The Impact of Neonatal Antibiotic Exposure on Atopic Sensitisation by the Age of 12 Months

Varhaislapsuuden antibioottialtistuksen vaikutus atooppiseen herkistymiseen 12 kuukauden ikään mennessä Bakteerien vaikutus terveyteen on merkittävä: ne ovat toisaalta hengenvaarallisten infektioiden aiheuttajia, mutta samanaikaisesti niiden läsnäolo on välttämätöntä terveen immuunipuolustuksen kehittymiseksi. Ensimmäisen elinvuoden aikana suoliston bakteerikanta on altis ulkoisten tekijöiden vaikutuksille. Varhaislapsuuden antibioottihoidolla voi olla tuhoisat seuraukset eri bakteerilajien suhteille, ja sen tiedetään altistavan erilaisille immuunivälitteisille sairauksille, kuten atopialle. Ei ole kuitenkaan selvitetty, onko tämä vaikutus johtunut käynnissä olevan infektion aiheuttamista muutoksista kehittyvään immuunijärjestelmään vai onko siihen ollut syynä infektioon aloitettu antibioottihoito. Tässä tutkimuksessa selvitettiin eroja kahden, varhaista antibioottihoitoa saaneen ryhmän välillä ja päätetapahtumaksi katsottiin myöhemmin lapsuudessa ilmenevä atopiataipumus. Toinen ryhmä sai antibioottihoitoa kliinisesti todistettuun bakteeri-infektioon (varhaiseen sepsikseen). Toinen ryhmä taas sai antibioottihoidon pelkästään infektioepäilyyn eli ns. empiirisen hoidon, joka lopetettiin alle viiden vuorokauden kuluessa kun katsottiin, ettei oireiden taustalla ollutkaan bakteeri-infektiota. Mukana vertailussa oli lisäksi ryhmä, joka ei saanut lainkaan varhaista antibioottihoitoa. Antibioottihoidon pitkäaikaisvaikutusta arvioitiin ihon prick-testillä, joka kertoo atopiaan liittyvästä IgE-välitteisestä herkistymisestä. Varhaisella antibioottihoidolla tarkoitetaan tässä alle 72 tunnin sisällä syntymästä alkanutta hoitoa G-penisilliinin ja gentamysiinin yhdistelmällä. Tutkimuksen aineisto koostui 755 vastasyntyneen lapsen seurantadatasta, joka saatiin neljän käynnissä olevan allergian ehkäisytutkimuksen aineistosta. Tutkimuksen mukaanottokriteereinä pidettiin sitä, että saatavilla oli tiedot sekä mahdollisen antibioottialtistuksen kestosta että ihon prick-testituloksesta joko 6 tai 12 kuukauden iässä. Tulokset analysoitiin logistisella regressioanalyysillä huomioiden mahdolliset sekoittavat tekijät: äidin allergia, ennenaikaisuus, tutkimusprobiootti, imetyksen kesto, äidin raskauden aikainen tupakointi ja synnytystapa. Potilasryhmässä, joka sai antibioottihoitoa ilman samanaikaista infektiota, nähtiin tilastollisesti merkittävästi vähemmän positiivisia prick-testituloksia verrattuna lapsiin, jotka eivät altistuneet antibiooteille. Tulos on merkittävä, sillä se osoittaa, että varhaisella antibioottihoidolla on kauaskantoisia vaikutuksia kehittyvään immuunijärjestelmään.

Sulfated fucan as support for antibiotic immobilization

Xylofucoglucuronan from Spatoglossum schröederi algae was tested as a support for antibiotic immobilization. The polysaccharide (20 mg in 6 ml) was first activated using carbodiimide, 1-ethyl-3-(3-dimethylamino-propyl)carbodiimide methiodide (20 mg in 2 ml), under stirring for 1 h at 25ºC and pH from 4.5 to 5.0. After adjusting the pH to 8.0, either gentamicin or amikacin (62.5 mg in 1.25 ml) was then immobilized on this chemically modified polysaccharide with shaking for 24 h in a cold room. Infrared spectra of the activated carbodiimide xylofucoglucuronan showed two bands to carbonyl (C = O at 1647.9 and 1700.7 cm-1) and to amide (CÝ-NH2) groups (1662.8 and 1714.0 cm-1). Microbial characterization of the derivatives was carried out by the disk diffusion method using Staphylococcus aureus or Klebsiella pneumoniae incorporated in Müller Hinton medium. Inhibition halos of bacterial growth were observed for the antibiotics immobilized on this sulfated heteropolysaccharide before and after dialysis. However, the halos resulting from the samples after dialysis were much smaller, suggesting that dialysis removed either non-covalently bound antibiotic or other small molecules. In contrast, bacterial growth was not inhibited by either xylofucoglucuronan or its activated form or by gentamicin or amikacin after dialysis. An additional experiment was carried out which demonstrated that the sulfated heteropolysaccharide was hydrolyzed by the microorganism. Therefore, the antibiotic immobilized on xylofucoglucuronan can be proposed as a controlled drug delivery system. Furthermore, this sulfated heteropolysaccharide can be extracted easily from sea algae Spatoglossum schröederi.

Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes

In order to evaluate the performance of a 1-h 75-g oral glucose tolerance test (OGTT) for the diagnosis of gestational diabetes mellitus (GDM), a cohort of 4998 women, 20 years or older, without previous diabetes being treated in prenatal care clinics in Brazil answered a questionnaire and performed a 75-g OGTT including fasting, 1-h and 2-h glucose measurements between their 24th and 28th gestational weeks. Pregnancy outcomes were transcribed from medical registries. GDM was defined according to WHO criteria (fasting: ≥126 mg/dL; 2-h value: ≥140 mg/dL) and macrosomia as a birth weight equal to or higher than 4000 g. Areas under the receiver operator characteristic curve (AUC) were compared and diagnostic properties of various cut-off points were evaluated. The AUCs for the prediction of macrosomia were 0.606 (0.572-0.637) for the 1-h and 0.589 (0.557-0.622) for the 2-h plasma glucose test. Similar predictability was demonstrable regarding combined adverse outcomes: 0.582 (0.559-0.604) for the 1-h test and 0.572 (0.549-0.595) for the 2-h test. When the 1-h glucose test was evaluated against a diagnosis of GDM defined by the 2-h glucose test, the AUC was 0.903 (0.886-0.919). The cut-off point that maximized sensitivity (83%) and specificity (83%) was 141 mg/dL, identifying 21% of the women as positive. A cut-off point of 160 mg/dL, with lower sensitivity (62%), had higher specificity (94%), labeling 8.6% as positive. Detection of GDM can be done with a 1-h 75-g OGTT: the value of 160 mg/dL has the same diagnostic performance as the conventional 2-h value (140 mg/dL). The simplification of the test may improve coverage and timing of the diagnosis of GDM.

Meditationes sancti evangelii 75

Arkit: A-B4.

Trailing end-point phenotype antibiotic-sensitive strains of Candida albicans produce different amounts of aspartyl peptidases

Candida albicans is an opportunistic fungal pathogen that causes severe systemic infections in immunosuppressed individuals. C. albicans resistance to antifungal drugs is a severe problem in patients receiving prolonged therapy. Moreover, trailing yeast growth, which is defined as a resistant MIC after 48 h of incubation with triazole antifungal agents but a susceptible MIC after 24 h, has been noted in tests of antifungal susceptibility against some C. albicans isolates. In this context, we recently noticed this phenomenon in our routine susceptibility tests with fluconazole/itraconazole and C. albicans clinical isolates. In the present study, we investigated the production of cell-associated and secreted aspartyl peptidases (Saps) in six trailing clinical isolates of C. albicans, since this class of hydrolytic enzymes is a well-known virulence factor expressed by this fungal pathogen. Sap2, which is the best-studied member of the Sap family, was detected by flow cytometry on the cell surface of yeasts and as a 43-kDa polypeptide in the culture supernatant, as demonstrated by Western blotting assay using an anti-Sap1-3 polyclonal antibody. Released aspartyl peptidase activity was measured with BSA hydrolysis and inhibited by pepstatin A, showing distinct amounts of proteolytic activity ranging from 5.7 (strain 44B) to 133.2 (strain 11) arbitrary units. Taken together, our results showed that trailing clinical isolates of C. albicans produced different amounts of both cellular and secreted aspartyl-type peptidases, suggesting that this phenotypic feature did not generate a regular pattern regarding the expression of Sap.

Antibiotic residues in Brazilian UHT milk: a screening study

The aim of this research was to carry out a screening study to check the incidence of antimicrobial residues in Brazilian UHT milk according to rapid yoghurt method. Of the 100 (100%) samples analysed, 96 (96%) showed no traces of antibiotic residues while 4 (4%) indicated probable presence of antibiotic residues. The results suggest that the Brazilian Sanitary Surveillance Agency should apply continuous monitoring programs in order to obtain a safe product offering no health risks to consumers.

