Outbreak of Gastrointestinal Sepsis Associated with Bacillus cereus-Contaminated Human Milk Fortifier in Preterm Neonates.

We report a cluster of acute gastrointestinal illness in seven preterm neonates temporally associated with a single batch of powdered human milk fortifier (HMF). Symptoms developed within 3-4 h of ingestion and included profuse diarrhea, dehydration, hypoglycemia, and shock. Blood and stool cultures were sterile. Microbiological analysis of unopened HMF sachets revealed contamination with Bacillus cereus and other spore-forming organisms. Withdrawal of the implicated batch and reinforcement of infection-control measures resulted in no further cases. This outbreak highlights the risk of pathogenic contamination of powdered HMF in neonatal intensive care units.