HO CHI MINH CITY UNIVERSITY OF TECHNOLOGY AND EDUCATION FACULTY OF CHEMICAL AND FOOD TECHNOLOGY SUBJECT: FOOD SAFETY TOPIC: CRONOBACTER INFECTIONS LINKED TO POWDERED INFANT FORMULA Instructor: Dr. Trương Quang Bình Group’s Member: 1. Nguyễn Trần Hoàng Anh 19116012 2. Trần Tiểu Phụng 19116053 3.
Nguyễn Thị Quỳnh Trân 19116013 4. Nguyễn Hoàng Hồng Thắm 19116049 HO CHI MINH CITY, JUNE 2022 0 0 MEMBER’S WORK Member’s name Work Completed or not Nguyễn Trần Hoàng Anh (Leader) 1; 3.2; 6 Completed Trần Tiểu Phụng 2.1 Completed Nguyễn Thị Quỳnh Trân 2.2; 4 Completed Nguyễn Hoàng Hồng Thắm 4;5 Completed 0 0 Table of Contents 1. Overview of Powdered infant formula. Powdered infant formula.
Processing of powdered infant formula. Preparation of the mix:. Homogenisation and emulsification:. Cronobacter illnesses linked powdered infant formula.
Some reported cases of Cronobacter spp. infections related to powdered infant formula (PIF). Reasons for the Cronobacter infection in powdered infant formula. Control in manufacturing environment.
Biocides to control Cronobacter. Control in the home. Reducing the level of contamination through heating reconstituted PIF prior to use. Minimizing the chance of contamination of reconstituted formula during preparation.
Minimizing the growth of C. sakazakii following reconstitution prior to consumption. Guidelines from Centers for Disease Control and Prevention - U. Department of Health & Human Services.
Introduction Breastfeeding of young newborns is undeniably preferable to ensure a healthy child's development. Nevertheless, it is not always feasible to breastfeed. Powdered infant formula (PIF) is designed to be a supplement to breast milk and can be used as a substitute if mothers are unable to breastfeed their children[1]. PIF is a low water activity non-sterile product.
Therefore, it might contain a range of bacteria that can grow rapidly following reconstitution[2]. (formerly Enterobacter sakazakii) is one of the most concerns in powdered infant formula. The Cronobacter spp. infections cause neonatal meningitis or necrotizing enterocolitis and bacteremia, which results in an alarming mortality rate has been reported [3].
Many cases of Cronobacter spp. infections have been researched that is linked epidemiologically to powdered infant formula (PIF) [4]. Cronobacter infections are uncommon, but they can be fatal to neonates. Although the amount of Cronobacter sakazakii has been found only 3 cfu/g in powdered infant formula [5], time-temperature abuse of prepared formula allows modest quantities of pollutants to rise, potentially causing illness.
Low populations, on the other hand, have been found to induce sickness even in the absence of abuse after preparation [6]. According to FAO/WHO in 2008 [7], there were at least 120 reported cases of neonatal and infant Cronobacter spp. infections and 27 fatalities worldwide. This might be an underestimation due to unreported and misidentified instances [2] [8].
In particular, most recently, in 2022, there were 4 cases of Cronobacter illness with 2 deaths believed to be linked to powdered milk. When the source of the infection was thought to be related to Abbott's powdered infant formula, the incident 1 0 0 became even more concerning. Furthermore, the FDA's recently disclosed inspection results document detailing a pattern of deficiencies with food safety procedures at Abbott's infant formula production plant raises the question of whether the manufacturing process of this factory causes Cronobacter infections. Considering the high risk of Cronobacter infections in formula milk as well as recent infections due to intrinsic contamination or through extrinsic contamination, our team decided to choose the topic: Cronobacter Infections Linked to Powdered Infant Formula with the desire to better understand Cronobacter spp., the causes of infection, and as well as offer recommended solutions to limit the risk of infection.
Overview of Powdered infant formula 2. Powdered infant formula [9] The term "powdered infant formula" refers to a variety of products, including both breast milk fortifiers and breast milk substitutes. The former are nutritional supplements added to breast milk, which may not be sufficiently nutritious for the baby if the baby was born prematurely. In general, the term <infant= refers to children less than 1 year in age.
Similac Infant Formula Powder This complicates matters because the Salmonella and Cronobacter spp. microbiological criteria for powdered infant formula are for products with an intended target age of up to 6 months, after which a more varied diet is introduced during the "weaning" phase. In some countries, commercially available PIF products for infants over 6 months are referred to as "follow-up formulas" or "follow-on formulas" for which the current microbiological criteria for <powdered infant formula= do not apply. Processing of powdered infant formula Dry blending, wet mixing, and a mixture of wet processing and dry blending are the three types of manufacturing processes used to make powdered infant formula [10], [11].
The dry blending process begins with the manufacture of individual ingredients, which are then obtained in powdered form from suppliers, heat-treated as needed, dried, and then dry-blended. All materials are mixed in a liquid phase and heat-treated in the wet mixing-spray process. Pasteurization or 3 0 0 sterilization, for example, is required before they are dry spray. A mixed approach is sometimes employed, in which some of the ingredients are processed using wet mixing to generate a foundation powder, and the other ingredients are added using dry blending [12], [13].
The dry blending technique has the advantage of consuming less energy and requiring less capital for equipment, construction, and maintenance. Because there is no water involved in the dry blending process, the risk of microbial contamination is greatly decreased. However, there are significant drawbacks to employing the dry blending procedure, such as the microbiological and physical quality of the finished product being dependent on raw materials, the inability to integrate oil, and component de-blending during transportation. One of the benefits of the wet mix technique is that all quality parameters, such as wet mixing, concentration by evaporation, and spray drying, may be managed more successfully than with dry mixing.
