Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section: a prospective cohort study.

OBJECTIVES: To investigate changes in vaginal microbiota during pregnancy, and the association between vaginal dysbiosis and reproductive outcomes. METHODS: A total of 730 (week 24) and 666 (week 36) vaginal samples from 738 unselected pregnant women were studied by microscopy (Nugent score) and characterized by 16S rRNA gene sequencing. A novel continuous vaginal dysbiosis score was developed based on these methods using a supervised partial least squares model. RESULTS: Among women with bacterial vaginosis in week 24 (n = 53), 47% (n = 25) also had bacterial vaginosis in week 36. In contrast, among women without bacterial vaginosis in week 24, only 3% (n = 18) developed bacterial vaginosis in week 36. Vaginal samples dominated by Lactobacillus crispatus (OR 0.35, 95% CI 0.20-0.60) and Lactobacillus iners (OR 0.40, 95% CI 0.23-0.68) in week 24 were significantly more stable by week 36 when compared with other vaginal community state types. Vaginal dysbiosis score at week 24 was associated with a significant increased risk of emergency, but not elective, caesarean section (OR 1.37, 955 CI 1.15-1.64, p < 0.001), suggesting a 37% increased risk per standard deviation increase in vaginal dysbiosis score. CONCLUSIONS: Changes in vaginal microbiota from week 24 to week 36 of pregnancy correlated with bacterial vaginosis status and vaginal community state type. A novel vaginal dysbiosis score was associated with a significantly increased risk of emergency, but not elective, caesarean section. This was not found for bacterial vaginosis or any vaginal community state type and could point to the importance of investigating vaginal dysbiosis as a nuanced continuum instead of crude clusters.

Environmental shaping of the bacterial and fungal community in infant bed dust and correlations with the airway microbiota.

BACKGROUND: From early life, children are exposed to a multitude of environmental exposures, which may be of crucial importance for healthy development. Here, the environmental microbiota may be of particular interest as it represents the interface between environmental factors and the child. As infants in modern societies spend a considerable amount of time indoors, we hypothesize that the indoor bed dust microbiota might be an important factor for the child and for the early colonization of the airway microbiome. To explore this hypothesis, we analyzed the influence of environmental exposures on 577 dust samples from the beds of infants together with 542 airway samples from the Copenhagen Prospective Studies on Asthma in Childhood2010 cohort. RESULTS: Both bacterial and fungal community was profiled from the bed dust. Bacterial and fungal diversity in the bed dust was positively correlated with each other. Bacterial bed dust microbiota was influenced by multiple environmental factors, such as type of home (house or apartment), living environment (rural or urban), sex of siblings, and presence of pets (cat and/or dog), whereas fungal bed dust microbiota was majorly influenced by the type of home (house or apartment) and sampling season. We further observed minor correlation between bed dust and airway microbiota compositions among infants. We also analyzed the transfer of microbiota from bed dust to the airway, but we did not find evidence of transfer of individual taxa. CONCLUSIONS: Current study explores the influence of environmental factors on bed dust microbiota (both bacterial and fungal) and its correlation with airway microbiota (bacterial) in early life using high-throughput sequencing. Our findings demonstrate that bed dust microbiota is influenced by multiple environmental exposures and could represent an interface between environment and child. Video Abstract.

Optimization of flow cytometry parameters for high-throughput screening of spores of the filamentous fungus Trichoderma reesei.

Flow cytometry (FCM) is a powerful technique still little used to study filamentous fungi due to physical constraints: the hyphae are too large to enter the FCM fluidic system, unless spores can be analyzed at a very early stage of germination. The technique nevertheless has strong potential for the study of these micro-organisms (spore sorting, viability, characterization etc.). This study focused on the investigation of several parameters, ranging from germination and storage conditions of T. reesei spores through to FCM gating, to detect their fluorescence during the first 24 h of germination. Fluorescent spores were first obtained after aerobic germination at 25 °C and monitored over 24 h using FCM, to screen for nine promoters controlling a green fluorescent protein gene. The fluorescence signal (FL1) was then acquired, in addition to the growth characterization of the spores, based on the size signal or Forward Scatter (FSC). They were combined to identify the best candidate(s) from among the nine promoters for the strongest- and earliest-possible fluorescence emission, which resulted in the following ranking: pTEF > pPKI > pGPD > pPDC. There are numerous possible applications of this work, ranging from molecular biology to monitoring fermentation.

Prenatal dietary supplements influence the infant airway microbiota in a randomized factorial clinical trial.

