Table 1.

Effects of HTST on safety of human milk.*

	References	HTST treatment parameters	Device	Milk components/properties	Impact of treatment (compared to raw milk)	Comparison HTST – HoP
Pathogens Microbicidal/Antimicrobial activity	Capriati et al. (27)	Fixed time/temperature: 70°C for few min. (not specified) pasteurized volume: 30 mL each batch Donors n = 2	Submerged bottles in a HoP pasteuriser modified to reach the determined plateau temperature.	Microbiological counts of native milk microflora (Total aerobic, Staphylococcus aureus, Bacillus cereus)	Undetectable after treatment (except B. cereus – one sample)	Similar eradication in HoP
	Aceti et al. (28)	Fixed time/temperature: 72°C for 15 s pasteurized volume total: 100 mL Donors n = 5	Patented prototype (EP 15176792.8–1,358).	Microbiological counts of native milk microflora (Total aerobic, Staphylococcus aureus, Enterobacteriaceae)	Undetectable microbial counts after treatment	Similar eradication in HoP
	Manzardo et al. (26)	Different time/ temperature combinations: 62 and 81°C for 5 s. pasteurized volume 60 mL each batch Donors n = 30	Virex II (Lauf, Tübingen, Germany)	Efficacy against inoculated microorganisms	Combination 81°C/5 s. resulted in no bacterial growth, with the exception of E. faecalis	HoP: 5 log reduction for all microorganisms except C. sakazakii (RV00078)
				Enterococcus faecalis ATC 29212–5.8 × 104 CFU/mL	62°C for 5 s: 0.76 log reduction; 81°C for 5 s: 3.3 log reduction
				Cronobacter sakazakii RV00078 and RV5-I-92 – 1.4 and 2.1 × 105 CFU/mL	62°C for 5 s: 1.9 and 1.3 log reduction; 81°C for 5 s: 5 log reduction
				Listeria monocytogenes 00218 and 0015–1.8 and 1.1 × 105 CFU/mL	62°C for 5 s: 1.2 and 1 log reduction; 81°C for 5 s: 5 log reduction
				Cytomegalovirus (HCMV)	As effective as raw human milk
				Respiratory syncytial virus (RSV)	As effective as raw human milk
				Rotavirus (HRoV)	As effective as raw human milk
				Rhinovirus (HRhV)	Reduced inhibitory dilution (HTST 0.06 vs. Raw 0.02)
				Herpes simplex virus type 1 and 2 (HSV-1, HSV-2)	As effective as raw human milk against HSV-2; reduced inhibitory dilution against HSV-1 (HTST 0.08 vs. Raw 0.05)
	Patil et al. (29)	Fixed time/temperature: 72°C for 15 s. pasteurized volume: 10 mL each batch Donors n = 48, pooled	Submerged bottles in a HoP pasteuriser modified to reach the determined plateau temperature:	Bactericidal activity against E. coli	Reduction in bacterial growth: after 4 h incubation: 95% after 8 h incubation: 94% after 24 h incubation: 26%	HoP showed a higher E. coli bactericidal activity than HTST after 24 h incubation (46%)
	Kontopodi et al. (24)	Fixed time/temperature: 72°C for 15 s. pasteurized volume total: 50 mL Donors n = 4, pooled	Laboratory scale pasteuriser	Bacteriostatic activity against E. coli and S. aureus	Growth rate per hour: significant increase in E. coli growth rate (HTST 4.2 vs. Raw 3.6), but similar for S. areus (growth rate 2.0 -fold per hour)	HoP caused the highest reduction in bacteriostatic capacity.

*p-value are indicated only when significant and/or reported in the original article; NS, not significantly different.