Jiménez Esther, Arroyo Rebeca, Cárdenas Nivia, Marín María, Serrano Pilar, Fernández Leonides, Rodríguez Juan M
Dpt. Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain.
Unidadde Endocrinología y Nutrición, Hospital Virgen del Rocío, Seville, Spain.
PLoS One. 2017 Jul 13;12(7):e0181071. doi: 10.1371/journal.pone.0181071. eCollection 2017.
Many physicians, midwives and lactation consultants still believe that yeasts (particularly Candida spp.) play an important role as an agent of nipple and breast pain despite the absolute absence of scientific proofs to establish such association. In this context, the objective of this study was to investigate the microorganisms involved in sore nipples and/or painful "shooting" breastfeeding by using a variety of microscopy techniques, as well as culture-dependent and-independent identification methods. Initially, 60 women (30 diagnosed as suffering "mammary candidiasis" and 30 with no painful breastfeeding) were recruited to elucidate the role of their pumps on the milk microbial profiles. After realizing the bias introduced by using such devices, manual expression was selected as the collection method for the microbiological analysis of milk samples provided by 529 women with symptoms compatible with "mammary candidiasis". Nipple swabs and nipple biopsy samples were also collected from the participating women. Results showed that the role played by yeasts in breast and nipple pain is, if any, marginal. In contrast, our results strongly support that coagulase-negative staphylococci and streptococci (mainly from the mitis and salivarius groups) are the agents responsible for such cases. As a consequence, and following the recommendations of the US Library of Medicine for the nomenclature of infectious diseases, the term "mammary candidiasis" or "nipple thrush" should be avoided when referring to such condition and replaced by "subacute mastitis".
许多医生、助产士和哺乳顾问仍然认为，酵母菌（尤其是念珠菌属）是导致乳头和乳房疼痛的一个重要因素，尽管完全没有科学证据来证实这种关联。在此背景下，本研究的目的是通过使用多种显微镜技术以及依赖培养和不依赖培养的鉴定方法，调查与乳头疼痛和/或哺乳期“刺痛”疼痛相关的微生物。最初，招募了60名女性（30名被诊断患有“乳腺念珠菌病”，30名无哺乳期疼痛），以阐明吸奶器对乳汁微生物谱的影响。在意识到使用此类设备所带来的偏差后，选择手动挤奶作为收集方法，用于对529名有“乳腺念珠菌病”相关症状的女性提供的乳汁样本进行微生物分析。还从参与研究的女性中采集了乳头拭子和乳头活检样本。结果表明，酵母菌在乳房和乳头疼痛中所起的作用（如果有的话）微乎其微。相反，我们的结果有力地支持凝固酶阴性葡萄球菌和链球菌（主要来自缓症链球菌和唾液链球菌组）是导致此类情况的病原体。因此，根据美国国立医学图书馆关于传染病命名的建议，在提及此类病症时应避免使用“乳腺念珠菌病”或“乳头鹅口疮”这一术语，而用“亚急性乳腺炎”来替代。
