Higher intake of coagulase-negative staphylococci from maternal milk promotes gut colonization with mecA-negative Staphylococcus epidermidis in preterm neonates

J Perinatol. 2018 Oct;38(10):1344-1352. doi: 10.1038/s41372-018-0183-y. Epub 2018 Aug 3.


Objective: We aimed to determine factors associated with gut colonization of preterm neonates with coagulase-negative staphylococci (CoNS) from maternal milk (MM).

Study design: CoNS isolated from weekly collected stool and MM of hospitalized preterm (n = 49) and healthy term neonates (n = 20) were genotyped. Colonization-related factors were determined by Cox proportional hazards regression.

Result: Gut colonization with mecA-negative Staphylococcus epidermidis from MM was less prevalent (40.8% vs. 95%) and delayed (median age 15.5 vs. 2 days) in preterm compared with term neonates. Enhanced colonization was associated with higher intake of CoNS from MM (hazard ratio (95% confidence interval) 1.006 (1.00-1.01) for 106 colony-forming units), lower proportion of mecA-positive predominant NICU strains in gut (0.09 (0.01-0.49) for 1%) and lower incidence of late-onset CoNS sepsis (5% vs. 34% in those without colonization).

Conclusion: Enteral feeding with larger proportion of unpasteurized MM and limiting spread of predominant strains may promote colonization with CoNS from MM.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast Feeding
  • Coagulase
  • Feces / microbiology
  • Female
  • Gastrointestinal Tract / microbiology*
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care Units, Neonatal
  • Longitudinal Studies
  • Milk, Human / microbiology*
  • Multilocus Sequence Typing
  • Neonatal Sepsis / prevention & control
  • Proportional Hazards Models
  • Prospective Studies
  • Skin / microbiology
  • Staphylococcus epidermidis / physiology*
  • Staphylococcus haemolyticus / physiology
  • Term Birth


  • Coagulase