Publication: Etiología y epidemiología de las mastitis humanas
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2016-08-16
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Universidad Complutense de Madrid
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Abstract
La mastitis infecciosa es una patología común durante la lactancia y constituye una de las primeras causas de destete precoz. Por tanto, debería ser considerada un problema de Salud Pública relevante, ya que priva a la pareja madre-hijo de los incuestionables beneficios que la lactancia proporciona. No obstante, la mastitis humana ha sido hasta la fecha una enfermedad subestimada e infradiagnosticada, ya que habitualmente sólo se consideran mastitis los casos agudos que cursan con una sintomatología evidente y su diagnóstico microbiológico no se realiza de forma rutinaria. La etiopatogenia de la mastitis se ha relacionado con un proceso de disbiosis en la glándula mamaria, que da lugar al sobrecrecimiento de ciertas especies presentes en la leche humana. Sin embargo, la ausencia de un diagnóstico microbiológico rutinario de la leche humana hace que los estudios microbiológicos sobre esta patología sean muy escasos y que se desconozca el papel que juegan muchos agentes etiológicos. En este trabajo, el análisis microbiológico de 1.849 muestras de leche materna procedentes de mujeres con mastitis ha revelado que el género Staphylococcus constituye el primer grupo microbiano implicado en esta patología, siendo Staphylococcus epidermidis la especie aislada con mayor frecuencia (91,56% de las muestras). La especie Staphylococcus aureus se detectó en el 29,74% de los casos. Los géneros Streptocococcus y Corynebacterium constituyeron, respectivamente, el segundo (70,20%) y tercer (16,60%) grupo microbiano con mayor prevalencia en este estudio. Estos resultados ponen de manifiesto que los estafilococos coagulasa-negativos, los estreptococos del grupo viridans y las corinebacterias, habitualmente considerados microorganismos comensales y subestimados como causa de mastitis humanas, tienen un papel relevante como agentes etiológicos de esta patología. Este hecho avala que el análisis microbiológico de la leche, identificando los agentes causales a nivel de especie, es el único medio posible para obtener un diagnóstico etiológico preciso y establecer un tratamiento eficaz para la mastitis...
Infectious mastitis is a common condition during lactation and constitutes one of the main causes of undesired weaning. This condition should be considered as a relevant Public Health issue, since it deprives the mother-infant pair from the wide range of health benefits that breastfeeding provides. Nevertheless, human mastitis remains to date widely underestimated because human milk cultures are not routinely performed and only acute mastitis cases with local and systemic symptoms are usually reported. It has been addressed that human mastitis is characterized by a dysbiosis process in the mammary gland, leading to an overgrowth of certain bacterial species present in human milk. However, the etiology of this condition has been scarcely investigated, and the role of some bacterial pathogens remains unclear. In this study, the microbiological analysis of 1,849 milk samples obtained from women with infectious mastitis has revealed that genus Staphylococcus was the most frequently isolated bacterial group. Staphylococcus epidermidis was the most common species (91.56% of the samples) while Staphylococcus aureus was detected in 29.74% of them. Streptococci and corynebacteria constituted the second (70.20%) and third (16.60%) most prevalent bacterial groups, respectively, in this study. These results show that coagulase-negative staphylococci, viridans group streptococci (VGS) and corynebacteria, usually dismissed as contaminant bacteria, may play an important role as etiological agents of mastitis. Therefore, microbiological analysis of human milk, identifying the disease-causing pathogens at the species level, should be the only method for determining the etiology of mastitis and establishing an efficient treatment of this condition...
Infectious mastitis is a common condition during lactation and constitutes one of the main causes of undesired weaning. This condition should be considered as a relevant Public Health issue, since it deprives the mother-infant pair from the wide range of health benefits that breastfeeding provides. Nevertheless, human mastitis remains to date widely underestimated because human milk cultures are not routinely performed and only acute mastitis cases with local and systemic symptoms are usually reported. It has been addressed that human mastitis is characterized by a dysbiosis process in the mammary gland, leading to an overgrowth of certain bacterial species present in human milk. However, the etiology of this condition has been scarcely investigated, and the role of some bacterial pathogens remains unclear. In this study, the microbiological analysis of 1,849 milk samples obtained from women with infectious mastitis has revealed that genus Staphylococcus was the most frequently isolated bacterial group. Staphylococcus epidermidis was the most common species (91.56% of the samples) while Staphylococcus aureus was detected in 29.74% of them. Streptococci and corynebacteria constituted the second (70.20%) and third (16.60%) most prevalent bacterial groups, respectively, in this study. These results show that coagulase-negative staphylococci, viridans group streptococci (VGS) and corynebacteria, usually dismissed as contaminant bacteria, may play an important role as etiological agents of mastitis. Therefore, microbiological analysis of human milk, identifying the disease-causing pathogens at the species level, should be the only method for determining the etiology of mastitis and establishing an efficient treatment of this condition...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Veterinaria, Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, leída el 25/01/2016