Antoine Lewin1, Caroline Quach2, Virginie Rigourd3, Jean-Charles Picaud4, Thérèse Perreault5, Pierre Frange6, Marc-Christian Domingo7, Cindy Lalancette7, Gilles Delage1, Marc Germain8. 1. Medical Affairs and Innovation, Héma-Québec, Montréal, Québec,Canada. 2. Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, Québec,Canada. 3. Région Île-de-France Human Milk Bank, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris,France. 4. Department of Neonatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France, and CarMeN Unit, INSERM U1060, INRA U1397, Claude Bernard University Lyon 1, Pierre Bénite,France. 5. Department of Neonatology and Department of Pediatrics, The Montreal Children's Hospital, Montreal, Québec,Canada. 6. Laboratory of clinical microbiology, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris,France. 7. Laboratoire de santé publique du Québec, Sainte-Anne-de-Bellevue, Québec,Canada. 8. Medical Affairs and Innovation, Héma-Québec, Québec, Québec,Canada.
Abstract
BACKGROUND: Banked human milk (BHM) has inherent infectious risks, even when pasteurized. Because of the ubiquity of Bacillus cereus in the environment and its ability to resist the Holder pasteurization process, there is a concern that BHM might lead to severe B. cereus infections. OBJECTIVE: We reviewed observed and published cases to determine the potential causal role of BHM as the source of these infections. METHODS: Two infants in the province of Québec (Canada) developed a B. cereus neonatal infection, and both had received BHM. We conducted bacteriological studies to compare clinical isolates and those found in these cases. RESULTS: After extended culture of BHM retention lots, B. cereus was found to have been involved in batches related to the first case. However, molecular typing showed that the strain was different from the clinical isolate, therefore excluding BHM as the source of contamination. In the second case, a Brevibacillus spp was isolated, a species distinct from the clinical isolate. CONCLUSION: Based on these cases and others reported in the literature, a causal link between B. cereus contaminated BHM and preterm neonatal infection has never been documented. Therefore, the risk that BHM can cause this infection remains theoretical. Given the widespread presence of B. cereus in the hospital environment and its capacity to resist standard cleaning procedures, it seems likely that airborne or direct or indirect contact are the main sources of most, if not all, cases of severe B. cereus neonatal infections, even in babies exposed to BHM.
BACKGROUND: Banked human milk (BHM) has inherent infectious risks, even when pasteurized. Because of the ubiquity of Bacillus cereus in the environment and its ability to resist the Holder pasteurization process, there is a concern that BHM might lead to severe B. cereus infections. OBJECTIVE: We reviewed observed and published cases to determine the potential causal role of BHM as the source of these infections. METHODS: Two infants in the province of Québec (Canada) developed a B. cereusneonatal infection, and both had received BHM. We conducted bacteriological studies to compare clinical isolates and those found in these cases. RESULTS: After extended culture of BHM retention lots, B. cereus was found to have been involved in batches related to the first case. However, molecular typing showed that the strain was different from the clinical isolate, therefore excluding BHM as the source of contamination. In the second case, a Brevibacillus spp was isolated, a species distinct from the clinical isolate. CONCLUSION: Based on these cases and others reported in the literature, a causal link between B. cereus contaminated BHM and preterm neonatal infection has never been documented. Therefore, the risk that BHM can cause this infection remains theoretical. Given the widespread presence of B. cereus in the hospital environment and its capacity to resist standard cleaning procedures, it seems likely that airborne or direct or indirect contact are the main sources of most, if not all, cases of severe B. cereus neonatal infections, even in babies exposed to BHM.
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Authors: Miroslava Jandová; Pavel Měřička; Michaela Fišerová; Aleš Landfeld; Pavla Paterová; Lenka Hobzová; Eva Jarkovská; Marian Kacerovský; Milan Houška Journal: Foods Date: 2022-04-02
Authors: Miroslava Jandová; Pavel Měřička; Michaela Fišerová; Aleš Landfeld; Pavla Paterová; Lenka Hobzová; Eva Jarkovská; Marian Kacerovský; Milan Houška Journal: Foods Date: 2021-12-01