Mycotoxicoses in children.

Mycotoxicoses are acute and chronic poisonings caused by mould toxins called mycotoxins. Although acute mycotoxicoses, caused by high mycotoxin levels in food are rare nowadays, they need to be described in order to inform physicians and other health care workers about their symptoms. Children are more sensitive to mycotoxins because of their lower body mass, higher metabolic rate, and underdeveloped organ functions and detoxication mechanisms. Some mycotoxicoses appear only in children, and some are more pronounced in children than in adults. Acute mycotoxicoses in children are reported poorly, mostly because they occur in the tropical regions with poor healthcare coverage. In developed countries healthcare authorities are more concerned about child exposure to low levels of mycotoxins with immunotoxic, genotoxic or carcinogenic properties.

Contaminação fúngica no leite humano e em sítios anatômicos de lactantes e lactentes / Fungal contamination in human milk and in the anatomic sites of breastfeeding mothers and infants

As infecções bacterianas ou fúngicas causam quadro clínico de mastite, que motiva desmame precoce. Os micro-organismos patogênicos, como leveduras do gênero Candida , quando em número elevado no intestino, podem causar disbiose. Nesta pesquisa, foram realizadas a detecção e a identificação de microbiota fúngica nas amostras de leite humano e de sítios anatômicos de mulheres e crianças atendidas pelo Banco de Leite Humano do Instituto Fernandes Figueira. A virulência dos isolados de levedura foi determinada pelos testes de atividade proteolítica. De 64 amostras analisadas, 81% foram positivas para fungos, com maior prevalência de Candida albicans (73%), seguida do complexo C. parapsilosis (15,4%). Perfis semelhantes aos verificados no total de amostras foram encontrados nas amostras de leite, nas mamas e na cavidade oral, sugerindo-se a ocorrência de associação entre a infecção cutânea da mãe e do lactente com o leite ingerido. O perfil associado à virulência dos isolados de Candida foi determinado pelo teste de produção de proteases, e 100% das amostras mostraram resultados fortemente positivos, indicando alto grau de infecciosidade . A alta prevalência de C. albicans nas amostras coletadas de mamas, no leite e na cavidade oral, é importante fator de risco à saúde de lactentes.(AU)

Bacterial or fungal infections might produce a clinical feature of mastitis, which is one of the main causes of precocious breast-feeding discontinuity. In addition, when the potentially pathogenic microorganisms as yeast of Candida genera were in high counting in the intestine, might cause dysbiosis. This study aimed detecting and identifying fungi in human milk and anatomical sites of breast-feeding women and infants who were enrolled at Human Milk Bank of the Institute Fernandes Figueira. The virulence of the yeast isolates was evaluated by means of proteolytic activity tests. Eight-one percent of 64 analyzed samples showed positive results to fungi, with a highest prevalence of Candida albicans (73%) followed by C. parapsilosis complex (15.4%). Similar profiles were found in samples of milk, of breasts and of infants mouth cavity, suggesting a correlation between breast-feeding mothers and infants cutaneous infections with the ingested milk. The virulence of the isolated Candida was determined by the proteolytic activity test. All of the isolates (100%) were strongly positive, indicating a high degree of infectivity. The high prevalence of C. albicans in samples collected from breasts, mouth cavity and milk is a crucial risk factor for the infants health.(AU)

[Mycotoxin research in humans]. / Investigación del efecto de las micotoxinas en el ser humano.

This study investigates the occurrence of aflatoxins in Ecuador. Early investigators proved the presence of aflatoxins in human and animal food, but the disturbing data lead to the formation of two research teams at Guayaquil University and the Agrarian University of Ecuador to investigate aflaxotins and other mycotoxins in food and their relationship to human health. Because the concept of mycotoxicosis as a result of the secondary metabolites produced by different species of moulds could cause different clinical patterns, the research team includes Aspergillus metabolites found in the urine of a patient with pulmonary aspergilloma. We considered that the body itself could create secondary metabolites. An ELISA method was used to detect mycotoxins with the specific reactive compounds using a company base assay. This allows the detection quantitative of such metabolites in 24 h collected urine. The patient was treated with itraconazole for nine months, after clinical, radiological and aflatoxins testing. We also investigated three other cases in children with a second level of malnutrition and only with vomitoxins results and in three investigated cases of otomycosis caused by Aspergillus niger only in one case traces of aflatoxins were found.

Experimental subchronic mycotoxicoses in mice: individual and combined effects of dietary exposure to fumonisins and aflatoxin B1.

We have used a murine model of subchronic mycotoxicoses produced by ingestion of mycotoxins. The five groups of animals studied were fed for 30, 60 and 90 days, respectively, with commercial diet (CD), experimental control diet (ECD), experimental with fumonisin B1 diet (EFD) and experimental with mixtures of mycotoxins diet (EMD). The animals fed EFD and EMD showed a significant increase in feed consumption/day with respect to the animals fed ECD (P < 0.005 for both groups). The biochemical measurements showed significant differences at 90 days in those animals fed EAD exhibiting a marked decrease in the values of alkaline phosphatase (ALP) and cholesterol (P < 0.05), along with a significant increase in calcium (P < 0.01). Differences in the decrease of the parameters studied were observed in mice fed EFD for triglycerides, cholesterol and calcium (P < 0.05 for all of them). The activity of aspartate transaminase (AST) increased significantly in animals fed EMD (P < 0.01). The tissue specimens at 60 days showed lesions in the livers of the animals fed EAD and EFD. At 90 days, and in those fed EAD, EFD and EMD, the lesions were intensified in the liver at 60 days in 80, 90 and 100% of the animals, respectively.

Worldwide regulations for ochratoxin A.

Currently, some 60 countries have enacted or proposed regulations for levels of mycotoxins in food and animal feed. Various factors may influence the establishment of tolerances for certain mycotoxins, such as the availability of data on dietary exposure and on toxicology, the distribution of the mycotoxins over commodities, the availability of analytical methodology, legislation in countries with which trading occurs and a sufficient food supply. Most of the existing regulations for mycotoxins concern aflatoxins, but the number of countries that regulate other mycotoxins as well is growing. Of the nephrotoxic mycotoxins, ochratoxin A was the only one for which regulations existed in 1990. At least 11 countries have proposed or official limits for ochratoxin A. The acceptable levels range from 1 to 50 micrograms/kg for food and from 100 to 1000 micrograms/kg for animal feed. The scientific basis for the established regulations appears to be weak, and a rationalization of tolerance levels for ochratoxin A would be highly desirable.