Changes in the physicochemical and microbiological properties of frozen araça pulp during storage

Araça belongs to the Myrtaceae family and is popularly known as araçá-comum, araçá-azedo, or araçá-do-campo. Frozen fruit pulp is of great importance for the food industry, which can produce it at the time of harvest, store it, and use it according to the demand of the consumer market and/or as an ingredient in the formulation of products such as yogurt, candies, and ice creams among others. The aim of this study was to evaluate the physical, chemical, and microbiological stability of frozen araça pulp during 12 months of frozen storage. It was observed that the levels of moisture (90.55-88.75%), ash (0.34-0.26%) total soluble sugars (7.11-6.62%), sucrose (3.55-1.39%), soluble pectin (0.24-0.23%), total pectin (0.5-0.46%), pH (3.82-2.31%), organic acids (698.12-122.25 µg.g-1 citric acid), and phenolic compounds (6.22-0.00 mg GAE.100 g-1) decreased during storage, whereas the levels of protein (0.61-0.83%), lipids (0.14-0.38%), total carbohydrates (8.36-9.78%), calorific value (37.14-45.86 kcal.100 g-1), reducing sugars (3.51-5.21%), soluble solids (5.17-6.0%), total antioxidant capacity (6.89-35.13%), and color parameters (L*49.75-50.67; a*0.79-1.82 and b*22.5-25.19) increased over the one-year storage period. According to the chemical and microbiological parameters assessed, the product can be stored for 12 months without loss of quality with addition of citric acid as a preservative.

Characterization and effect of clarified araçá (Psidium guineenses Sw.) juice on postprandial glycemia in healthy subjects

Brazilian native fruits are excellent sources of bioactive compounds of phenolic nature. Some of these compounds are able to inhibit carbohydrate- metabolizing enzymes (in vitro), α-amylase and α-glucosidase, delaying carbohydrate digestion. This study aimed to evaluate the effect of clarified araçá (Psidium guineenses Sw.) juice on postprandial glycemia in humans after consumption of 25 g of available carbohydrates (approximately 50 g of white bread) and characterize the phenolic compounds and in vitro antioxidant capacity of araçá juice and pulp. The results showed that the clarified juice had a positive effect on postprandial glycemia reducing the total amount of glucose absorbed, lengthening the time to reach maximum blood glucose concentration, reducing glucose incremental velocity, and decreasing glucose incremental percentage. Both frozen pulp and clarified juice had high amounts of phenolic compounds, antioxidant capacity, and proanthocyanidins, among which oligomers (monomers to tetramers), pentamers, hexamers, heptamers, octamers, nonamers, decamers, and polymers were detected, and they are probably associated with in vivo effects.

Application of enzymatic preparations to produce araçá pulp and juice

In the present study, the effect of pectinases on the production of pulp and juice of araçá and the presence of bioactive compounds were evaluated. An enzyme extract (EE) produced by Aspergillus niger LB-02-SF in solid state fermentation and the commercial enzyme Ultrazym®AFP-L were used in this study. After enzyme treatment with the EE preparation, the extraction yield increased by 23.1% and viscosity decreased by 42.8%, during pulp maceration. During juice processing, there was an increase of 70.6% in clarification and a decrease of 72.87% in turbidity. Higher values of these parameters, 47.7, 69.0, 80.7, and 79.7%, respectively, were obtained using the Ultrazym®AFP-L, which also led to a significant increase in the polyphenol content, both in the pulp (24%) and in the juice (28%), with a less pronounced effect when the EE was applied (10 and 21%, respectively). The anthocyanins content in the araçá pulp increased after treatment with the commercial preparation (23%), and there was no significant increase with the use of EE. The use of Ultrazym®AFP-L increased the β-carotene content by 29.4% in the fruit pulp, while the treatment with EE did not result in significant changes compared with those of the juice and pulp controls.

Development of a rapid method for the determination of antibiotic residues in honey using UPLC-ESI-MS/MS

Abstract An accurate, reliable and fast multianalyte/multiclass ultra-performance liquid chromatography–tandem mass spectrometry (UPLC–MS/MS) method was developed and validated for the simultaneous analysis of 23 pharmaceuticals, belonging to different classes amphenicols, sulfonamides, tetracyclines, in honey samples. The method developed consists of ultrasonic extraction followed by UPLC–ESI–MS/MS with electrospray ionization in both positive mode and negative mode. The influence of the extraction solvents and mobile phase composition on the sensitivity of the method, and the optimum conditions for sample weight and extraction temperature in terms of analyte recovery were extensively studied. The identification of antibiotics is fulfilled by simultaneous use of chromatographic separation using an Acquity BEH C18 (100 mm x 2.1 mm, 1.7 µm) analytical column with a gradient elution of mobile phases and tandem mass spectrometry with an electrospray ionization. Finally, the method developed was applied to the determination of target analytes in honey samples obtained from the local markets and several beekeepers in Muğla, Turkey. Ultrasonic-extraction of pharmaceuticals from honey samples is a well-established technique by UPLC–ESI–MS/MS, the uniqueness of this study lies in the simultaneous determination of a remarkable number of compounds belonging to 23 drug at the sub-nanogram per kilogram level.