[Early-onset neonatal infection: assessment of professional practices in 14 maternity wards in the Île-de-France region in 2013]. / Infections néonatales bactériennes précoces : évaluation des pratiques professionnelles dans 14 maternités d'Île-de-France en 2013.

INTRODUCTION: Early-onset neonatal infection remains a major cause of morbidity and mortality in neonates. Both universal vaginal screening for group-B streptococcus (GBS) and intrapartum antibiotic prophylaxis have decreased the incidence of early-onset GBS disease. Almost 12 years after the implementation of the French recommendations, we assessed the practices around screening, diagnosis, and treatment of early-onset neonatal infection in the Île-de-France region. PATIENTS AND METHODS: We conducted a prospective, multicenter, observational study in 14 volunteer maternity wards from 18 to 31 March 2013. All live newborn infants delivered at 35 gestational weeks or more were eligible. Maternal, obstetrical, and neonatal characteristics were collected, as well as the management of suspected early-onset neonatal infections. RESULTS: A total of 1194 mothers and 1217 neonates were included. Among the latter, 54% had bacteriological samplings at birth, with at least a gastric aspirate. Bacteriological samples were collected at birth in 85% of cases based on major or minor anamnestic infection criteria defined by the French National Authority for Health in 2002. In addition, 26% of neonates had at least one blood sample taken. Antibiotic treatment was administered in 4% of the infants with cefotaxime administered in two thirds of cases. CONCLUSION: An update of the French guidelines for the management of early-onset neonatal infections is required in order to improve targeting of newborn infants suspected of having an infection and to optimize the antibiotics administered. Moreover, the role of bacteriological sampling at birth needs to be clarified.

Probiotic characterization of potential hydrolases producing Lactococcus lactis subsp. lactis isolated from pickled yam.

The aim of this study was to characterize potential probiotic strain co-producing α-amylase and ß-galactosidase. Sixty-three strains, isolated from pickle samples were screened for their hydrolase producing capacity by utilizing different starches as carbon source. One out of 63 strains, isolated from traditionally fermented pickled yam showing maximum hydrolase activity (α-amylase (36.9 U/ml) and ß-galactosidase (42.6 U/ml)) within a period of 48 hours was identified as Lactococcus lactis subsp. lactis. Further, it was assessed for the probiotic characteristics under gastrointestinal conditions like acidic, alkaline, proteolytic enzymes, bile stress and found to exhibit tolerance to these stresses. The therapeutic potential of the isolate is implicated because of its antagonistic effect against enteric foodborne pathogens (Salmonella typhimurium, Escherichia coli 0157:H7, Staphylococcus aureus, Yersinia enterocolitica and Aeromonas hydrophila). The results of this study entail a potential applicability of the isolate in developing future probiotic foods besides the production of industrially significant hydrolases.

In vitro assessment of the gastrointestinal transit tolerance of taxonomic reference strains from human origin and probiotic product isolates of Bifidobacterium.

Next to health promoting effects, the functional aspect of probiotic strains also involves their capacity to reach the colon as viable metabolically active cells. The present study aimed to assess the potential of 24 probiotic product isolates and 42 human reference strains of Bifidobacterium to survive gastrointestinal transit under in vitro conditions. The survival capacity of exponential and stationary phase cultures upon exposure to gastric and small intestinal juices was determined using a recently developed microplate-based assay in combination with the LIVE/DEAD BacLight Bacterial Viability kit. All 66 strains tested displayed a considerable loss in viability during exposure to an acidic pepsin containing solution (pH 2.0). Among the 10 taxa tested, cultures of B. animalis ssp. lactis appeared to be most capable to survive gastric transit. Although to a lesser extent, the presence of bile salts also affected the viability of most of the strains tested. Except for 3 strains, all 66 strains showed bile salt hydrolase activity using an agar-based assay. In contrast, the bifidobacterial strains used in this study appeared to possess a natural ability to survive the presence of pancreatin (pH 8.0). Although the effect was not significant, a slightly enhanced tolerance to gastrointestinal transit was observed when cells were in the stationary phase, especially when exposed to acid, compared with cells being in the exponential phase. Survival in the gastrointestinal tract appeared to be largely strain-dependent and hence implies that different strains will likely display a different behavior in functionality. The assay used in this study allows an initial assessment of strains for use as probiotic cultures prior to selecting potential candidate strains for further investigation in vivo.

In vitro assessment of the upper gastrointestinal tolerance of potential probiotic dairy propionibacteria.

This study aimed to assess the transit tolerance of potential probiotic dairy propionibacteria strains in human upper gastrointestinal tract in vitro, and to evaluate the effect of food addition on viability of these strains in simulated pH 2.0 gastric juices. The transit tolerance of 13 dairy propionibacteria strains was determined at 37 degrees C by exposing washed cell suspensions to simulated gastric juices at pH values at 2.0, 3.0, and 4.0, and simulated small intestinal juices (pH 8.0) with or without 0.3% bile salts. The viability of dairy propionibacteria in pH 2.0 simulated gastric juice with So-Good original soymilk or Up & Go liquid breakfast was also determined. The simulated gastric transit tolerance of dairy propionibacteria was strain-dependent and pH-dependent. All tested strains were tolerant to simulated small intestinal transit. The addition of So-Good original soymilk or Up & Go liquid breakfast greatly enhanced the survival of dairy propionibacteria strains in pH 2.0 simulated gastric juices. Dairy propionibacteria strains demonstrate high tolerance to simulated human upper gastrointestinal tract conditions and offer a relatively overlooked, yet alternative source for novel probiotics besides Lactobacillus and Bifidobacterium.

[Optimization of the number of bacteriologic tests in the diagnosis of tuberculosis]. / Zur Optimierung der Zahl bakteriologischer Untersuchungen in der Diagnostik der Tuberkulose.

A retrospective analysis over three years in the Cantonal Hospital of Basel favours the continued use of acid-fast smears in suspected tuberculosis. 54% of pulmonary tuberculosis cases can already be diagnosed with acid-fast smears. Smears of gastric aspirates and urine specimens can usually be dispensed with, as the false-positive quotation is much too high (18% for gastric aspirates and 89% for urine specimens). Where there are sputum specimens available, no additional cultures of gastric aspirates are necessary. If pulmonary tuberculosis is diagnosed, cultures of urine specimens are recommended as a means of searching for (probable) urogenital infection.