Transmission of Cytomegalovirus From Mothers to Preterm Infants by Breast Milk

Jim, Wai-Tim; Shu, Chyong-Hsin; Chiu, Nan-Chang; Kao, Hsin-An; Hung, Han-Yang; Chang, Jui‐Hsing; Peng, Chun-Chih; Hsieh, Wen-Shyang; Liu, Kuei-Chen; Huang, Fu‐Yuan

doi:10.1097/01.inf.0000137571.35541.55

Cited by 96 publications

(100 citation statements)

References 23 publications

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“…However, no studies performed to date had evaluated the effects of frozen-thawed breast milk in a clinical context. Taken together, 22,29,32,33 these data and our results suggest that frozen-thawed breast milk reduces CMV transmission rates, although differences between ethnic groups and endemic CMV strains must also be taken into account.…”

Section: Discussionmentioning

confidence: 63%

“…[18][19][20] Recently, maternal CMV reactivation during lactation was analyzed by PCR. [9][10][11][12][21][22][23] In these studies, the rate of CMV DNA-lactia ranged from 87.5 to 97.3%. In our study, all seropositive mothers had CMV DNA in their breast milk.…”

Section: Discussionmentioning

confidence: 99%

“…In a prospective study of 38 CMV seropositive mothers and their 42 infants (<35 weeks gestational age; <1500 g birth weight) in Taiwan, the infants largely received frozenthawed breast milk; 6 of 40 infants (15%) exposed to CMV DNApositive breast milk acquired CMV infection, although a sepsis-like syndrome was observed in 5 of the 6 infected infants. 22 In another prospective study of 56 CMV seropositive mothers and 65 of their infants (<1000 g birth weight) in Canada, the infants mainly received frozen-thawed breast milk; 4 of 65 infants (6%) acquired CMV infection, and sepsis-like syndrome was observed in 1 of 4 (25%) infants. 29 In our studies and these, frozen milk was mainly used and the transmission rates were low compared with Hamprecht et al's 11 findings.…”

Section: Discussionmentioning

confidence: 99%

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Transmission of cytomegalovirus via breast milk in extremely premature infants

et al. 2010

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Objective: We prospectively evaluated the rate of postnatal cytomegalovirus (CMV) transmission through breast milk in extremely premature infants to address the impact of CMV infection on preterm infants during lactation.Study Design: A total of 25 mothers and 27 infants (two sets of twins) with birth weights <1000 g and/or gestational ages <28 weeks were enrolled in the study. They were mostly fed frozen-thawed breast milk. Breast milk, serum and urine samples were collected every 2 weeks and screened for CMV infection using the real-time polymerase chain reaction.Result: All of the 21 CMV-seropositive mothers had detectable CMV DNA in their breast milk, with a peak at 4 to 6 weeks postpartum. CMV infection was confirmed in only one infant (4.3%) who displayed almost no clinical symptoms. Conclusion:At our institutes, we mainly use frozen-thawed breast milk. We found low CMV transmission rates even in extremely premature infants, and the CMV-positive infant did not develop serious symptoms.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Transmission of cytomegalovirus via breast milk in extremely premature infants

et al. 2010

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“…Other studies re ported a CMV transmission rate of 2.5% to 15% when FT BM is used [29][30][31] . While HP is highly effective at removing viable CMV, it may inactivate biologically active components such as Igs, enzymes, hormones, growth factors, cytokines, and heat-labile vitamins 6,32) .…”

Section: Resultsmentioning

confidence: 99%

Breast Milk-Transmitted Cytomegalovirus Infection in Preterm Infants

Gang

Chang

2018

Neonatal Med

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Purpose: The purpose of this study is to describe the rate of cytomegalovirus (CMV) virolactia, and the prevalence of breast milk (BM)-transmitted postnatal CMV infection among premature infants after freeze-thawing (FT) and Holder pasteurization (HP) of breast milk. Methods: This is a single-center, retrospective study of 312 infants born at less than 32 weeks of gestation, or with a birth weight less than 1,500 g from January 2013 to June 2017. All infants were screened for CMV-specific immunoglobulin (Ig) G and IgM at birth. Initial CMV specific polymerase chain reaction (PCR) and CMV culture were performed on mothers' BM and babies' urine within the first 21 days of life. FT and HP of BM was used to prevent the transmission of CMV. For the surveillance of postnatal CMV infection, CMV culture and CMV specific PCR of urine from babies were repeated one to two months after the initial screening. Screening for viremia and viruria was performed if postnatal CMV infection was suspected. Results: Among 178 BM samples obtained from mothers of CMV-IgG-seropositive infants, 80 (44.9%) were CMV PCR positive. CMV deoxyribonucleic acid (DNA) was detected in five of the 22 BM samples (22.7%) obtained from the mothers of CMV-IgG seronegative infants. When CMV DNA load in BM was measured before and after HP, various results were shown. Sixty-three infants out of 232 (27.2%) were evaluated for postnatal CMV infection and four infants out of 63 (6.3%) were infected. Conclusion: Interventions to prevent BM-transmitted CMV infection can reduce the chance of postnatal CMV infection, but not completely eliminate it.

