title: The presence of endotoxin in powdered infant formula milk and the influence of endotoxin and Enterobacter sakazakii on bacterial translocation in the infant rat.
abstract: Lipopolysaccharide (LPS) is a heat stable endotoxin that persists during the processing of powdered infant formula milk (IFM). Upon ingestion it may increase the permeability of the neonatal intestinal epithelium and consequently bacterial translocation from the gut. To determine the level of endotoxin present in IFM, 75 samples were collected from seven countries (representing 31 brands) and analysed for endotoxin using the kinetic colorimetric Limulus amoebocyte lysate (LAL) assay. The endotoxin levels ranged from 40 to 5.5 x 10(4) endotoxin units (EU) per gram and did not correlate with the number of viable bacteria. The neonate rat model was used to address the risk of endotoxin-induced bacterial translocation from the gut. Purified Escherichia coli LPS was administered to rat pups followed by inoculation with Enterobacter sakazakii ATCC 12868. Bacteria were isolated from the mesentery, spleen, blood and cerebral spinal fluid (CSF) of endotoxin-treated rats due to enhanced gut and blood brain barrier penetration. Histological analysis of the colon showed marked distension of the mucosal and muscular layers. It is plausible that the risk of neonatal bacteraemia and endotoxemia, especially in neonates with immature innate immune systems, may be raised due to ingestion of IFM with high endotoxin levels.
authors.affiliation: Department of Pathology, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90027, USA.
authors.forename: Stacy
authors.initials: S
authors.lastname: Townsend
authors.forename: Juncal
authors.initials: J
authors.lastname: Caubilla Barron
authors.forename: Catherine
authors.initials: C
authors.lastname: Loc-Carrillo
authors.forename: Stephen
authors.initials: S
authors.lastname: Forsythe
mesh_terms: D000818:Animals; D018988:Bacterial Translocation / Q000187:drug effects*; D001681:Biological Assay; D015169:Colony Count, Microbial; D044083:Cronobacter sakazakii / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D004731:Endotoxins / Q000096:biosynthesis / Q000494:pharmacology*; D005506:Food Contamination / Q000032:analysis*; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D008070:Lipopolysaccharides / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D004731:Endotoxins; D008070:Lipopolysaccharides