Microbial Diversity in Milk of Women With Mastitis: Potential Role of Coagulase-Negative Staphylococci, Viridans Group Streptococci, and Corynebacteria

Mediano, Pilar; Fernández, Leónides; Jiménez, Esther; Arroyo, Rebeca; Espinosa-Martos, Irene; Rodríguez, Juan M.; Marín, María

doi:10.1177/0890334417692968

Cited by 53 publications

(52 citation statements)

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“…Among the latter, S. epidermidis is emerging as the leading cause of mastitis worldwide (Contreras and Rodríguez, 2011). In this sense, the results of the present study confirm the important role that S. epidermidis plays as an etiologic agent in human mastitis, in agreement with previous studies (Delgado et al, 2008, 2009; Mediano et al, 2017). …”

Section: Discussionsupporting

confidence: 93%

“…R. mucilaginosa , the most common species of this genus isolated in this study, has been previously involved in prosthetic device infections, which could be related, as in the case of coagulase-negative staphylococci, to the organism’s ability to produce a biofilm (Bruminhent et al, 2013). In this study, Corynebacterium and Rothia were found in 11 and 22% of samples, respectively, which suggests an important role in human mastitis pathogenesis, according to a previous study (Mediano et al, 2017). In relation to antimicrobial susceptibility, the VITEK 2 technology used for AST in this study is not available for these bacterial genera yet, and therefore the analyses of their antimicrobial resistance profiles will be part of a future study.…”

Section: Discussionsupporting

confidence: 83%

“…Most streptococci isolated from mastitis samples belonged to the VGS, mainly to mitis and salivarius groups, as previously reported (Delgado et al, 2008; Arroyo et al, 2010; Mediano et al, 2017). These microorganisms are normally related to subacute and subclinical processes (WHO, 2000; Contreras and Rodríguez, 2011).…”

Section: Discussionsupporting

confidence: 83%

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Identification of Emerging Human Mastitis Pathogens by MALDI-TOF and Assessment of Their Antibiotic Resistance Patterns

Marín

Arroyo²,

Espinosa-Martos³

et al. 2017

Front. Microbiol.

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Lactational mastitis constitutes one of the main causes of undesired weaning, depriving the mother–infant pair from the benefits of breastfeeding; therefore, this condition should be considered a relevant public health issue. The role of specific microorganisms remains unclear since human milk cultures and antibiotic susceptibility testing (AST) are not routinely performed, despite the fact that this would be key to ensure an early and effective diagnosis and treatment. The objective of this study was to describe the culturable microbial diversity in 647 milk samples from breastfeeding women with clinical symptoms of mastitis by Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF) VITEK MS technology and to analyze the antimicrobial susceptibility profiles of a collection of isolates from these samples by the VITEK 2 AST system. Staphylococcus epidermidis was the most common species isolated from mastitis samples (87.6%), while Staphylococcus aureus was detected in 22.1%. Streptococci constituted the second (68.6%) most prevalent bacterial group, with Streptococcus mitis/oralis, Streptococcus salivarius, and Streptococcus parasanguinis detected with frequencies of 40.8, 36.8, and 14.4%, respectively. The antibiotic susceptibility profiles of 642 staphylococcal isolates indicated a remarkable resistance to benzylpenicillin (88.3%) and erythromycin (67.3%) with differences between species. A high percentage of Staphylococcus isolates were resistant to at least one antibiotic (Staphylococcus hominis, 100%; S. epidermidis, 98.2%; S. aureus, 92.9%; Staphylococcus lugdunensis, 90.5%) and the percentage of multidrug-resistance (MDR) isolates was noticeable (S. hominis, 81%; S. epidermidis, 64.4%; S. aureus, 11.5%; S. lugdunensis, 10.5%). In relation to streptococcal isolates (n = 524), AST revealed high or moderate percentages of resistance to erythromycin (68.7%), benzylpenicillin (63.7%), ampicillin (51.5%), and tetracycline (30.8%). Antibiotic resistance to at least one antibiotic was detected in 97.6% of S. parasanguinis, 92.6% of S. salivarius, 83.3% of S. mitis/oralis, and 72.4% of Streptococcus vestibularis isolates. A significant number of MDR streptococcal isolates was also found (S. parasanguinis, 51.2%; S. salivarius, 39.3%; S. mitis/oralis, 34.6%; and S. vestibularis, 19%). The results highlight the important role of coagulase-negative staphylococci and streptococci as human mastitis-causing agents. Moreover, the high rates of antimicrobial resistance among these microorganisms must be contemplated as an issue of clinical relevance in relation to treatment options.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 83%

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Identification of Emerging Human Mastitis Pathogens by MALDI-TOF and Assessment of Their Antibiotic Resistance Patterns

Marín

Arroyo²,

Espinosa-Martos³

et al. 2017

Front. Microbiol.

