Table 1.

Overview of the anti-pathogenic functionalities of HMO mixtures.

HMO Characteristics (Source)	[HMO]	Strains Used	Observed Effects	References
Breast milk collected from first and fourth week of lactation	1:2 dilution	Gram-positive: Streptococcus pneumoniae Gram-negative: Haemophilus influenzae	Anti-adhesive effects against Haemophilus influenzae (HMWF) and Streptococcus pneumoniae (all HMOs)	[23]
Breast milk from healthy women collected 30 days after delivery	6 mg/mL	Gram-negative: UPEC	Anti-adhesive effects of neutral fractions (high > low Mw)	[28]
Colostrum (d1–4), transitional (d12–17) and mature (d28–32) breast milk from healthy women	25–1200 μg/well (50 μL)	Gram-negative: ETEC (CFA/I, CFA/II fimbriae), UPEC (P, P-like fimbriae)	Inhibition of hemagglutination by desialylated fraction associated with binding to P-fimbriae	[27]
Pooled transitional breast milk samples	20 g/L	Gram-negative: Neisseria meningitidis	Inhibition of binding to pili by acidic HMO fraction	[35]
HMO fractions and modified HMO fractions from pooled human milk	1–2 g/L	Isolated, immobilized P-selectin	Interference acidic HMO fraction and P-selectin. Neutral HMOs show no interference.	[41]
Colostrum (different fractions) collected four days after delivery	1, 5, and 10 mg/mL	Gram-negative: EPEC, Vibrio cholerae, Salmonella fyris	Anti-adhesive effects against Salmonella fyris (acidic, neutral, LMw), and Vibrio cholerae (neutral, hMw)	[17]
HMOs isolated from pooled human milk	15 mg/mL	Gram-negative: UPEC	Inhibition of bacterial invasion but no anti-adhesive effects, protection	[39]
Breast milk from healthy women collected between 3 days and 3 months postnatal	5 mg/mL	Gram-positive: GBS	Up to 40% growth inhibition	[21]
Breast milk from healthy women collected between 3 days and 3 months postnatal	5 mg/mL	Gram-positive: GBS (CNCTC, GB590, GB2)	8–32× MIC reduction with antibiotics in combination with HMOs	[42]
Breast milk from healthy women collected between 3 days and 3 months postnatal	5 mg/mL	Gram-positive: GBS, Staphylococcus aureus Gram-negative: Acinetobacter baumannii	GBS and Staphylococcus aureus biofilm inhibition, no antimicrobial effect	[43]
Breast milk from healthy women collected between 3 days and 3 months postnatal	5 mg/mL	Gram-negative: GBS (GB590, GB2)	HMO mixture more effective inhibition of pathogen growth and viability reduction than isolated oligosaccharides	[44]