Isolation and Identification of Bacteria and Fungi Correlated with Mastitis in Breastfeeding Women in AI-Anbar Governorate/West of Iraq
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Abstract
Mastitis is a common phenomenon experienced by a lot of breastfeeding women. Lactational mastitis, commonly occurs because of prolonged milk duct engorgement, which allows bacteria to enter through breaks in the skin, resulting in an infection. Mastitis can occur at various stages of lactation, although it is most observed within the second and third weeks following childbirth. For isolation and identification of bacteria associated with mastitis, Blood agar medium, MacConkey agar, and mannitol salt agar were used, whereas Sabouraud Dextrose Agar (SDA) was used for fungal isolation. Different biochemical test has been performed for bacterial isolates including gram stain, catalase, coagulase, and Vitec 2 compact. For fungal isolates, KOH treatment and lactophenol cotton blue test were performed. Fungal DNA was extracted then PCR was used for the detection ITS Gene of candida spp. Using gel electrophoresis of PCR product on 2% agarose. The study revealed Staphylococcus aureus, Klebsiella pneumoniae, and Candida spp. as significant bacteria that are commonly related to mastitis in women. The prevalence of Staphylococcus aureus was seen to be high, with a notable manifestation of lesions. Additionally, both Staphylococcus aureus and Klebsiella pneumoniae were shown to be associated with the presence of redness. Candida albicans had a notable prominence, displaying a heightened prevalence in the regions of the nipple. Furthermore, it demonstrated a correlation with the presence of lesions and redness. The presence of redness was observed as a notable sign in cases linked with Candida tropicalis. This study provides insights into the microbial diversity linked to mastitis mainly in breastfeeding women, highlighting the prevalence of Staphylococcus aureus, Klebsiella pneumoniae, and Candida spp.
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] Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet. 2016 Jan 30;387(10017):475-90.
Bode L, Raman AS, Murch SH, Rollins NC, Gordon JI. Understanding the mother-breastmilk-infant “triad”. Science. 2020 Mar 6;367(6482):1070-2.
Christian P, Smith ER, Lee SE, Vargas AJ, Bremer AA, Raiten DJ. The a need to study human milk as a biological system. The American journal of clinical nutrition. 2021 May;113(5):1063-72.
Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwaz EG, Richter LM, Victora CG. Breastfeeding 2: why invest, and what it will take to improve breastfeeding practices. Lancet. 2016;387(10017):491-504.
Horta BL, Rollins N, Dias MS, Garcez V, Pérez‐Escamilla R. Systematic review and meta‐analysis of breastfeeding and later overweight or obesity expands on previous study for World Health Organization. Acta Paediatrica. 2023 Jan;112(1):34-41.
Miller EM. Beyond Passive Immunity: Breastfeeding, milk, and collaborative mother-infant immune systems. InBreastfeeding 2017 Dec 22 (pp. 26-39). Routledge.
Williams JE, Carrothers JM, Lackey KA, Beatty NF, Brooker SL, Peterson HK, Steinkamp KM, York MA, Shafii B, Price WJ, McGuire MA. Strong multivariate relations exist among milk, oral, and fecal microbiomes in mother-infant dyads during the first six months postpartum. The Journal of Nutrition. 2019 Jun 1;149(6):902-14.
Wilson E, Woodd SL, Benova L. Incidence of and risk factors for lactational mastitis: a systematic review. Journal of Human Lactation. 2020 Nov;36(4):673-86.
Moyo GP. Breast Pathologies and Inadequate Breastfeeding Practices: A Survey Among a Group of Newly Delivered Women in Yaounde, Cameroon. Journal of Family Medicine and Health Care. 2020;6(3):87-90.
Barker M, Adelson P, Peters MD, Steen M. Probiotics and human lactational mastitis: A scoping review. Women and birth. 2020 Nov 1;33(6):e483-91.
Li D, Li J, Yuan Y, Zhou J, Xiao Q, Yang T, Li Y, Jiang L, Gao H. Risk factors and prognosis of acute lactation mastitis developing into a breast abscess: A retrospective longitudinal study in China. Plos one. 2022 Sep 1;17(9):e0273967.
Abramowitz C, Deutch A, Shamsian E, Musheyev Y, Ftiha F, Burnstein S, Deutsch AL. Red Cabbage: A Novel Treatment for Periductal Lactational Mastitis. Cureus. 2022 Dec 31;14(12).
Tao YN, Tong XK, Qian C, Wan H, Zuo JP. Microbial quantitation of colostrum from healthy breastfeeding women and milk from mastitis patients. Ann Palliat Med. 2020 Jul 1;9(4):1666-80.
