Padín Fontán Marta, Martín-Forero Maestre Montserrat, Rodríguez Otero Iván, Durán Fernández-Feijoo Cristina, Suárez Albo María, Concheiro Guisán Ana
Sección de Neonatología y Banco de Leche de Vigo (BLV). Hospital Álvaro Cunqueiro.
Nutr Hosp. 2022 Oct 17;39(5):1064-1067. doi: 10.20960/nh.04014.
Introduction: breastfeeding is the gold standard for infant's nutrition. Human milk bank is an essential tool to guarantee availability and safety in those situations when breastfeeding is not an option. The manipulation during the extraction of the human milk by the donors is a critical point to ensure an adequate microbiological safety. Therefore, knowing the bacterial flora that prevails in donated milk is essential to draw conclusions that can lead to taking measures in the management of the bank. Objectives: to analyze the prevalence of microorganisms in milk samples donated to the milk bank and how the bacterial flora behaves according to the profile of the donors and the donor milk circuits. Methods: the present work is a retrospective descriptive observational study that analyzes characteristics and the positive microbiological results within our milk bank samples from June 1, 2016 to December 31, 2020. All milk bank donors voluntarily signed an informed consent that authorizes the use of data to investigation. Results: during the study period, a total of 1,587 liters of raw milk were donated by 266 women, highlighting that, despite the SARS-CoV-2 virus pandemic, 2020 has been the year in which more volume of milk has been dispensed. The results show that 221 batches had at least one positive microbiological isolation (149 of them were before and 46 after pasteurization). Pre and post-pasteurization rate varies over the years with a decrease in the pre-pasteurization discard rate (3,9%) and increase in the post-pasteurization rate (5,3%). The most frequently isolated germs found in pre-pasteurization cultures were gram positive cocci and Enterobacter and a decrease in the positivity to S. aureus after establishing an eradication protocol. In post-pasteurization cultures, the most commonly found germs are Bacillus. Regarding the donor's profile, it was found a non statistically significant way that those women with the highest donation volume and/or admission of their offspring in Neonatology were associated with higher frequency of positive cultures. Conclusions: bacteriological analysis of milk samples is an essential part of quality control for a milk bank. Our results reflect a good extraction system and transportation, as well as good training from the bank's professionals. Nevertheless, improvement of processes is necessary to reduce the rate of contamination and the amount of discarded milk.
母乳喂养是婴儿营养的黄金标准。母乳库是在无法进行母乳喂养的情况下确保母乳供应和安全的重要工具。捐赠者在采集母乳过程中的操作是确保足够微生物安全性的关键点。因此,了解捐赠母乳中占主导的细菌菌群对于得出可促使母乳库采取管理措施的结论至关重要。
分析捐赠给母乳库的母乳样本中微生物的流行情况,以及细菌菌群如何根据捐赠者的特征和捐赠母乳流程表现。
本研究是一项回顾性描述性观察研究,分析了2016年6月1日至2020年12月31日期间我们母乳库样本的特征和微生物学阳性结果。所有母乳库捐赠者均自愿签署知情同意书,授权使用数据进行调查。
在研究期间,266名女性共捐赠了1587升生乳,值得注意的是,尽管有新冠病毒大流行,2020年仍是分发母乳量最多的一年。结果显示,221批样本至少有一次微生物学阳性分离(其中149批在巴氏杀菌前,46批在巴氏杀菌后)。巴氏杀菌前后的比率多年来有所变化,巴氏杀菌前的废弃率下降(3.9%),巴氏杀菌后的比率上升(5.3%)。在巴氏杀菌前培养物中最常分离出的细菌是革兰氏阳性球菌和肠杆菌,在制定根除方案后金黄色葡萄球菌的阳性率有所下降。在巴氏杀菌后培养物中,最常见的细菌是芽孢杆菌。关于捐赠者的特征,发现捐赠量最高和/或其后代入住新生儿科的女性与阳性培养物频率较高之间没有统计学上的显著关联。
母乳样本的细菌学分析是母乳库质量控制的重要组成部分。我们的结果反映了良好的采集系统和运输,以及母乳库专业人员的良好培训。然而,有必要改进流程以降低污染率和废弃母乳量。