Work

Banked Human Milk and Quantitative Risk Assessment of Bacillus cereus Infection in Premature Infants: A Simulation Study

Year: 2019

Type: article

Abstract: Background . Banked human milk (BHM) offers potential health benefits to premature babies. BHM is pasteurized to mitigate infectious risks, but pasteurization is ineffective against sporulating bacteria such as Bacillus cereus . Sepsis related to Bacillus cereus in premature infants is severe and can often be fatal. Even if a causal link has never been established, BHM has been suggested as a potential source of infection in premature infants. Objective . Our aim was to estimate the potential risk of Bacillus cereus infection in preterm infants caused by the ingestion of contaminated pasteurized BHM using different post-pasteurization release criteria (i.e., 9 sampling of 100 microliters versus the HMBANA guideline of 1 sampling of 100 microliters per pool). Methods . In the absence of scientific evidence regarding the risk of Bacillus cereus infection by the ingestion of BHM in premature infants, risk assessment using Monte Carlo simulation with the exponential dose-response model was performed. Three scenarios of infectious risk (annual incidence rate of 0.01%, 0.13%, and 0.2%) with 18 variations of the B. cereus virulent dose (from 0.5 CFU/ml to 200 CFU/ml) were simulated. Results . The mean risk differential between the two methods of post-pasteurization bacteriological control for realistic infectious doses of 30 to 200 CFU/ml ranges from 0.036 to 0.0054, 0.47 to 0.070, and 0.72 to 0.11 per million servings, for each of the three scenarios. Conclusion . Simulation highlights the very small risk of Bacillus cereus infection following the ingestion of pasteurized BHM, even in the worst case scenarios, and suggests that a 100-microliter sample for post-pasteurization culture is sufficient.

Source: Canadian Journal of Infectious Diseases and Medical Microbiology

DOI: 10.1155/2019/6348281

Authors: Antoine Lewin, Gilles Delage, France Bernier, Marc Germain

Institutions: Héma-Québec, Université de Sherbrooke

Language: English

Topic: Infant Nutrition and Health

Subfield: Nutrition and Dietetics

Field: Nursing

Domain: Health Sciences

SDGs: Good health and well-being, Zero hunger

Open Access status: gold

Estimated APC paid: $2,160