title: Host Defense Proteins in Breast Milk and Neonatal Yeast Colonization.
abstract: BACKGROUND
  Colonization increases risk for invasive candidiasis in neonates. Breast milk host defense proteins may affect yeast colonization of infants.
  
  
  OBJECTIVE
  This study aimed to evaluate breast milk host defense proteins relative to yeast colonization in infants.
  
  
  METHODS
  Infants admitted for longer than 72 hours to the neonatal intensive care unit at Women & Infants Hospital in Providence, Rhode Island, were eligible. After consent, expressed breast milk and swabs from oral, rectal, and inguinal sites from infants were cultured weekly for 12 weeks, or until discharge, transfer, or death. Breast milk was tested for levels of human lactoferrin, lysozyme, apolipoprotein J, mucin-1, dermcidin, and soluble CD14 using commercial ELISA. Concentrations of these components were compared in breast milk received by infants who were colonized or not colonized with yeast.
  
  
  RESULTS
  From an original cohort of 130, 61 infants had samples available for this subanalysis. A convenience sample of stored breast milk was analyzed. Median lactoferrin, apolipoprotein J, and mucin-1 did not differ between colonized and uncolonized groups. Soluble CD14 was higher in the surface-colonized group (1.8 μg/mL, n = 12) compared with the surface-uncolonized group (1.6 μg/mL, n = 12, P = .02). Median lysozyme levels were higher in the surface-uncolonized group (483.0 ng/mL, n = 12) versus the surface-colonized group (298.3 ng/mL, n = 12, P = .04). Median dermcidin levels were higher in the surface-uncolonized group (19.4 ng/mL, n = 12) versus the surface-colonized group (8.7 ng/mL, n = 12, P = .04).
  
  
  CONCLUSIONS
  This study shows an association between colonization with Candida in neonates and lower levels of lysozyme and dermcidin in received breast milk. Further study is needed to confirm these findings.
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, WI, USA.
authors.forename: Brian D W
authors.initials: BD
authors.lastname: Chow
authors.affiliation: Brown University, Providence, RI, USA.
authors.forename: Juliann L
authors.initials: JL
authors.lastname: Reardon
authors.affiliation: Bristol County Agricultural High School, Dighton, MA, USA.
authors.forename: Emily O
authors.initials: EO
authors.lastname: Perry
authors.affiliation: Brown University, Providence, RI, USA Women & Infants Hospital of Rhode Island, Providence, RI, USA.
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Laforce-Nesbitt
authors.affiliation: Women & Infants Hospital of Rhode Island, Providence, RI, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Tucker
authors.affiliation: Brown University, Providence, RI, USA Women & Infants Hospital of Rhode Island, Providence, RI, USA jbliss@wihri.org.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Bliss
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D002175:Candida / Q000302:isolation & purification*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008895:Milk, Human / Q000378:metabolism*; D009055:Mouth / Q000382:microbiology*; D012007:Rectum / Q000382:microbiology*; D012867:Skin / Q000382:microbiology*
chemical_list: D015415:Biomarkers
keywords: Candida; breastfeeding; colonization; neonatal