Bacterial attachment to oropharyngeal epithelial cells in breastfed newborns

On day 2 post partum, swab samples were obtained from the oropharyngx of 20 healthy, breast-fed babies. The samples were examined for aerobes (culture on agar plates), for bacterial coating with the immunoglobulins SIgA, IgG and IgM (immunofluorescence assay), for bacterial attachment to epithelial cells (fluorescence microscopy of acridine orange stained material, and scanning electron microscopy). alpha-Hemolytic streptococci grew almost exclusively in the oropharynx, while 32% (median value) of the epithelial cells showed bacterial attachment in abundance, viz. > 50 attached bacteria per cell, 66% (median value) of the bacteria showed positive reactivity when treated with anti-human SIgA serum. 72% (median value) of the bacteria were coated with IgG, but no IgM coating of the bacteria could be detected. Newborns do not possess IgA antibodies, as only IgG is able to pass the placental barrier. The SIgA-rich colostrum is capable of coating the oropharyngeal bacteria of breast-fed babies during their first days after birth. However, despite abundant SIgA-coating, bacteria still succeed in attaching to the epithelial cells of the oropharynx. This finding hints that factors other than SIgA impede the bacterial/cellular adhesion mechanism.