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母乳喂养与巨细胞病毒向早产儿的传播。病例报告和母乳中 CMV-DNA 的动力学。

Breastfeeding and transmission of cytomegalovirus to preterm infants. Case report and kinetic of CMV-DNA in breast milk.

机构信息

Department of Medical and Surgical Specialities and Public Health, Public Health section, University of Perugia School of Medicine, Italy.

出版信息

Ital J Pediatr. 2011 Jan 19;37:6. doi: 10.1186/1824-7288-37-6.

Abstract

BACKGROUND

Breastfeeding has a major impact on CMV epidemiology. Postnatal CMV reactivation's incidence during lactation is nearby the maternal seroprevalence. Although perinatal CMV infection has practically no consequences in term newborn, it may cause, in some cases, a severe symptomatic disease in preterm newborns. The aims of the present study are to evaluate the rate and clinical expression of CMV infection breast milk transmitted in preterm infants and to check the safety of the freezing treated breast milk.

METHODS

The study included fifty-seven preterm infants and their CMV seropositive mothers. Fresh breast milk samples have been collected from 1(st) to 9(th) postpartum week. Both fresh breast milk and 72, 96, 120 hours frozen samples have been examined, checking the presence of CMV; urine samples have been tested too.

RESULTS

70.2% of tested mothers showed reactivation of the infection, and CMV-positive breast milk during the six weeks postpartum has been found. However, only one infant was infected by CMV, developing hepatic affection concomitantly with a multi-system involvement, as shown CMV DNA detection in urine, saliva, blood, gastric aspirate, and stools.

CONCLUSION

Freezing breast milk at -20°C and pasteurization may respectively reduce or eliminate the viral load.

摘要

背景

母乳喂养对 CMV 流行病学有重大影响。哺乳期产后 CMV 再激活的发生率接近母体血清阳性率。虽然围产期 CMV 感染在足月新生儿中几乎没有任何后果,但在某些情况下,可能会导致早产儿出现严重的症状性疾病。本研究的目的是评估 CMV 感染母乳在早产儿中的传播率和临床表现,并检查冷冻处理母乳的安全性。

方法

该研究包括 57 名早产儿及其 CMV 血清阳性母亲。从产后第 1 周到第 9 周收集新鲜母乳样本。检查新鲜母乳和 72、96、120 小时冷冻样本中 CMV 的存在情况,并检测尿液样本。

结果

70.2%的检测母亲出现了感染再激活,在产后 6 周内发现了 CMV 阳性母乳。然而,只有一名婴儿被 CMV 感染,表现为肝损伤,同时伴有多系统受累,尿液、唾液、血液、胃液和粪便中 CMV DNA 检测阳性。

结论

-20°C 冷冻和巴氏消毒可分别降低或消除病毒载量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/842a/3032676/3d329d223b8c/1824-7288-37-6-1.jpg

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