Diagnostic methods for mastitis in cows are not appropriate for use in humans: commentary.

Linda J Kvist

doi:10.1186/s13006-016-0061-1

Abstract

Healthcare workers are now being targeted for marketing of diagnostic tools for mastitis that were developed for the dairy industry and which aim to provide information regarding choice of antibiotic treatment. Meanwhile, scientists are striving to understand how the human microbiome affects health and wellbeing and the importance of maintenance of bacterial balance in the human body. Breast milk supplies a multitude of bacteria to populate the baby’s intestinal tract and kick-start the immune system. Researchers propose a paradigm shift in the understanding of bacterial content in breast milk and an alternative paradigm for the understanding of lactational mastitis: there is the beginning of evidence that many cases of lactational mastitis will resolve spontaneously. An international group of researchers is attempting to answer how dietary habits, birth mode, genetics and environmental factors may impact the bacterial content of breast milk. Until we have more comprehensive knowledge about the human milk microbiome, diagnostic aids for identification of women in need of antibiotic therapy for mastitis remain unreliable. Diagnostic aids could lead to the injudicious use of antibiotic therapy, which in turn may rob the infant of bacteria valuable for development of its immune system. The marketing of diagnostic aids for use in human medicine, that were originally developed for use in cows, is neither evidence-based nor good ethical practice.

Highlights

After an extended weekend break in July 2015, I returned to my desk and opened my mail box–the usual onslaught of messages waited
What was the sales pitch? The market development manager wondered if I would be interested in qPCR analysis of milk from women with mastitis needing antibiotic treatment, which would give an answer within 3–4 h
That identification of bacteria in breast milk, whether by culture-dependent or culture-independent methods, is not yet a reliable means to decide on treatment with antibiotic therapy

Summary

Background

A lactation problem common to both animals and humans is mastitis. The development of new knowledge can be enhanced if we open our minds to the fact that there must be many similarities between the mammals of our planet. The content of cows’ milk is very carefully monitored and an outbreak of bovine mastitis in a dairy farm can be a very costly problem when the milk cannot be sold due to either bacterial or antibiotic contamination. In both the European Union and the US, antimicrobial residue in milk renders it unfit for sale [1, 2]. This would seem to be a counter-incentive to the injudicious use of antibiotics. A large number of internationally recognized experts in infection control convened in 2011 and reported that in order to contain the increasing threat to human health posed by resistant bacteria there is an urgent need for regulation on a global level of antibiotic use in food animals [4]

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