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“…Such diagnosis is made in virtually all cases by visual assessment of the breast, without supporting laboratory findings and ignoring that the evidence of a potential association Candida -painful breastfeeding is largely anecdotal [10,11]. Recently, studies applying milk microbial analysis (including some examining for the presence of yeasts) have shown that coagulase-negative staphylococci (CNS), streptococci (mitis and salivarius groups) and corynebacteria may be actually the agents responsible for such symptoms [12–15]. However, studies directed to specifically and systematically investigate the presence or absence of Candida cells and/or DNA in a large collection of milk samples from women with these symptoms are very scarce.…”

Section: Introductionmentioning

confidence: 99%

Mammary candidiasis: A medical condition without scientific evidence?

et al. 2017

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Many physicians, midwives and lactation consultants still believe that yeasts (particularly Candida spp.) play an important role as an agent of nipple and breast pain despite the absolute absence of scientific proofs to establish such association. In this context, the objective of this study was to investigate the microorganisms involved in sore nipples and/or painful “shooting” breastfeeding by using a variety of microscopy techniques, as well as culture-dependent and–independent identification methods. Initially, 60 women (30 diagnosed as suffering “mammary candidiasis” and 30 with no painful breastfeeding) were recruited to elucidate the role of their pumps on the milk microbial profiles. After realizing the bias introduced by using such devices, manual expression was selected as the collection method for the microbiological analysis of milk samples provided by 529 women with symptoms compatible with “mammary candidiasis”. Nipple swabs and nipple biopsy samples were also collected from the participating women. Results showed that the role played by yeasts in breast and nipple pain is, if any, marginal. In contrast, our results strongly support that coagulase-negative staphylococci and streptococci (mainly from the mitis and salivarius groups) are the agents responsible for such cases. As a consequence, and following the recommendations of the US Library of Medicine for the nomenclature of infectious diseases, the term “mammary candidiasis” or “nipple thrush” should be avoided when referring to such condition and replaced by “subacute mastitis”.

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“…Los principales marcadores de inflamación son la plasmina y su zimógeno, el plasminóge-no, la elastasa y las catepsinas D y B, que provienen de leucocitos neutrófilos llegados desde la circulación 45 . También hay que considerar que las bacterias que causan la mastitis liberan en la leche sus propios enzimas que, además de causar proteólisis, dañan el tejido mamario y pueden enfermar al consumidor [46][47][48] . Teniendo en cuenta la calidad de las proteínas de la leche humana así como las identidades y actividades de sus enzimas y péptidos, el desarrollo y aplicación de metódicas de transcriptómica, proteómica y técnicas de bioinformática permitirán evaluar de mejor manera su funcionamiento y significado fisiológico.…”

Section: Hidrólisis De Las Proteínas De La Leche Materna Y Madurez Fetalunclassified

Avances en el conocimiento de las proteínas de la leche materna

Brunser

2018

Rev. chil. pediatr.

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Recibido el 25 de abril de 2017; aceptado el 12 de octubre de 2017 Palabras clave: Leche materna; enzimas; péptidos; tripsina; plasmina ResumenLa glándula mamaria y la leche materna son el resultado de millones de años de una evolución que llevó a una composición óptima para el crecimiento y desarrollo de recién nacidos y lactantes; la leche materna favorece el crecimiento, la adaptación y la supervivencia de su organismo y de sus órganos inmaduros. Análisis recientes han demostrado en ella la presencia de 1606 proteínas que en su mayoría son sintetizadas en los acinos de la glándula mamaria aunque otras proteínas y péptidos provienen de órganos como el sistema linfático y el aparato digestivo. La composición de la leche materna incluye enzimas que modifican sus proteínas y originan péptidos antimicrobianos, antihipertensivos y estimuladores del metabolismo. Esta actividad proteolítica actúa en sitios específicos de las cadenas peptídicas de la proteína de la leche. La activación extemporánea de estos enzimas en los acinos es regulada por péptidos inhibidores y activadores que previenen procesos inflamatorios. Algunos enzimas de la leche actúan en el tubo digestivo de recién nacidos y lactantes y complementan la menor concentración y actividad de sus propios enzimas digestivos. Así, la enteroquinasa de la leche estimula la liberación de enzimas pancreáticos (mediada por el estímulo de la colecistoquininapancreozimina); la lipasa activada por las sales biliares complementa la baja producción de lipasa pancreática. Estas actividades probablemente facilitan la nutrición de los prematuros, cuyo tubo digestivo es más permeable a las proteínas parcialmente hidrolizadas y cuyas actividades enzimáticas y factores defensivos locales no han alcanzado su plena madurez. Esto también puede estimular en ellos la tolerancia inmunológica. En este artículo se presentan los aspectos fisiológicos relevantes de la leche materna, y los avances en el conocimiento de su composición, para el cabal conocimiento del pediatra de esta importante materia. Keywords:Breast milk; enzymes; peptides; trypsin; plasmin AbstractThe mammary gland and maternal milk are the product of millions of years of evolution that resulted in an optimal composition that sustains the growth and development of newborns and infants. Maternal milk supports the growth, adaptation and survival of this immature organism. Recent studies have detected 1606 different proteins in human milk, most of them synthesized in the acini of the glandular tissue while others originate from distant organs such as the lymphoid tissue and the digestive tract. Maternal milk enzymes modify its proteins and liberate peptides with antimicrobial, antihypertensive or stimulatory activities. This proteolytic activity occurs at specific sites in peptide Correspondencia: obrunser@icloud.com

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Microbial Diversity in Milk of Women With Mastitis: Potential Role of Coagulase-Negative Staphylococci, Viridans Group Streptococci, and Corynebacteria

Cited by 53 publications

References 51 publications

Identification of Emerging Human Mastitis Pathogens by MALDI-TOF and Assessment of Their Antibiotic Resistance Patterns

Identification of Emerging Human Mastitis Pathogens by MALDI-TOF and Assessment of Their Antibiotic Resistance Patterns

Mammary candidiasis: A medical condition without scientific evidence?

Avances en el conocimiento de las proteínas de la leche materna

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