Bacteriological Screening of Donor Human Milk Before and After Holder Pasteurization
Bacteriological Screening of Donor Human Milk Before and After Holder Pasteurization
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DOI：
10.1089/bfm.2009.0032
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发表时间：
2010-06-01
影响因子：
2.7
通讯作者：
Updegrove, Kim
中科院分区：
文献类型：
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作者：
Landers, Susan;Updegrove, Kim
背景：为了确定供体母乳是否有细菌污染，我们培养了霍氏巴氏消毒前后的牛奶样本。方法：在2003年期间，所有冷冻供体乳样品在巴氏消毒前解冻并无菌放置在池中。所有单独和合并的样品培养和孵育48小时。对B族链球菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、α -链球菌、肠球菌和芽孢杆菌进行特异性微生物学鉴定。革兰氏阴性杆状细胞（GNRs）有亚型，但未被特异性鉴定。阳性培养以定量菌落计数表达。结果：共培养了303个供体池和810个供体母乳。44池（15%）代表“早产供体母乳”，来自妊娠36周之前分娩的母亲捐赠的母乳。在巴氏灭菌前，185个池（62%）至少生长了一种乳糖发酵GNR， 58个池（19%）生长了第二种乳糖发酵GNR。44%的人培养了不发酵乳糖的GNR， 20%的人培养了氧化酶阳性的GNR。大多数（87%）为葡萄球菌定植。鉴定出的其他革兰氏阳性菌包括肠球菌（16%）、α -链球菌（8%）和金黄色葡萄球菌（4%）。只有一份牛奶样品检测出耐甲氧西林金黄色葡萄球菌。大多数汇集的牛奶样本都有两种或两种以上的微生物。22%的母亲的乳汁在常规培养中没有生长可检测到的细菌。早产母亲的乳汁的细菌定植谱与足月分娩的母亲相似。在对供体牛奶进行常规霍尔德巴氏消毒后，93%的牛奶样本在常规细菌培养中没有生长。结论：各种各样的细菌污染了来自供体母亲的母乳。大多数牛奶样品生长凝固酶阴性葡萄球菌和革兰氏阴性菌。虽然正常的皮肤菌群通常是从牛奶样品中培养出来的，但也有许多巴氏消毒前的牛奶样品被致病菌污染。然而，巴氏灭菌是一种有效的方法，可以从供体母乳样本中去除任何可检测到的细菌。
Background: In order to ascertain any bacterial contamination of donor human milk, we cultured milk samples both before and after Holder pasteurization.Methods: During 2003, all frozen donor milk samples were thawed and aseptically placed in pools prior to pasteurization. All individual and pooled samples were cultured and incubated for 48 hours. Specific microbiologic identification of group B Streptococcus, Staphylococcus aureus, coagulase-negative Staphylococcus, alpha-Streptococcus, Enterococcus, and Bacillus sp. was performed. Gram-negative rods (GNRs) were subtyped but not specifically identified. Positive cultures were expressed in quantitative colony counts.Results: Samples from 303 pools and 810 individual mother's donor milk were cultured. Forty-four pools (15%) represented "preterm donor milk'' from milk donated by mothers who delivered prior to 36 weeks of gestation. Before pasteurization, 185 pools (62%) grew at least one lactose-fermenting GNR, and 58 pools (19%) grew a second lactose-fermenting GNR. Forty-four percent grew a non-lactose-fermenting GNR, and 20% grew an oxidase-positive GNR. The majority (87%) were colonized with Staphylococcus. Other Gram-positive organisms identified included Enterococcus (16%), alpha-Streptococcus (8%), and S. aureus (4%). Only one milk sample was positive for methicillin-resistant S. aureus. The majority of pooled milk samples grew two or more organisms. Milk from 22% of mothers did not grow detectable bacteria on routine cultures. The bacteriologic colonization profiles of milk from mothers delivering prematurely were similar to those of mothers delivering at term. After routine Holder pasteurization of donor milk, 93% of milk samples showed no growth on routine bacterial cultures.Conclusions: A wide variety of bacteria contaminate human milk from donor mothers. Most milk samples grew coagulase-negative Staphylococcus and Gram-negative organisms. Although normal skin flora was cultured typically from milk samples, there were also many prepasteurization milk samples contaminated with pathogenic organisms. Holder pasteurization was, however, an effective means by which to remove any detectable bacteria from samples of donor human milk.