Does the intestinal bifidobacterial colonisation affect bacterial translocation?

The aim of this work was to investigate the possible role of the intestinal anaerobic flora (especially bifidobacteria) in regulating bacterial translocation (BT) which can be defined as the passage of intestinal microbes through the mucosa to internal organs. Default in BT regulation concurs with pathogenesis of sepsis in various human conditions, such as acute pancreatitis, cirrhosis, necrotising enterocolitis or multiple organ failure. The intestinal flora was studied in human flora associated mice (HF mice) and BT was quantified in Peyer's patches (PP), blood, spleen, liver and lungs. HF mice displayed a heterogenic intestinal colonisation with bifidobacteria. High colonisation of both caecum and colon by bifidobacteria led to a poorer bacterial contamination of blood, liver and lungs. Moreover, ileal, caecal and colonic bifidobacterial counts negatively correlated with the bacterial dissemination (number of contaminated organs per mouse). In contrast, Bacteroides fragilis group counts positively correlated with bacteraemia, lungs contamination or bacterial dissemination. Additionally, clostridia localised in the colon affected bacterial uptake by PP and lungs contamination as indicated by positive correlations between bacterial populations in these respective locations. These results indicate that bifidobacteria, when established in high counts, reduced BT to liver, blood and lungs, whereas B. fragilis group favoured the bacterial passage. Clostridia established in the distal ileum also seemed to favour BT to lungs. The manipulation of the bacterial flora to optimise the regulatory effect on BT should therefore focus on the selective promotion of bifidobacteria and avoid an increase in potentially detrimental populations such as B. fragilis group and clostridia.

Intra-familial transmission of Helicobacter pylori infection in children of households with multiple generations in Vietnam.

This community-based cross-sectional study in 533 participants from 135 households with multiple generations living in the same household aimed at investigating the relationship between Helicobacter pylori infection in children and the other household members. H. pylori infection in children was found significantly associated with the infection in mothers [OR (95% CI): 2.50 (1.19-5.26)], even after being adjusted for sex, age group and sibling number [adjusted OR (95% CI): 2.47 (1.12-5.47)]. It was also significantly associated with the infection in both parents [adjusted OR (95% CI): 4.14 (1.29-13.23)]. No significant association between H. pylori infection in the father, grandparent(s), uncle or aunt with that in their children was found. Results from the present study showed intra-familial transmission in a multi-generation population and supported the hypothesis of person-to-person transmission of H. pylori infection.

Prevalence of and factors associated with Helicobacter pylori infection in children in the north of Vietnam.

The study aimed at evaluating the seroprevalence of and sociodemographic, health, lifestyle, and environmental hygiene conditions associated with Helicobacter pylori infection in Vietnamese children. Data from 824 children, aged from 6 months to 15 years and gastrointestinal symptom free when consulted, admitted to a university hospital, were collected using a structured questionnaire and ELISA test for H. pylori infection. The data were examined using univariate and multivariate analyses. H. pylori seroprevalence was 34.0%. Age groups from 3 to 6 years and older than 6, and number of offspring were positively and independently associated with H. pylori seropositivity [adjusted OR (95% CI): 2.9 (1.5-5.5); 1.9 (1.1-3.1) and 1.8 (1.1-2.6), respectively]. Breastfeeding more than 6 months was negatively and independently associated with H. pylori seropositivity [adjusted OR (95% CI): 0.5 (0.3-0.9)]. Mother's age, history of allergy, gastro-duodenal disease history in the past, initiating collective life before 6 years, sharing bed with parents and time of bed sharing with parents > 24 months were positively but not independently associated with H. pylori seropositivity. None of the other environmental or lifestyle conditions examined was associated with H. pylori infection. Our results support person-to-person transmission and the role of sociodemographic factors in H. pylori infection.

Assessment of a rapid urinary antigen detection by an immunochromatographic test for diagnosis of pneumococcal infection in children.

The aim of the study was to evaluate the Binax Now rapid immunochromatographic test (ICT) for the detection of Streptococcus pneumoniae urinary antigen in children suffering from potentially pneumococcal infections. A total of 287 patients, with a median age of 34.9 months and divided into 3 groups, were studied; the first group of patients with a suspected pneumococcal infection (n = 112), the second group with infectious symptoms nonsuggestive of a pneumococcal infection (n = 54), and the third group was composed of asymptomatic children (n = 121). In group 1, sensitivity of ICT was 100% and specificity was 55.9% (95% confidence interval, 44.1- 67.7). Forty-six (85.1%) patients from the second group were true negatives. Twenty-five (20.7%) patients from the third study group were nasopharyngeal pneumococcal carriers, and the ICT was positive in 13 carriers (10.7%). The high sensitivity level of ICT in our study indicates that a negative test could rule out a pneumococcal infection, contrasted with a poor specificity.

[Fibrodysplasia ossificans progressiva in children. The interest of early diagnosis and treatment]. / Fibrose ossifiante progressive de l'enfant. Intérêt d'un diagnostic et d'une prise en charge précoces.

INTRODUCTION: A rare genetic disease (with around a hundred cases in France), fibrodysplasia ossificans progressiva is characterized by heterotopic ossification and congenital malformation of the bones. It is worsened by physical trauma, progresses in successive flares and slowly results in total confinement of the children because of the calcification of the muscles and ankylosis of all the joints. OBSERVATIONS: We report the case of two children exhibiting fibrodysplasia ossificans progressiva in whom diagnosis was delayed at the age of 4 and 18 months respectively. DISCUSSION: Fibrodysplasia ossificans progressiva must be diagnosed during the neonate period. Early treatment will help to avoid the factors of aggravation, slow the progression of the disease and provide the children with improved quality of life. Unfortunately, there is no efficient treatment, bisphosphonates and corticosteroids are only beneficial during the flares. Hope for the future relies on gene therapy.

Increased poliovirus-specific intestinal antibody response coincides with promotion of Bifidobacterium longum-infantis and Bifidobacterium breve in infants: a randomized, double-blind, placebo-controlled trial.

To determine whether the size of the intestinal bifidobacterial population can influence the immune response to poliovirus vaccination in infants, we set up a randomized, placebo-controlled trial. From birth to 4 mo, infants were given a fermented infant formula (FIF) or a standard formula (placebo). Bifidobacteria were quantified monthly in infant stools. Antipoliovirus IgA response to Pentacoq was assessed before and 1 mo after the second vaccine injection. Thirty infants were randomized, and 20 completed the study (nine in the placebo group and 11 in the FIF group). Fecal bifidobacterial level was significantly higher with the FIF group at 4 mo of age (p=0.0498). Furthermore, B. longum/B. infantis carriage was higher at 4 mo in the FIF group (p=0.0399). Antipoliovirus IgA titers increased after Pentacoq challenge (p <0.001), and the rise was significantly higher in the FIF group (p <0.02). Antibody titers correlated with bifidobacteria, especially with B. longum/B. infantis and B. breve levels (p <0.002). Infants who harbored B. longum/B. infantis also exhibited higher levels of antipoliovirus IgAs (p <0.002). In conclusion, the present results indicate that antipoliovirus response can be triggered with a fermented formula that is able to favor intestinal bifidobacteria. Whether this effect on the immune system is achieved through the bifidogenic effect of the formula (mainly through B. longum/B. infantis and B. breve stimulation) or directly linked to compounds (i.e. peptides) produced by milk fermentation remains to be investigated.