Rimoldi SG, Pileri P, Mazzocco MI, Romeri F, Bestetti G, Calvagna N, Tonielli C, Fiori L, Gigantiello A, Pagani C, Magistrelli P. The role of Staphylococcus aureus in mastitis: A multidisciplinary working group experience. Journal of Human Lactation. 2020 Aug;36(3):503-9.
Blackmon MM, Nguyen H, Mukherji P. Acute Mastitis.
Jena P, Duggal S, Gur R, Kumar A, Bharara T, Dewan R. Staphylococcus aureus in breast abscess-major culprit besides others. Indian Journal of Medical Sciences. 2019 Oct 19;71(1):40-4.
Lin XR. Study on the pathogenesis of maladjustment of lactating mastitis microflora. Journal of Hainan Medical University. 2019;25(3):83-6.
Al-Dafay AM, AL-Ruaby KJ, AlQushawi AA. Detection of Phospholipase and Asparty1 Protaines gens in Candida Species Isolated From Mammary Candidiasis in Lactating Women. Indian Journal of Forensic Medicine & Toxicology. 2021 Jun 2;15(3):5428-35.
Mitchell KB, Johnson HM, Eglash A, Academy of Breastfeeding Medicine. ABM Clinical Protocol# 30: breast masses, breast complaints, and diagnostic breast imaging in the lactating woman. Breastfeeding Medicine. 2019 May 1;14(4):208-14.
Amir LH, Cullinane M, Garland SM, Tabrizi SN, Donath SM, Bennett CM, Cooklin AR, Fisher JR, Payne MS. The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol. BMC pregnancy and childbirth. 2011 Dec;11(1):1-1.
Parija SC. Staphylococcus. InTextbook of Microbiology and Immunology 2023 Mar 17 (pp. 339-354). Singapore: Springer Nature Singapore.
Omotosho O, Ukatu S, Okandeji M, Okunlade O, Adeola A, Emikpe B. Antimicrobial Resistance Profile of Aerobic Nasal Microflora of Nigerian Indigenous Pigs. Alexandria Journal for Veterinary Sciences. 2023 Jan 1;76(1).
Iida R, Hashimoto K, Hirata K, Matsuoka K, Yokoyama S. Detection System of Gram Types for Bacteria from Gram Stained Smears Images. InICPRAM 2020 (pp. 477-484).
Sapkota J, Sharma M, Jha B, Bhatt CP. Prevalence of staphylococcus aureus isolated from clinical samples in a tertiary care hospital: A descriptive cross-sectional study. JNMA: Journal of the Nepal Medical Association. 2019 Nov;57(220):398.
Rakotovao-Ravahatra ZD, Randriatsarafara FM, Milasoanjara RN, Ranaivosoa MK, Rakotovao AL, Rasamindrakotroka A. Assessment of the coagulase test in the identification of Staphylococcus aureus strains. Journal of Biotechnology and Biomedicine. 2019;2(3):105-11.
Venugopal D, Husain K, Mustafa SA, Sabeen S. Epidemiology, risk factors and antimicrobial profile of Vulvovaginal Candidiasis (VVC): A study among women in the central region of Saudi Arabia. Journal of Medical Mycology. 2021 Jun 1;31(2):101049.
Sulmiyati S, Said NS, Fahrodi DU, Malaka R, Maruddin F. The Characteristics of Yeast Isolated from Commercial Kefir Grain, Indonesia. Hasanuddin Journal of Animal Science (HAJAS). 2019 May 30;1(1):26-36.
Hidayati Y, Asnaily A, Jumaisal A, Simanjuntak JP. Comparison of Several Types of Plasma as Media in the Germ Tube Test for Identification of Candida Albicans. Jurnal Teknokes. 2023 Apr 13;16(2).
Xie J, Fu Y, Jiang D, Li G, Huang J, Li B, Hsiang T, Peng Y. Intergeneric transfer of ribosomal genes between two fungi. BMC Evolutionary Biology. 2008 Dec;8(1):1-7.
Petti CA, Bosshard PP, Brandt ME, Clarridge JE, Feldblyum TV, Foxall P, Furtado MR, Pace N, Procop G. Interpretive criteria for identification of bacteria and fungi by DNA target sequencing; approved guideline. Clinical and Laboratory Standards Institute (CLSI) Documents. 2008;28:19087-898.
Tille P. Bailey & Scott's diagnostic microbiology-E-Book. Elsevier Health Sciences; 2015 Dec 28.
Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. Diagnostic microbiology. The nonfermentative gram-negative bacilli. Philadelphia: Lippincott-Raven Publishers. 1997:253-320.
