Diagnostic methods for mastitis in cows are not appropriate for use in humans: commentary
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COMMENTARY
Open Access
Diagnostic methods for mastitis in cows are not appropriate for use in humans: commentary Linda J. Kvist1,2
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. Keywords: Lactational mastitis, Breast milk, Microbiome, qPCR diagnostic tests, Immune system
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. We must, however, also remember that there are very many “specifics” that govern how we view disease in domestic animals and in humans. The dairy industry is a multi-billion dollar industry in many high-income countries whereas the production of human milk is not usually seen as a revenue-generating occupation (even though in recent years breast milk has been marketed on the World Wide Web). 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. Correspondence: [email protected] 1 Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden 2 Department of Obstetrics & Gynaecology, Helsingborg Hospital, 25187 Helsingborg, Sweden
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. However, the US Department of Agriculture stated in 2008 that almost all dairy cows receive prophylactic intra-mammary infusions of antibioti
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