  • Infants younger than 2 months old. These infants are most likely to develop meningitis if they get sick from Cronobacter.
  • Infants born prematurely.
  • Infants with weakened immune systems. Babies with this condition can't fight germs as well because of illness or medical treatment, such as chemotherapy for cancer.

Although less common, older children and adults can also can Cronobacter infection. People 65 and older and people with weakened immune systems are more likely to get Cronobacter in their blood.

People with weakened immune systems include those being treated with immune-suppressing drugs for cancer, other illnesses, or organ transplants, or those with HIV infection or genetic conditions.

How it spreads

Cronobacter bacteria are found naturally in the environment. The bacteria can contaminate dry foods like

  • Powdered infant formula
  • Powdered milk
  • Herbal teas
  • Starches

and feeding items like breast pump equipment.

Keep in mind

Cronobacter infections in infants less than 12 months old are often linked to powdered infant formula. Powdered formula is not sterile and might have germs in it. Powdered infant formula can get contaminated in homes or in processing facilities that make it.

In the home

You can accidentally get Cronobacter in powdered formula after you open the container. Cronobacter can live on surfaces in your home, such as a kitchen counter or sinks, and in water.

In the home, Cronobacter could get into powdered formula:

  • If you place formula lids or scoops on contaminated surfaces and later touch the formula.
  • If you mix the formula with contaminated water or in a contaminated bottle.

In a processing facility

Cronobacter can also get into powdered infant formula in a processing facility:

  • If the manufacturer uses contaminated ingredients to make the formula.
  • If the formula powder touches a contaminated surface in the facility (or during manufacturing).

Prevention

To prevent babies from getting Cronobacter infection:

Keep Reading Preventing Cronobacter in Infants

Quick facts

Fact

Until 2024, invasive Cronobacter infection was not on the list of nationally notifiable conditions, and Minnesota and Michigan were the only states that required reporting. Because most states did not require reporting before 2024, rates of Cronobacter infection in the United States are not well understood, and the true number of annual cases is unknown.


Listing Cronobacter as a nationally notifiable condition will help us learn more about the true number of cases that occur each year.

  • Evidence1 suggests Cronobacter infections are most common in infants less than 2 months old and often cause death in this age group. Also, infections among older adults may be more common, although milder, than infections among infants.
  • While cases in older children and adults do occur, these cases are not nationally notifiable, and therefore are not currently collected in routine surveillance.
  • Around 20% of infants with meningitis or bloodstream infections due to Cronobacter in the United States have died2.
  • Worldwide, approximately 40% of infants reported to have Cronobacter meningitis or bloodstream infections have died2.
  • Typically, CDC receives 2-4 reports of severe Cronobacter infections in infants annually from health departments and has received reports from 32 states.
  • From January 2002 to July 2022, CDC received 76 reports of severe Cronobacter illnesses among infants.

Testing and diagnosis

Cronobacter infection is diagnosed by laboratory testing of blood or cerebrospinal fluid.

For Health Care Providers Clinical Testing and Diagnosis for Cronobacter Infection

Treatment

Antibiotics can treat Cronobacter infections. Infants with sepsis or meningitis should be hospitalized.

For Health Care Providers Patient Care for Cronobacter infection
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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
  1. https://wwwnc.cdc.gov/eid/article/26/5/19-0858_article?msclkid=41816932c24c11ec95e4634026f06c34
  2. https://wwwnc.cdc.gov/eid/article/26/5/19-0858_article