The Nippon Foundation Human Milk Bank, Nihonbashi-koamicho Square Building 1F, 17-10 Nihonbashi-koamicho, Chuo-ku, Tokyo, 103-0016, Japan.
Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan.
Int Breastfeed J. 2023 Jun 8;18(1):29. doi: 10.1186/s13006-023-00563-3.
Reducing the disposal of donated human milk (HM) is important for efficient management of human milk banks (HMBs). The presence of bacteria growth is the main factor that contributes to the disposal of donated HM. The bacterial profile in HM is suspected to differ between term and preterm mothers, with HM from preterm mothers containing more bacteria. Thus, elucidation of the causes of bacterial growth in preterm and term HM may help to reduce the disposal of donated preterm HM. This study compared the bacterial profiles of HM between mothers of term infants and mothers of preterm infants.
This pilot study was conducted in the first Japanese HMB, which was initiated in 2017. This study analyzed 214 human milk samples (term: 75, preterm: 139) donated by 47 registered donors (term: 31, preterm: 16) from January to November 2021. Bacterial culture results in term and preterm HM were retrospectively reviewed in May 2022. Differences in total bacterial count and bacterial species count per batch were analyzed using the Mann-Whitney U test. Bacterial loads were analyzed using the Chi-square test or Fisher's exact test.
The disposal rate did not significantly differ between term and preterm groups (p = 0.77), but the total amount of disposal was greater in the preterm group (p < 0.01). Coagulase-negative Staphylococci, Staphylococcus aureus, and Pseudomonas fluorescens were frequently found in both types of HM. Serratia liquefaciens (p < 0.001) and two other bacteria were present in term HM; a total of five types of bacteria, including Enterococcus faecalis and Enterobacter aerogenes (p < 0.001) were present in preterm HM. The median (interquartile range) total bacterial counts were 3,930 (435-23,365) colony-forming units (CFU)/mL for term HM and 26,700 (4,050-334,650) CFU/mL for preterm HM (p < 0.001).
This study revealed that HM from preterm mothers had a higher total bacterial count and different types of bacteria than HM from term mothers. Additionally, preterm infants can receive nosocomial-infection-causing bacteria in the NICU through their mother's milk. Enhanced hygiene instructions for preterm mothers may reduce the disposal of valuable preterm human milk, along with the risk of HM pathogen transmission to infants in NICUs.
减少捐赠人乳的处理量对于人乳库（HMB）的有效管理很重要。细菌生长是导致捐赠人乳处理的主要因素。早产儿母亲的人乳中的细菌谱被怀疑与足月母亲的人乳中的细菌谱不同，早产儿母亲的人乳中含有更多的细菌。因此，阐明早产儿和足月人乳中细菌生长的原因可能有助于减少捐赠早产儿人乳的处理量。本研究比较了足月婴儿和早产儿母亲的人乳中的细菌谱。
本研究为在 2017 年启动的第一家日本 HMB 中进行的一项初步研究。该研究分析了 2021 年 1 月至 11 月期间，47 名注册捐赠者（足月：31 名，早产：16 名）捐赠的 214 个人乳样本（足月：75 名，早产：139 名）。2022 年 5 月回顾性分析了足月和早产儿 HMB 的细菌培养结果。使用 Mann-Whitney U 检验分析每批总细菌计数和细菌种类计数的差异。使用卡方检验或 Fisher 精确检验分析细菌负荷。
足月组和早产儿组的处理率无显著差异（p=0.77），但早产儿组的处理量较大（p<0.01）。凝固酶阴性葡萄球菌、金黄色葡萄球菌和荧光假单胞菌在两种类型的 HMB 中均经常发现。液化沙雷氏菌（p<0.001）和另外两种细菌存在于足月 HMB 中；总共有 5 种细菌，包括粪肠球菌和产气肠杆菌（p<0.001）存在于早产儿 HMB 中。足月 HMB 的总细菌计数中位数（四分位距）为 3930（435-23365）菌落形成单位（CFU）/mL，早产儿 HMB 为 26700（4050-334650）CFU/mL（p<0.001）。
本研究表明，早产儿母亲的人乳总细菌计数和细菌种类均高于足月母亲的人乳。此外，早产儿在 NICU 中可以通过母亲的乳汁获得医院感染引起的细菌。加强对早产儿母亲的卫生指导，可能会减少有价值的早产儿人乳的处理量，同时降低 HMB 病原体向 NICU 中婴儿传播的风险。
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