Expressed Breast Milk as a Predictor of Neonatal Yeast Colonization in an Intensive Care Setting

Chow, Brian; Reardon, Juan; Perry, Emily O.; Laforce-Nesbitt, Sonia S.; Tucker, Richard; Bliss, Joseph M.

doi:10.1093/jpids/pit090

Cited by 7 publications

(8 citation statements)

References 26 publications

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“…4 Data presented here suggest that there may be an association between lysozyme and dermcidin concentration in expressed breast milk and colonization with yeast in a neonatal intensive care setting when individual milk samples were analyzed, taking into account that subjects may have contributed more than one milk specimen. Concentrations of the host defense proteins, lysozyme and dermcidin, were lower in breast milk given to infants colonized with yeast than in the breast milk given to uncolonized infants.…”

Section: Discussionmentioning

confidence: 93%

“…Results from the entire cohort have been reported in detail elsewhere. 4 Of the original 129 subjects with culture data available, 61 infants were eligible for inclusion in the present study. In this subgroup, 16% were colonized, all with Candida species.…”

Section: Resultsmentioning

confidence: 99%

“…3 An association of fungal colonization with receipt of expressed breast milk colonized with yeast has also recently been reported. 4 …”

Section: Introductionmentioning

confidence: 99%

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Host Defense Proteins in Breast Milk and Neonatal Yeast Colonization

Chow

Reardon

Perry³

et al. 2015

J Hum Lact

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Background Colonization increases risk for invasive candidiasis in neonates. Breast milk host defense proteins may affect yeast colonization of infants. Objective To evaluate breast milk host-defense proteins relative to yeast colonization in infants. Methods Infants admitted for longer than 72h to the NICU at Women and Infants Hospital in Providence, RI, were eligible. After consent, expressed breast milk and swabs from oral, rectal, and inguinal sites from infants were cultured weekly for 12 weeks, or until discharge, transfer, or death. Breast milk was tested for levels of human lactoferrin, lysozyme, apolipoprotein J, mucin-1, dermcidin, and soluble CD14 using commercial ELISA. Concentrations of these components were compared in breast milk received by infants who were colonized or not colonized with yeast. Results From an original cohort of 130, 61 infants had samples available for this subanalysis. A convenience sample of stored breast milk was analyzed. Median lactoferrin, apolipoprotein J, and mucin-1, did not differ between colonized and uncolonized groups. Soluble CD14 was higher in the surface-colonized group (1.8 μg/ml, n=12) compared with the surface-uncolonized group (1.6 μg/ml, n=12, p=0.02). Median lysozyme levels were higher in the surface-uncolonized group (483.0 ng/ml, n=12) vs. the surface-colonized group (298.3 ng/ml, n=12, p=0.04). Median dermcidin levels were higher in the surface-uncolonized group (19.4 ng/ml, n= 12) vs. the surface-colonized group (8.7 ng/ml, n=12, p=0.04). Conclusions This study shows an association between colonization with Candida in neonates and lower levels lysozyme and dermcidin in received breast milk. Further study is needed to confirm these findings.

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Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

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Host Defense Proteins in Breast Milk and Neonatal Yeast Colonization

Chow

Reardon

Perry³

et al. 2015

J Hum Lact

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“…However, colonization with C. parapsilosis generally occurs later in the course of ICU admission and is the organism more commonly cultured from the hands of health care workers, suggesting horizontal transmission of this species [13]. The more recent finding that receiving breast milk colonized with yeast is associated with yeast colonization in preterm infants, albeit not always by the same species, highlights an additional potential exposure unique to these patients relative to other groups at risk [15]. …”

Section: Risk Factorsmentioning

confidence: 99%

Neonatal Candidiasis: New Insights into an Old Problem at a Unique Host-Pathogen Interface

Arsenault

Bliss

2015

Curr Fungal Infect Rep

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Candida species are the leading cause of invasive fungal infections in premature infants. Associated with substantial morbidity and mortality, these infections represent serious and sometimes catastrophic complications in the course of hospitalization of a preterm infant in the neonatal intensive care unit. Although virulence factors of Candida and the host defense mechanisms that are important in protection from candidiasis have been the subject of intensive study, considerably less is known about the features of this disease that are specific to premature neonates. As animal models for neonatal candidiasis have been developed, efforts to understand the similarities and differences of candidiasis in the neonatal host relative to other immunocompromised patients have begun to provide insights to these questions.

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“…has been linked to yeast colonization in infants. (23) As such, breast milk serves as a potential ongoing yeast exposure for infants throughout the neonatal period. Therefore, any effective prophylactic regimen meant to prevent or eliminate gastrointestinal colonization likely requires ongoing administration.…”

Section: Discussionmentioning

confidence: 99%

Dietary Supplementation With Medium-Chain Triglycerides Reduces Candida Gastrointestinal Colonization in Preterm Infants

Arsenault

Gunsalus

Laforce-Nesbitt

et al. 2019

Pediatric Infectious Disease Journal

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Expressed Breast Milk as a Predictor of Neonatal Yeast Colonization in an Intensive Care Setting

Abstract: Recovery of yeast from breast milk is associated with colonization with yeast in the neonate. Because Candida transmission via breast milk had a 30% concordance, breast milk is only one of several ways colonization occurs. Further study is needed on mechanisms of colonization.

Cited by 7 publications

References 26 publications

Host Defense Proteins in Breast Milk and Neonatal Yeast Colonization

Host Defense Proteins in Breast Milk and Neonatal Yeast Colonization

Neonatal Candidiasis: New Insights into an Old Problem at a Unique Host-Pathogen Interface

Dietary Supplementation With Medium-Chain Triglycerides Reduces Candida Gastrointestinal Colonization in Preterm Infants

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