[Determinants of Cognitive Development in Preschoolers - Results of the Mann-Zeichen Test]. / Determinanten der kognitiven Entwicklung bei Kindern ­ Ergebnisse des Mann-Zeichen-Tests aus der Vorschuluntersuchung.

OBJECTIVES: To study the determinants and factors influencing the development of cognition and perception using the Mann-Zeichen Test in preschool children. METHODS: Data were obtained from the Ulm Birth Cohort Study (UBCS) including newborns and their mothers recruited in Ulm between 2000-2001. Data were collected using self-administered parental questionnaires following delivery (baseline examination) and at 2, 3, 4, and 6 years of children's age. Cognitive development was tested using drawings of n=298 children at a school entrance examination (mean age=5.8 years, SD=0.4). Bi- und multivariable linear regression analyses were conducted. RESULTS: In boys, we observed statistically significant positive associations between high paternal education and the children's cognitive development (regression coefficient b, p-value: 6.65, p=0.018). There was a trend towards negative association between institutional care during the first 3 years of life (b=- 0.18/months of institutional care, p=0.074), as well as allergic diseases (b=- 6.02, p=0.075) and cognitive development. More than 30 min. spent on watching television (TV) or video at children's age of 4 years was significantly associated with reduced cognitive abilities at 6 years of age (b=- 9.37, p=0.005). In girls, there was a trend towards negative association between maternal education (b=- 4.43, p=0.091) and a positive association between allergic diseases and the cognitive development (b=6.42, p=0.075). Mutually adjusted, the effects were attenuated in boys and girls. However, a negative association between paternal education and time spent watching TV with children's cognitive ability was observed. CONCLUSION: The study shows modifiable factors associated with the cognitive abilities at age 6 years, especially early TV consumption in boys.

Microbiological diagnosis and molecular typing of Legionella strains during an outbreak of legionellosis in Southern Germany.

An explosive outbreak of Legionnaires' disease with 64 reported cases occurred in Ulm/Neu-Ulm in the South of Germany in December 2009/January 2010 caused by Legionella (L.) pneumophila serogroup 1, monoclonal (mAb) subtype Knoxville, sequence type (ST) 62. Here we present the clinical microbiological results from 51 patients who were diagnosed at the University hospital of Ulm, the results of the environmental investigations and of molecular typing of patients and environmental strains. All 50 patients from whom urine specimens were available were positive for L. pneumophila antigen when an enzyme-linked immunosorbent assay (EIA) was used following concentration of those urine samples that tested initially negative. The sensitivity of the BinaxNow rapid immunographic assay (ICA), after 15 min reading and after 60 min reading were 70% and 84%, respectively. Direct typing confirmed the monoclonal subtype Knoxville in 5 out of 8 concentrated urine samples. Real time PCR testing of respiratory tract specimens for L. pneumophila was positive in 15 out of 25 (60%) patients. Direct nested sequence based typing (nSBT) in some of these samples allowed partial confirmation of ST62. L. pneumophila serogroup 1, monoclonal subtype Knoxville ST62, defined as the epidemic strain was isolated from 8 out of 31 outbreak patients (26%) and from one cooling tower confirming it as the most likely source of the outbreak. While rapid detection of Legionella antigenuria was crucial for the recognition and management of the outbreak, culture and molecular typing of the strains from patients and environmental specimens was the clue for the rapid identification of the source of infection.

Role of infected parents in transmission of helicobacter pylori to their children.

AIM: Infected parents, especially infected mothers, may play a key role in transmission of Helicobacter pylori within the family. The aim of this population-based study was to determine the role of parental infection status in transmission of H. pylori to the child by taking into consideration the infection status of both parents simultaneously. METHODS: Study subjects were a sample of preschool children in the city of Ulm, located in Southern Germany, who were screened for school fitness between January and July, 1998. The infection status of the children was determined by the 13C-urea breath test (UBT). Parental infection status was determined by measurement of specific H. pylori IgG antibodies in saliva using a modified immunoassay (Milenia H. pylori IgG; DPC, Biermann, Germany). The parents provided additional information through a standardized questionnaire. RESULTS: We included 305 children ages 5 to 7 years (mean age, 5.8 years) and their parents in the analysis. Prevalence of H. pylori infection in children by means of UBT was 10.2% [95% confidence interval (CI) 7.0-14.1%]. The prevalence of infection was 5.1% if the mother showed no salivary antibody response against H. pylori and 17.3% if she did. Prevalence of infection in children was 6.8% if the father showed no salivary antibody response and 19.1% if he did. After adjustment for potential confounders (including infection of the spouse), the odds ratio for H. pylori infection of the child was 3.9 (95% CI 1.4 to 10.6) when the mother was saliva-positive and 2.0 (95% CI 0.8 to 5.3) when the father was saliva-positive. CONCLUSION: This study strengthens previous evidence that in the population studied infected parents, in particular mothers may play a key role in transmission of H. pylori to the child.