Infection Control Unit, Grenoble Alpes University Hospital, Grenoble, France; Univ Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France(1).
Infection Control Unit, Grenoble Alpes University Hospital, Grenoble, France.
Int J Hyg Environ Health. 2019 Mar;222(2):183-187. doi: 10.1016/j.ijheh.2018.09.003. Epub 2018 Sep 25.
This study analyzes the bacteriological quality of breast milk samples destined to direct milk donation to preterm infants under 34 Gestational Weeks (GW) hospitalized in a neonatology and a neonatal intensive care unit of a French university hospital. All samples of breast milk destined to direct milk donation between April 2007 and December 2016 were included. A sample was defined as compliant if its total flora was less than 10 Colony Forming Units per milliliter (CFU/mL) and in the absence of Staphylococcus aureus and other pathogens. A total of 777 samples were taken from 629 mothers. The overall non-compliance rate for the initial sample was 21.3%; 63 samples (10.0%) had a total flora ≥ 10 CFU/mL, 63 (10.0%) were contaminated by a pathogenic bacteria and 8 (1.3%) were non-compliant because of both. An increase of the non-compliance rate was observed between 2008 and 2016 (10.2%-26.1%). The increase of the total flora non-compliance rate began in 2011, in link with the doubling of the number of samples taken, to reach a peak in 2013 then decreased in link with development of portable pump. No statistically significant difference of the presence of S. aureus in breast milk was observed. For the other pathogenic bacteria, the rate increased significantly in 2014. The increase of the non-compliance rate could be explained by a decrease of best practices in milk collection. Education of mothers should be strengthened.
本研究分析了法国某大学附属医院新生儿科和新生儿重症监护病房中,拟直接捐赠给胎龄小于 34 周的早产儿的母乳样本的细菌学质量。所有在 2007 年 4 月至 2016 年 12 月间拟直接捐赠的母乳样本均包含在内。如果总菌群少于每毫升 10 个菌落形成单位(CFU/mL),且不存在金黄色葡萄球菌和其他病原体,则认为样本合格。共采集了 629 位母亲的 777 个样本。初始样本的总体不合格率为 21.3%;63 个样本(10.0%)的总菌群≥10 CFU/mL,63 个样本(10.0%)受到病原菌污染,8 个样本(1.3%)因两者均不合格。2008 年至 2016 年期间,不合格率呈上升趋势(10.2%-26.1%)。总菌群不合格率的上升始于 2011 年,与样本数量的翻倍有关,在 2013 年达到峰值,随后随着便携式泵的发展而下降。母乳中金黄色葡萄球菌的存在没有统计学差异。对于其他病原菌,2014 年的检出率显著增加。不合格率的上升可能是由于采集母乳时最佳操作减少所致。应加强对母亲的教育。