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Case definition

Case Classification

Suspect

• Meets clinical criteria AND supportive laboratory evidence, OR
• Meets clinical criteria AND epidemiologic linkage criteria.

Probable

• Meets clinical criteria AND epidemiologic linkage criteria AND supportive laboratory evidence.

Confirmed

• Meets clinical criteria AND confirmatory laboratory evidence.

Comments

ÐÇ¿ÕÓéÀÖ¹ÙÍø requests that all Cronobacter isolates be forwarded to the Enteric Diseases Laboratory Branch for further characterization.

For more detail about the case definition, visit in the National Notifiable Disease Surveillance System.

When to report cases

Reporting is required for invasive Cronobacter infections in infants.

The joint ÐÇ¿ÕÓéÀÖ¹ÙÍø, United States Food and Drug Administration (FDA), the Association of Public Health Laboratories (APHL), and Council of State and Territorial Epidemiologists (CSTE) Cronobacter Position Statement Implementation Workgroup provides for clinical specimen collection, isolate submission, and communications of cases of invasive Cronobacter illness in infants, in addition to product testing recommendations. Reporting is recommended within 48 hours of genus-level identification, or in accordance with jurisdictional submission rules.

After a case has been reported, ÐÇ¿ÕÓéÀÖ¹ÙÍø requests that isolates be sent in accordance with submission instructions.

Instructions and contact information

The ÐÇ¿ÕÓéÀÖ¹ÙÍø's Infectious Disease Laboratories accepts samples from state public health laboratories and other federal agencies. Refer to Submitting Specimens to ÐÇ¿ÕÓéÀÖ¹ÙÍø for additional information.

Detailed information regarding sample submissions including specimen requirements, laboratory contact information, test turnaround times and supplemental information are cataloged in a searchable Test Directory.

• The test order for Cronobacter identification, including isolates derived from human sources, is listed under Test Code ÐÇ¿ÕÓéÀÖ¹ÙÍø-10123.
• The test order for Cronobacter isolation from primary sources (including but not limited to opened cans of infant formula, breast milk, and pump parts) is listed under Test Code ÐÇ¿ÕÓéÀÖ¹ÙÍø-10106.

ÐÇ¿ÕÓéÀÖ¹ÙÍø surveillance data

ÐÇ¿ÕÓéÀÖ¹ÙÍø collects surveillance data for invasive Cronobacter spp. infections in infants, which is a nationally notifiable condition.

State and local health officials use a standard form through a secure outbreak response platform called SEDRIC to collect detailed information on these infections. Information collected about the patient includes:

• Demographic information
• Clinical information
• Infant feeding history
• Environmental information

This information is reported to the Cronobacter Surveillance System.

Key Findings

Data from the Cronobacter Surveillance System inform our understanding of invasive Cronobacter infections in infants in the United States.

• It is estimated that there are ~18 cases per year in the United States.
• Between 2001 and 2018, 1-10 cases have been voluntarily reported to ÐÇ¿ÕÓéÀÖ¹ÙÍø annually.
• In 2024, invasive Cronobacter infections in infants became a Nationally Notifiable Condition.

Resources

Cronobacter Workflow for Reporting