Postnatal cytomegalovirus infection in an extremely premature infant transmitted via breast milk: A case report

Abstract

= Abstract = Cytomegalovirus (CMV) is one of the most commonly encountered viral pathogens in newborn infants and is found in 0.3-2.4% of all live births. It has been demonstrated that 40-96% of seropositive mothers shed the virus via their breast milk. Breast milk containing CMV can cause almost one-third of CMV infections occurring in infants. A case of postnatal CMV infection in an extremely premature infant (gestational age 24 +5 weeks, birth weight 750 g) transmitted via breast milk is presented. For neonatal intensive care unit (NICU) management of severe thrombocytopenia, anemia, and sepsis syndrome, the infant received repeated transfusions of platelets; intravenous (IV) immunoglobulins; and gammairradiated, filtrated packed red cells and was fed her mother's breast milk since the second week of life. CMV infection was diagnosed with positive CMV immunoglobulin M (IgM) and positive urine CMV culture at the second month of life. Considering the negative CMV IgM and urine CMV culture at birth, postnatally-acquired CMV infection was suspected and confirmed with completely identical nucleotide sequence alignments of the infantile blood isolate and the maternal breast milk isolate. To our knowledge, this is the first case of proven postnatal CMV infection transmitted via breast milk in an extremely premature infant in Korea. (Korean J Pediatr 2009;52:1053-1058

A New High Hydrostatic Pressure Process to Assure the Microbial Safety of Human Milk While Preserving the Biological Activity of Its Main Components

“…In addition, this HHP process was evaluated for the inactivation of cytomegalovirus (CMV). This virus was selected due to its risk of human milk contamination and risk of postnatal infection ( 40 , 42 – 44 ).…”

“… b Inactivation Efficiency (IE) of Staphylococcus aureus (ATCC 6538) after the new HHP treatment. The inoculation rate was limited to 5.7 log the initial contamination of human milk accepted for a decontamination treatment (as LTLT as the present time) by Staphylococcus aureus being limited to 4 log due to the release of toxins ( 40 ) . …”

Inactivation of Cytomegalovirus in Breast Milk Using Ultraviolet-C Irradiation: Opportunities for a New Treatment Option in Breast Milk Banking

“…The severity of infection is varied and a detrimental effect on the long term developmental outcomes for infected infants has not consistently been shown. Illustrating the confusion surrounding this area, while some investigators have concluded that post-partum CMV infection is a relatively mild and self-limiting infection with no obvious long term sequelae [ 20 ], others have published case studies of infants that are severely affected by infection [ 12 , 21 ] and a recent multi-centre study demonstrated an association between postnatal CMV infection and increased risk of bronchopulmonary dysplasia [ 22 ]. In 2010 an evaluation of the current post-partum CMV infection literature concluded that no statements could be justified that either endorsed or did not recommend treatment of breast milk where mothers were excreting CMV [ 23 ].…”

Impact of a Home Care Educational Program for Mothers Having Pre-term Infants in General Hospitals in Port Said

“…Infections constitute a serious problem for preterm infants given their higher susceptibility due to immaturity of their immune system. As a result, they may not be able to adequately fight off bacteria, fungi, viruses and other organisms that can cause infections (Mullany et al, 2003;Kim et al, 2009). Oral thrush may occur in babies because their immune systems take time to mature, making them less able to resist infection.…”