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“…Negli anni successivi diversi Autori in vari paesi hanno studiato la trasmissione dell'infezione da CMV con il latte materno nei neonati prematuri o di basso peso alla nascita e le ripercussioni cliniche di questa trasmissione. [18][19][20][21][22] Nella Tabella 1 sono sintetizzati i risultati dei principali studi condotti negli ultimi anni; le differenze che si osservano tra uno studio e l'altro, in parte attribuibili alle diverse metodologie di lavoro e ai diversi criteri utilizzati per la definizione di infezione sintomatica, sono sicuramente in parte dovute al fatto che in numerosi studi il latte materno non veniva somministrato fresco, ma in parte o completamente dopo essere stato congelato; l'utilizzo di latte congelato può aver contribuito a creare qualche bias sulla problematica relativa all'acquisizione dell'infezione da CMV con il latte materno nel pretermine, in quanto il congelamento, come noto, può ridurre l'infettività del latte. 12,23 Solamente 3 studi 16/17, 20, 21 dopo quelli condotti da Vochem e Hamprecht 14,15 hanno utilizzato latte umano non trattato durante il periodo dello studio.…”

Section: Cytomegalovirus (Cmv)unclassified

Herpesviruses and breast milk

et al. 2014

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Breast milk has always been the best source of nourishment for newborns. However, breast milk can carry a risk of infection, as it can be contaminated with bacterial or viral pathogens. This paper reviews the risk of acquisition of varicella-zoster virus (VZV) and cytomegalovirus (CMV), herpesviruses frequently detected in breastfeeding mothers, via breast milk, focusing on the clinical consequences of this transmission and the possible strategies for preventing it. Maternal VZV infections are conditions during which breastfeeding may be temporarily contraindicated, but expressed breast milk should always be given to the infant. CMV infection acquired through breast milk rarely causes disease in healthy term newborns; an increased risk of CMV disease has been documented in preterm infants. However, the American Academy of Pediatrics (AAP) does not regard maternal CMV seropositivity as a contraindication to breastfeeding; according to the AAP, in newborns weighing less than 1500 g, the decision should be taken after weighing the benefits of breast milk against the risk of transmission of infection. The real efficacy of the different methods of inactivating CMV in breast milk should be compared in controlled clinical trials, rigorously examining the negative consequences that each of these methods can have on the immunological and nutritional properties of the milk itself, with a view to establish the best risk-benefit ratio of these strategies before they are recommended for use in clinical practice. RiassuntoIl latte materno rappresenta da sempre il migliore alimento per il neonato. Esso, tuttavia, può comportare un rischio infettivo, in quanto può essere contaminato sia da agenti batterici sia da agenti virali. Lo scopo di questa revisione è quello di descrivere lo "stato dell'arte" sul rischio di trasmissione con il latte materno degli herpesvirus di più frequente riscontro nella donna che allatta: varicella-zoster virus (VZV) e cytomegalovirus (CMV), sulle conseguenze cliniche di questa trasmissione e sulle possibili strategie di prevenzione. Per quanto riguarda l'infezione da VZV, le linee guida formulate per l'Unione Europea, che raccomandano di separare la madre con varicella in atto dal neonato durante la fase contagiosa, ma di alimentare sempre ed esclusivamente il neonato protetto con le immunoglobuline specifiche anti-VZV con il latte materno spremuto, appaiono appropriate, in quanto tengono in considerazione sia il rischio potenziale di acquisire una varicella postnatale sia gli innumerevoli benefici del latte materno. Per quanto riguarda l'infezione da CMV, allattare o no con latte materno i neonati prematuri nati da madre CMV-positiva rimane ad oggi una questione controversa. L'Accademia Americana di Pediatria considera la sieropositività materna per CMV come una condizione che non controindica l'allattamento materno, anche nei neonati prematuri. I diversi metodi di inattivazione del CMV nel latte umano dovrebbero essere confrontati in trials clinici controllati, valutando rigorosamente le r...

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Transmission of Cytomegalovirus From Mothers to Preterm Infants by Breast Milk

Cited by 96 publications

References 23 publications

Transmission of cytomegalovirus via breast milk in extremely premature infants

Transmission of cytomegalovirus via breast milk in extremely premature infants

Breast Milk-Transmitted Cytomegalovirus Infection in Preterm Infants

Herpesviruses and breast milk

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