Fitzstevens John L, Smith Kelsey C, Hagadorn James I, Caimano Melissa J, Matson Adam P, Brownell Elizabeth A
1 Department of Biology, Swarthmore College, Swarthmore, Pennsylvania, USA.
2 Connecticut Human Milk Research Center, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
Nutr Clin Pract. 2017 Jun;32(3):354-364. doi: 10.1177/0884533616670150. Epub 2016 Sep 27.
Human milk-associated microbes are among the first to colonize the infant gut and may help to shape both short- and long-term infant health outcomes. We performed a systematic review to characterize the microbiota of human milk. Relevant primary studies were identified through a comprehensive search of PubMed (January 1, 1964, to June 31, 2015). Included studies were conducted among healthy mothers, were written in English, identified bacteria in human milk, used culture-independent methods, and reported primary results at the genus level. Twelve studies satisfied inclusion criteria. All varied in geographic location and human milk collection/storage/analytic methods. Streptococcus was identified in human milk samples in 11 studies (91.6%) and Staphylococcus in 10 (83.3%); both were predominant genera in 6 (50%). Eight of the 12 studies used conventional ribosomal RNA (rRNA) polymerase chain reaction (PCR), of which 7 (87.5%) identified Streptococcus and 6 (80%) identified Staphylococcus as present. Of these 8 studies, 2 (25%) identified Streptococcus and Staphylococcus as predominant genera. Four of the 12 studies used next-generation sequencing (NGS), all of which identified Streptococcus and Staphylococcus as present and predominant genera. Relative to conventional rRNA PCR, NGS is a more sensitive method to identify/quantify bacterial genera in human milk, suggesting the predominance of Streptococcus and Staphylococcus may be underestimated in studies using older methods. These genera, Streptococcus and Staphylococcus, may be universally predominant in human milk, regardless of differences in geographic location or analytic methods. Primary studies designed to evaluate the effect of these 2 genera on short- and long-term infant outcomes are warranted.
与母乳相关的微生物是最早在婴儿肠道定植的微生物之一，可能有助于塑造婴儿短期和长期的健康状况。我们进行了一项系统综述，以描述母乳中的微生物群特征。通过全面检索PubMed（1964年1月1日至2015年6月31日）确定了相关的原始研究。纳入的研究在健康母亲中进行，用英文撰写，鉴定母乳中的细菌，使用非培养方法，并在属水平报告原始结果。12项研究符合纳入标准。所有研究在地理位置和母乳采集/储存/分析方法上各不相同。11项研究（91.6%）在母乳样本中鉴定出链球菌，10项研究（83.3%）鉴定出葡萄球菌；在6项研究（50%）中，两者均为主要菌属。12项研究中的8项使用了传统的核糖体RNA（rRNA）聚合酶链反应（PCR），其中7项（87.5%）鉴定出存在链球菌，6项（80%）鉴定出存在葡萄球菌。在这8项研究中，2项（25%）鉴定出链球菌和葡萄球菌为主要菌属。12项研究中的4项使用了下一代测序（NGS），所有这些研究都鉴定出存在链球菌和葡萄球菌且为主要菌属。相对于传统的rRNA PCR，NGS是一种更敏感的方法来鉴定/定量母乳中的细菌属，这表明在使用较老方法的研究中，链球菌和葡萄球菌的优势可能被低估。无论地理位置或分析方法存在差异，链球菌和葡萄球菌这两个菌属可能在母乳中普遍占主导地位。有必要开展旨在评估这两个菌属对婴儿短期和长期结局影响的原始研究。
