Breastfeeding and transmission of cytomegalovirus to preterm infants. Case report and kinetic of CMV-DNA in breast milk.
BACKGROUND
Breastfeeding has a major impact on CMV epidemiology. Postnatal CMV reactivation's incidence during lactation is nearby the maternal seroprevalence. Although perinatal CMV infection has practically no consequences in term newborn, it may cause, in some cases, a severe symptomatic disease in preterm newborns. The aims of the present study are to evaluate the rate and clinical expression of CMV infection breast milk transmitted in preterm infants and to check the safety of the freezing treated breast milk.


METHODS
The study included fifty-seven preterm infants and their CMV seropositive mothers. Fresh breast milk samples have been collected from 1(st) to 9(th) postpartum week. Both fresh breast milk and 72, 96, 120 hours frozen samples have been examined, checking the presence of CMV; urine samples have been tested too.


RESULTS
70.2% of tested mothers showed reactivation of the infection, and CMV-positive breast milk during the six weeks postpartum has been found. However, only one infant was infected by CMV, developing hepatic affection concomitantly with a multi-system involvement, as shown CMV DNA detection in urine, saliva, blood, gastric aspirate, and stools.


CONCLUSIONS
Freezing breast milk at -20°C and pasteurization may respectively reduce or eliminate the viral load.
Department of Medical and Surgical Specialities and Public Health, Public Health section, University of Perugia School of Medicine, Italy.
Manuela
M
Chiavarini
Patrizia
P
Bragetti
Alessandra
A
Sensini
Elio
E
Cenci
Roberto
R
Castronari
Marta J
MJ
Rossi
Ambra
A
Fantauzzi
Liliana
L
Minelli
D001942:Breast Feeding / Q000009:adverse effects*; D003587:Cytomegalovirus / Q000235:genetics* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000635:transmission* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008895:Milk, Human / Q000821:virology*; D009035:Mothers; D019562:Viral Load
D004279:DNA, Viral
Clin Microbiol Rev. 1998 Jul;11(3):533-54
9665982
Pediatr Infect Dis J. 1998 Jan;17(1):53-8
9469396
Lancet. 2001 Feb 17;357(9255):513-8
11229670
J Clin Virol. 2008 Mar;41(3):198-205
18243784
J Pediatr. 1984 May;104(5):669-73
6325653
Pediatr Infect Dis J. 2004 Sep;23(9):848-51
15361725
J Pediatr. 1994 Feb;124(2):318-22
8301446
Early Hum Dev. 2005 Dec;81(12):989-96
16278059
J Pediatr. 1982 Sep;101(3):440-3
6286914
Pediatrics. 1983 Sep;72(3):295-9
6310479
J Pediatr. 1983 Jun;102(6):918-22
6304275
Lancet. 2000 Feb 5;355(9202):451-5
10841125
Clin Infect Dis. 2001 Dec 15;33(12):1998-2003
11712092
J Pediatr. 1981 Feb;98(2):281-7
6257877
Pediatr Res. 2004 Oct;56(4):526-8
15388851
Curr Opin Infect Dis. 2007 Aug;20(4):408-11
17609601
Proc Natl Acad Sci U S A. 1994 Mar 29;91(7):2384-9
8146127
Adv Exp Med Biol. 2000;478:231-9
11065076