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可致早产儿严重感染:医院和人乳库层面的意义。

Induces Severe Infections in Preterm Neonates: Implication at the Hospital and Human Milk Bank Level.

机构信息

Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France.

Région Île-de-France Human Milk Bank, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France.

出版信息

Toxins (Basel). 2021 Feb 7;13(2):123. doi: 10.3390/toxins13020123.

Abstract

Human breast milk (HBM) is a source of essential nutrients for infants and is particularly recommended for preterm neonates when their own mother's milk is not available. It provides protection against infections and decreases necrotizing enterocolitis and cardiovascular diseases. Nevertheless, HBM spoilage can occur due to contamination by pathogens, and the risk of a shortage of HBM is very often present. is the most frequent ubiquitous bacteria responsible for HBM being discarded. It can contaminate HBM at all stages, from its collect point to the storage and delivery. can induce severe infection in newborns with very low birth weight, with sometimes fatal outcomes. Although the source of contamination is rarely identified, in some cases, HBM was suspected as a potential source. Even if the risk is low, as infection due to in preterm infants should not be overlooked, human milk banks follow strict procedures to avoid contamination, to accurately identify remaining bacteria following pasteurization and to discard non-compliant milk samples. In this review, we present a literature overview of infections reported in neonates and the suspected sources of contamination. We highlight the procedures followed by the human milk banks from the collection of the milk to its microbiological characterization in Europe. We also present improved detection and decontamination methods that might help to decrease the risk and to preserve the public's confidence in this vital biological product for infants whose mothers cannot breastfeed.

摘要

人乳(HBM)是婴儿必需营养素的来源,尤其是当早产儿的母亲无法提供母乳时,更推荐使用 HBM。它提供了抗感染的保护,降低了坏死性小肠结肠炎和心血管疾病的风险。然而,由于病原体污染,HBM 可能会变质,而且 HBM 短缺的风险经常存在。 是最常见的普遍存在的细菌,负责 HBM 的丢弃。它可以在 HBM 的所有阶段污染,从收集点到储存和运输。 在极低出生体重的新生儿中可引起严重感染,有时导致致命后果。尽管污染的来源很少被确定,但在某些情况下,HBM 被怀疑是潜在的来源。即使风险较低,由于感染 不应该忽视早产儿,人乳库遵循严格的程序来避免污染,在巴氏消毒后准确识别残留细菌,并丢弃不符合标准的奶样。在这篇综述中,我们介绍了在新生儿中报告的 感染和疑似污染来源。我们强调了欧洲人乳库从收集母乳到对其进行微生物特征分析所遵循的程序。我们还介绍了改进的检测和去污方法,这些方法可能有助于降低风险,并保持公众对这种对无法母乳喂养的婴儿至关重要的生物制品的信心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfa9/7915446/3bdcf30a909e/toxins-13-00123-g001.jpg

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