As a result, the microbiological, physical, and chemical properties of the powder are improved [14]. However, there are certain drawbacks, such as increased equipment costs, more maintenance, and the presence of both wet and dry regions in one manufacturing plant. Manufacturing process of powdered infant formula by wet mixing- spray drying process 5 0 0 The three key stages of the wet mixing-spray drying process are always the same: mix preparation, evaporation, and drying. Preparation of the mix: The basic components widely used in powdered infant formula are shown in Table 1.
The physical qualities of powdered infant formula wet-mixes are influenced by the quality and pre-treatment of the ingredients [16]. Fresh skim milk that has been heat-treated, for example, has been reported to have higher viscosities after evaporation than fresh skim milk that has not been heat-treated [17]. Typical raw material for powdered infant formula [16] Casein Source Skim milk powder (SMP), evaporated skim milk, acid casein, sodium/calcium/potassium caseinate, milk protein concentrate (MPC*) Whey Source Demineralised whey powder (DWP), whey protein concentrates (WPC*), whey protein isolates (WPI), hydrolysed whey ingredients Alternative protein Soy milk, soy protein isolate, locust bean seed protein, source amino acids Oils Soy, corn, safflower, sunflower, colza, palm, copra, structured lipids Carbohydrates Lactose, starch, sucrose, corn syrup, corn syrup solids Major minerals Calcium carbonate, calcium phosphates, dibasic magnesium phosphate, potassium citrate, magnesium chloride 6 0 0 Minor minerals Potassium iodide, ferrous sulphate, manganese sulphate, copper sulphate, zinc sulphate Vitamins A, D, E, K, B1, B2, B6, B12, niacin, folic acid, pantothenic acid, biotine, choline, inositol Functional Soy lecithin, mono- and diglycerides ingredients Before mixing, these items must be prepared and hydrated. Powder hydration is usually divided into multiple stages, including wetting, sinking, dispersion, and dissolution [18].
To minimize hydration time, high shear devices can be utilized to scatter raw materials [19], [20]. To guarantee thorough hydration, the mixture is then held in a huge tank. Water-soluble minerals are dissolved in hot water separately and then added to the mixture. With the addition of alkali or citric acid solution, the pH of the mixture can be changed [21].
When oil-soluble vitamins are needed in the mix, they are first dissolved in oil before being added to the oil mix tank. The oil- soluble vitamins are premixed and added to the final storage tank before being dried or mixed with the spray-dried powder if they are encapsulated. Regardless of whether batch or continuous processing is used, the pipes and tank should be flushed with compressed air at least once a day, and the mixing line should be cleaned in situ (CIP) at least once a day [10]. The lactose content of raw materials is particularly crucial for hydration since it preserves the original structure of proteins after drying.
Lactose, after all, is a somewhat insoluble sugar. As a result, there is a critical dry matter concentration at which lactose is no longer soluble during the wet-mixing of powdered infant formula [16]. Homogenisation and emulsification: During the wet-mixing of powdered infant formula, fat stabilization is critical to avoid separation. Proteins are amphiphilic molecules with both hydrophobic and hydrophilic areas that play a key role in the emulsification of powdered infant formula.
Fat is broken down into little globules during homogenization and stabilized by proteins that absorb at the fat-water interface. Hydrophobic sections of adsorbed proteins are oriented toward the fat phase, while hydrophilic areas are oriented toward the aqueous phase. Furthermore, powdered infant formula, especially powdered infant formula containing hydrolyzed proteins, may contain low molecular weight surfactants that act as emulsifiers. Surfactants, like proteins, have hydrophobic areas that soak in the fat-water interface and hydrophilic sections that are in touch with the aqueous phase [16].
Heat treatment: Heat treatment is an important control point for powdered infant formula's microbiological purity. Heat treatment can be placed at any point in the process. Because aggregates of fat globules formed during heat treatment [22] may be disrupted by homogenisation, it may be desirable to position the heat treatment before homogenisation to produce a more stable emulsion [21]. McCarthy et al.
[19],[20] used heat treatment before homogenization in their research. Evaporation: To remove water from powdered infant formula wet-mixes before spray drying, evaporation is commonly used. Evaporation can remove water at a lower cost of energy than spray drying [23]. The dairy business frequently uses falling film evaporators.
The wet-mix flows by gravity through a series of tubes during falling film evaporation, producing a film on the inside of each tube as it descends. The outside of the tubes is sprayed with live steam, which causes the water in the wet- 8 0 0 mix to evaporate. Evaporation takes place in a vacuum (50 to 70 °C), which permits heat-sensitive wet-mixes to evaporate. The amount of concentration that may be achieved is determined by viscosity increase; post-evaporation viscosity of whole milk should not exceed 603100 mPa.s for efficient drying [24].
Evaporation can impact the physical condition of wet-mix elements in addition to viscosity changes. Liu et al. During evaporation, calcium phosphate is transferred from a soluble to a colloidal micellar form, which lowers pH. During evaporation, McCarthy et al.
noticed an increase in the size of fat globules in IMF emulsions [20]. Spray drying: Spray drying is used to make powdered infant formula. Wet-mixes that have been atomised into fine droplets (103400 μm) to improve the area of contact with the hot air is removed with hot air [24]. Spray dryers with two or three stages are commonly used to make powdered infant formula.
Spray drying in two or three stages comprises a large drying chamber (stage 1) in which the majority of the water is removed, followed by supplemental drying utilizing an internal fluidised bed (stage 2) and/or exterior fluidised bed (stage 3). Powder particle agglomeration is used to improve the wettability and flowability of powdered baby formula. Random collisions of atomized particles during drying will cause spontaneous agglomeration of powder particles. The atomised particles from two or more atomising machines are positioned so that they overlap in forced primary aggregation.