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The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: Study protocol
journal contributionposted on 16.02.2021, 05:58 by Lisa Amir, Meabh Cullinane, SM Garland, SN Tabrizi, SM Donath, CM Bennett, Amanda Cooklin, JRW Fisher, MS Payne
Background: The CASTLE (Candida and Staphylococcus Transmission: Longitudinal Evaluation) study will investigate the micro-organisms involved in the development of mastitis and "breast thrush" among breastfeeding women. To date, the organism(s) associated with the development of breast thrush have not been identified. The CASTLE study will also investigate the impact of physical health problems and breastfeeding problems on maternal psychological health in the early postpartum period.Methods/Design: The CASTLE study is a longitudinal descriptive study designed to investigate the role of Staphylococcus spp (species) and Candida spp in breast pain and infection among lactating women, and to describe the transmission dynamics of S. aureus and Candida spp between mother and infant. The relationship between breastfeeding and postpartum health problems as well as maternal psychological well-being is also being investigated. A prospective cohort of four hundred nulliparous women who are at least thirty six weeks gestation pregnant are being recruited from two hospitals in Melbourne, Australia (November 2009 to June 2011). At recruitment, nasal, nipple (both breasts) and vaginal swabs are taken and participants complete a questionnaire asking about previous known staphylococcal and candidal infections. Following the birth, participants are followed-up six times: in hospital and then at home weekly until four weeks postpartum. Participants complete a questionnaire at each time points to collect information about breastfeeding problems and postpartum health problems. Nasal and nipple swabs and breast milk samples are collected from the mother. Oral and nasal swabs are collected from the baby. A telephone interview is conducted at eight weeks postpartum to collect information about postpartum health problems and breastfeeding problems, such as mastitis and nipple and breast pain.Discussion: This study is the first longitudinal study of the role of both staphylococcal and candidal colonisation in breast infections and will help to resolve the current controversy about which is the primary organism in the condition known as breast thrush. This study will also document transmission dynamics of S. aureus and Candida spp between mother and infant. In addition, CASTLE will investigate the impact of common maternal physical health symptoms and the effect of breastfeeding problems on maternal psychological well-being. © 2011 Amir et al; licensee BioMed Central Ltd.
The major funding was provided by the National Health and Medical Research Council Project Grant (541907) in 2009 - 2010. Additional funding was received by the Faculty of Health Sciences, La Trobe University (2011 - 2012), and from the Helen Macpherson Smith Trust (2011 - 2012). We are grateful to the members of the CASTLE study reference group (Belinda Barnes, Wendy Brodribb, Amanda Cooklin, Jane Fisher, Liz McGuire, Kate Mortensen, Anita Moorhead, Ross Pagano, Marie Pirotta, Christine Scott, Narelle Warren).
JournalBMC Pregnancy and Childbirth
Article NumberARTN 54
Rights StatementThe Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.
Science & TechnologyLife Sciences & BiomedicineObstetrics & GynecologyFEEDING WOMENIDENTIFICATIONSYMPTOMSDIAGNOSISMASTITISHEALTHMILKNipplesMilk, HumanHumansStaphylococcus aureusCandida albicansStaphylococcal InfectionsCandidiasis, CutaneousPainBreast DiseasesClinical ProtocolsColony Count, MicrobialRisk FactorsCohort StudiesLongitudinal StudiesProspective StudiesPostpartum PeriodAdultInfant, NewbornCanadaFemaleYoung AdultObstetrics & Reproductive Medicine