Lupetti A, Barnini S, Castagna B, Capria AL, Nibbering PH. Rapid identification and antimicrobial susceptibility profiling of Gram-positive cocci in blood cultures with the Vitek 2 system. European journal of clinical microbiology & infectious diseases. 2010 Jan;29:89-95.
Iqbal Z, Mumtaz MZ, Malik A. Extensive drug-resistance in strains of Escherichia coli and Klebsiella pneumoniae isolated from pediatric urinary tract infections. Journal of Taibah University Medical Sciences. 2021 Aug 1;16(4):565-74.
Amraei S, Eslami G, Taherpour A, Hashemi A. The role of ACT and FOX genes in Klebsiella pneumoniae strains isolated from hospitalized patients. Micro Nano Bio Aspects. 2022 Aug 1;1(2):18-25.
Wayne PA. Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing: 20th informational supplement. CLSI document M100-S20. 2010.
Acharya T, Hare J. Sabouraud agar and other fungal growth media. InLaboratory Protocols in Fungal Biology: Current Methods in Fungal Biology 2022 Feb 3 (pp. 69-86). Cham: Springer International Publishing.
Thammahong A, Kiatsurayanon C, Edwards SW, Rerknimitr P, Chiewchengchol D. The clinical significance of fungi in atopic dermatitis. International journal of dermatology. 2020 Aug;59(8):926-35.
Larone DH. Medically important fungi: a guide to identification, ASM Press. Washington, DC.[Google Scholar]. 2011.
Singh S. Microbial assay techniques. Medical Microbiology. 2022 Apr 4:177.
Saeed AS, Saadullah AA. Isolation, Identification and Antifungal Susceptibility Testing of Candida Species from Dermatologic Specimens in Duhok Province. ZANCO Journal of Pure and Applied Sciences. 2019 Sep 10;31(4):1-8.
Zhu Y, O’Brien B, Leach L, Clarke A, Bates M, Adams E, Ostrowsky B, Quinn M, Dufort E, Southwick K, Erazo R. Laboratory analysis of an outbreak of Candida auris in New York from 2016 to 2018: impact and lessons learned. Journal of clinical microbiology. 2020 Mar 25;58(4):e01503-19.
Chu H, Duan Y, Lang S, Jiang L, Wang Y, Llorente C, Liu J, Mogavero S, Bosques-Padilla F, Abraldes JG, Vargas V. The Candida albicans exotoxin candidalysin promotes alcohol-associated liver disease. Journal of Hepatology. 2020 Mar 1;72(3):391-400.
Cullinane M, Amir LH, Donath SM, Garland SM, Tabrizi SN, Payne MS, Bennett CM. Determinants of mastitis in women in the CASTLE study: a cohort study. BMC Family Practice. 2015 Dec;16(1):1-8.
Castro I, García-Carral C, Furst A, Khwajazada S, García J, Arroyo R, Ruiz L, Rodríguez JM, Bode L, Fernández L. Interactions between human milk oligosaccharides, microbiota, and immune factors in milk of women with and without mastitis. Scientific Reports. 2022 Jan 25;12(1):1367.
Kvist LJ, Larsson BW, Hall-Lord ML, Steen A, Schalén C. The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment. International breastfeeding journal. 2008 Dec;3:1-7.
Fredebeul-Krein F, Schmenger A, Wente N, Zhang Y, Krömker V. Factors associated with the severity of clinical mastitis. Pathogens. 2022 Sep 24;11(10):1089.
Berens PD. Breast pain: engorgement, nipple pain, and mastitis. Clinical obstetrics and gynecology. 2015 Dec 1;58(4):902-14.
Li D, Li J, Yuan Y, Zhou J, Xiao Q, Yang T, Li Y, Jiang L, Gao H. Risk factors and prognosis of acute lactation mastitis developing into a breast abscess: A retrospective longitudinal study in China. Plos one. 2022 Sep 1;17(9):e0273967.
Amir LH, Donath SM, Garland SM, Tabrizi SN, Bennett CM, Cullinane M, Payne MS. Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia. BMJ open. 2013 Jan 1;3(3):e002351.
Merad Y, Derrar H, Belkacemi M, Drici A, Belmokhtar Z, Drici Sr AE. Candida albicans mastitis in breastfeeding woman: an under recognized diagnosis. Cureus. 2020 Dec 11;12(12).
Kaski K, Kvist LJ. Deep breast pain during lactation: a case-control study in Sweden investigating the role of Candida albicans. International breastfeeding journal. 2018 Dec;13:1-9.
Hanna L, Cruz SA. Candida mastitis: a case report. The Permanente Journal. 2011;15(1):62.
Krukowski H, Saba L. Bovine mycotic mastitis. Folia Vet. 2003;47:3-7.