Salivary dysbiosis and the clinical spectrum in anti-Ro positive mothers of children with neonatal lupus.

Mothers giving birth to children with manifestations of neonatal lupus (NL) represent a unique population at risk for the development of clinically evident pathologic autoimmunity since many are asymptomatic and only become aware of anti-SSA/Ro positivity (anti-Ro+) based on heart block in their fetus. Accordingly, we hypothesized that the microbiome in saliva is associated with the development of autoreactivity and in some cases the progression in health status from benign to overt clinical disease including Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE). The study comprised a clinical spectrum of anti-Ro+ mothers, all of whom gave birth to a child with NL: 9 were asymptomatic or had an undifferentiated autoimmune disease (Asym/UAS) and 16 fulfilled criteria for SS and/or SLE. Microbial diversity was reduced across all levels from kingdom to species for the anti-Ro+ mothers vs healthy controls; however, there were no significant differences between Asym/UAS and SS/SLE mothers. Relative abundance of Proteobacteria and more specifically class Betaproteobacteria decreased with clinical severity (healthy controls < Asym/UAS < SS/SLE). These ordered differences were maintained through the taxonomic hierarchy to three genera (Lautropia, Comamonas, and Neisseria) and species within these genera (L. mirabilis, N. flavescens and N. oralis). Biometric analysis comparing von Willebrand Factor domains present in human Ro60 with L. mirabilis proteins support the hypothesis of molecular mimicry. These data position the microbiome in the development of anti-Ro reactivity and subsequent clinical spectrum of disease.

Bacterial contamination associated with electronic faucets: a new risk for healthcare facilities.

OBJECTIVE: To investigate the safety of the hospital water supply following a major flood. DESIGN: Surveillance was conducted of the hospital water supply as it entered the hospital and at randomly selected water faucets throughout the facility. SETTING: A newly constructed surgical critical-care unit in a 265-bed community hospital that had to be evacuated and was out of operation for 6 weeks following a major flood of the city. METHODS: Random water samples throughout the facility were analyzed for heterotrophic plate counts (HPCs), chlorine, and coliforms utilizing standard methods. RESULTS: Water samples entering the hospital met appropriate standards, indicating the city water distribution system was not contaminated. Of 169 faucets tested, 13 (22%) of 59 electronic faucets exceeded the HPC threshold, and 12 (11%) of 110 manual faucets exceeded the HPC threshold (P<.14). A comparison of two brands of electronic faucets with manual faucets and with each other revealed that the HPC threshold was exceeded by 11 (32%) of 34 brand A faucets as compared to 12 (11%) of 110 manual faucets (P<.006). The HPC threshold was exceeded by 2 (8%) of 25 brand B faucets compared to 12 (11%) of 110 manual faucets (P<.94). Contamination rates of brand A and brand B faucets differed significantly (P<.003). Similar testing 2 months after hyperchlorination of the water supply indicated that the HPC threshold was exceeded by 16 (52%) of 31 brand A faucets compared to 10 (9.%) of 110 manual faucets (P<.0000003) and by 2 (18%) of 25 brand B faucets compared to 10 (9%) of 110 manual faucets (P=1.0). CONCLUSIONS: A certain brand of electronic water faucet used in the hospital was associated with unacceptable levels of microbial growth in water and was a continuing source of bacteria potentially hazardous to patients.

Evaluation of the Megaduct sweat collector for mineral analysis.

Accurate measurement of sweat mineral loss is important for whole body mineral balance estimates and dietary reference intake formulation. Currently, common localized sweat collection methods such as the pouch and patch techniques may be limited by skin encapsulation and/or hidromeiosis, which may alter sweat mineral concentrations. The design of the newly developed Megaduct sweat collector may avoid these possible limitations. Therefore, the purpose of this study was to evaluate the utility of the Megaduct sweat collector for mineral analysis. Megaduct sweat collectors were affixed to ten volunteers on the final day of a heat acclimation protocol; collection time, sweat volume, and mineral concentrations of calcium, copper, iron, potassium, sodium, and zinc were measured. Megaduct filling required a collection period of 62 ± 3 min due to a small collection surface (22.1 cm(2)). The mineral content of the sweat was 0.3 ± 0.1 mmol L(-1), 1.5 ± 1.5 µmol L(-1), 8.5 ± 2.1 mmol L(-1), 43.2 ± 15.0 mmol L(-1), and 10.1 ± 5.7 µmol L(-1) for Ca, Cu, K, Na, and Zn, respectively. The Megaduct sweat collector appears to avoid skin encapsulation and hidromeiosis, and captures sweat with similar mineral concentrations as reported in the literature for pouches. However, the filling time of the Megaduct (>60 min) may not capture possible changes in sweat mineral concentrations that are documented to occur in as little as 15 to 30 min.