430. Effect of Endogenous Human Lactoferrin and Lysozyme in Breast Milk on Neonatal Colonization with Yeast
Session: Poster Abstract Session: Pediatric Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • ID Week 2013 Poster Lactoferrin v2.pdf (508.2 kB)
  • Background:

    Colonization is a risk factor for invasive candidiasis in neonates.  We have shown previously that in a NICU setting, receiving breast milk colonized with yeast is associated with increased colonization in infants.  However, the majority of these mother-infant pairs were discordant for the yeast species isolated.  This observation led us to speculate that other factors present in breast milk may affect the likelihood of yeast colonization of both the milk and the infant receiving it.  In this study, levels of endogenous human lactoferrin and lysozyme were evaluated in these breast milk samples, hypothesizing that lower levels of these proteins are associated with yeast colonization.

    Methods:

    Infants who were admitted for longer than 72h to the NICU at Women and Infants Hospital in Providence, RI were eligible.  After obtaining informed consent, expressed breast milk and swabs from oral, rectal, and inguinal sites of the infants were cultured weekly for 12 weeks, or until discharge, transfer, or death.   Cultures were analyzed using standard laboratory methods.  Breast milk samples were tested for levels of lactoferrin and lysozyme using commercial ELISA.

    Results:

    Characteristics of the population were previously described.  Briefly, 29 (22.3%) of 130 enrolled infants were surface-colonized with yeast. Ten infants (7.7%) received breast milk colonized with yeast, but only 3 of these surface-colonized infants had a species concordant with that found in breast milk.  Randomly selected breast milk samples from the surface-colonized and surface-uncolonized group were selected for analysis.  Lactoferrin levels did not differ between groups (30.3 +/- 20.62 mg/ml surface-colonized group, 17.0 +/- 16.8 surface-uncolonized group, p=0.09).  Lysozyme levels were higher in the surface-uncolonized group (460.3 +/- 197.4 mg/ml) vs the surface-colonized group (278.3 +/-148.9 mg/ml, p=0.02). 

    Conclusion:

    This study shows an association between higher levels of lysozyme and an uncolonized state for Candida in neonates.  No significant difference was noted in lactoferrin levels.  Further study is needed to confirm these findings and elucidate potential mechanisms.

    Brian Chow, MD, Medicine, Alpert Medical School of Brown University, Providence, RI; Infectious Diseases, The Miriam Hospital, Providence, RI, Emily Perry, SB, The Rhode Island Free Clinic, Providence, RI, Juliann Reardon, BS, The Warren Alpert Medical School, Brown University, Providence, RI, Sonia Laforce-Nesbitt, MS, Neonatology, Brown University, Providence, RI; Neonatology, Women and Infant's Hospital, Providence, RI and Joseph Bliss, MD, PhD, Pediatrics, Women and Infants Hospital, Providence, RI; Brown University, Providence, RI

    Disclosures:

    B. Chow, None

    E. Perry, None

    J. Reardon, None

    S. Laforce-Nesbitt, None

    J. Bliss, None

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