Quality of powdered substitutes for breast milk with regard to members of the family Enterobacteriaceae.

Members of the family Enterobacteriaceae were cultured from 52.5% of 141 milk substitute infant formulas which were obtained in 35 countries. The concentration did not exceed a level of 1 CFU/g in any product. The species which were isolated most frequently were Enterobacter agglomerans, cloacae, Enterobacter sakazakii, and Klebsiella pneumoniae. If infections due to these organisms occur, it can be useful to include a check of the hygienic precautions which are taken during the preparation and storage of the formula. Milk powders without members of the Enterobacteriaceae might offer extra protection to the newborn if some multiplication does occur in the formula.