Role of human milk oligosaccharides in Group B Streptococcus colonisation

• Published in: Clinical & translational immunology Vol. 5; no. 8; pp. e99 - n/a
• Main Authors: Andreas, Nicholas J, Al‐Khalidi, Asmaa, Jaiteh, Mustapha, Clarke, Edward, Hyde, Matthew J, Modi, Neena, Holmes, Elaine, Kampmann, Beate, Mehring Le Doare, Kirsty
• Format: Journal Article
• Language: English
• Published: Australia Nature Publishing Group 01.08.2016; John Wiley & Sons, Inc
• Subjects: Abbreviations; Babies; Birth; Blood groups; Breast milk; Breastfeeding & lactation; Clinical trials; Colostrum; Enzymes; Gene expression; Infants; Lewis system; Magnetic resonance spectroscopy; Medical research; Microbiota; Morbidity; Mothers; NMR; Nuclear magnetic resonance; Oligosaccharides; Original; Postpartum; Principal components analysis; Rectum; Risk factors; Serotypes; Spectrum analysis; Streptococcus; Streptococcus infections; Viruses
• ISSN: 2050-0068; 2050-0068
• DOI: 10.1038/cti.2016.43

Group B Streptococcus (GBS) infection is a major cause of morbidity and mortality in infants. The major risk factor for GBS disease is maternal and subsequent infant colonisation. It is unknown whether human milk oligosaccharides (HMOs) protect against GBS colonisation. HMO production is genetically determined and linked to the Lewis antigen system. We aimed to investigate the association between HMOs and infant GBS colonisation between birth and postnatal day 90. Rectovaginal swabs were collected at delivery, as well as colostrum/breast milk, infant nasopharyngeal and rectal swabs at birth, 6 days and days 60–89 postpartum from 183 Gambian mother/infant pairs. GBS colonisation and serotypes were determined using culture and PCR. 1H nuclear magnetic resonance spectroscopy was used to characterise the mother's Lewis status and HMO profile in breast milk. Mothers who were Lewis‐positive were significantly less likely to be colonised by GBS (X2=12.50, P<0.001). Infants of Lewis‐positive mothers were less likely GBS colonised at birth (X2=4.88 P=0.03) and more likely to clear colonisation between birth and days 60–89 than infants born to Lewis‐negative women (P=0.05). There was no association between Secretor status and GBS colonisation. In vitro work revealed that lacto‐N‐difucohexaose I (LNDFHI) correlated with a reduction in the growth of GBS. Our results suggest that HMO such as LNDFHI may be a useful adjunct in reducing maternal and infant colonisation and hence invasive GBS disease. Secretor status offers utility as a stratification variable in GBS clinical trials. Antibacterials: Breast milk sugars reduce streptococcal colonization Specific sugars in breast milk protect a mother and her child against group B streptococcus (GBS) bacteria. GBS can be transmitted from mother to child during pregnancy or childbirth, and commonly causes serious infections in the first three months of life. Previous experiments suggested that sugars in breast milk called human milk oligosaccharides (HMOs) might protect against GBS. Nicholas Andreas, Kirsty Mehring‐Le Doare and colleagues from Imperial College London, UK, have now determined that one HMO, 3‐fucosyllactose, of GBS colonization in Gambian mothers and their children, and another, lacto‐N‐difucohexaose I, may help to clear GBS colonization. These findings suggest that these two sugars could be used with antibiotics to treat GBS colonization and infection