Maternal dietary interventions during pregnancy with fish oil and high dose vitamin D have been shown to reduce the incidence of asthma and wheeze in offspring, potentially through microbial effects in pregnancy or early childhood. Here we analyze the bacterial compositions in longitudinal samples from 695 pregnant women and their children according to intervention group in a nested, factorial, double-blind, placebo-controlled, randomized trial of n-3 long-chain fatty acids and vitamin D supplementation. The dietary interventions affect the infant airways, but not the infant fecal or maternal vaginal microbiota. Changes in overall beta diversity are observed, which in turn associates with a change in immune mediator profile. In addition, airway microbial maturation and the relative abundance of specific bacterial genera are altered. Furthermore, mediation analysis reveals the changed airway microbiota to be a minor and non-significant mediator of the protective effect of the dietary interventions on risk of asthma. Our results demonstrate the potential of prenatal dietary supplements as manipulators of the early airway bacterial colonization.

Pathogen surveillance in the informal settlement, Kibera, Kenya, using a metagenomics approach.

BACKGROUND: Worldwide, the number of emerging and re-emerging infectious diseases is increasing, highlighting the importance of global disease pathogen surveillance. Traditional population-based methods may fail to capture important events, particularly in settings with limited access to health care, such as urban informal settlements. In such environments, a mixture of surface water runoff and human feces containing pathogenic microorganisms could be used as a surveillance surrogate. METHOD: We conducted a temporal metagenomic analysis of urban sewage from Kibera, an urban informal settlement in Nairobi, Kenya, to detect and quantify bacterial and associated antimicrobial resistance (AMR) determinants, viral and parasitic pathogens. Data were examined in conjunction with data from ongoing clinical infectious disease surveillance. RESULTS: A large variation of read abundances related to bacteria, viruses, and parasites of medical importance, as well as bacterial associated antimicrobial resistance genes over time were detected. Significant increased abundances were observed for a number of bacterial pathogens coinciding with higher abundances of AMR genes. Vibrio cholerae as well as rotavirus A, among other virus peaked in several weeks during the study period whereas Cryptosporidium spp. and Giardia spp, varied more over time. CONCLUSION: The metagenomic surveillance approach for monitoring circulating pathogens in sewage was able to detect putative pathogen and resistance loads in an urban informal settlement. Thus, valuable if generated in real time to serve as a comprehensive infectious disease agent surveillance system with the potential to guide disease prevention and treatment. The approach may lead to a paradigm shift in conducting real-time global genomics-based surveillance in settings with limited access to health care.

Roles of tert-butyl formate, tert-butyl alcohol and acetone in the regulation of methyl tert-butyl ether degradation by Mycobacterium austroafricanum IFP 2012.

Mycobacterium austroafricanum IFP 2012 is a Gram-positive strain able to grow on methyl tert-butyl ether (MTBE) as a sole carbon and energy source. The effect of two downstream metabolites of MTBE, tert-butyl formate (TBF) and tert-butyl alcohol (TBA) on MTBE degradation was investigated using resting cells. The addition of low concentrations of TBF decreased the MTBE degradation rate by about 30%. In contrast, the addition of TBA did not have a significant effect on MTBE degradation rate, even at high concentrations; and it was also shown that TBA degradation occurred only once MTBE was exhausted. At neutral pH, TBF hydrolysis involved mainly an esterase-type activity regulated by the presence of TBA. The TBF degradation rate was about four times lower than the MTBE degradation rate. Furthermore, acetone was identified as an intermediate during TBA degradation. An acetone mono-oxygenase activity, inhibited by methimazole but not by acetylene, was suggested. It was different from the MTBE/TBA mono-oxygenase and, thus, acetone did not appear to compete with MTBE and TBA for the same enzyme. These new results show that the metabolic regulation of the early steps of MTBE degradation by M. austroafricanum IFP 2012 is complex, involving inhibition and competition phenomena.

Blind separation of signals with mixed kurtosis signs using threshold activation functions.

A parameterized activation function in the form of an adaptive threshold for a single-layer neural network, which separates a mixture of signals with any distribution (except for Gaussian), is introduced. This activation function is particularly simple to implement, since it neither uses hyperbolic nor polynomial functions, unlike most other nonlinear functions used for blind separation. For some specific distributions, the stable region of the threshold parameter is derived, and optimal values for best separation performance are given. If the threshold parameter is made adaptive during the separation process, the successful separation of signals whose distribution is unknown is demonstrated and compared against other known methods.

The role of glucose in hemodialysis: the effects of glucose-free dialysate.

Glucose-free dialysate has been traditionally used in patients on chronic hemodialysis, reportedly without any side effects. Although hypoglycemia is not produced, several other metabolic changes must occur to maintain the euglycemic state. We studied ten patients on chronic hemodialysis using both a glucose-free bath and a glucose bath. Without glucose, a drop in osmolality of 20 mosm/kg H2O occurred, whereas a change of only 10 mosm/kg H2O was observed using a glucose bath. Abnormal EEG changes were observed after dialysis without glucose that were not present or were minimal with a glucose bath.

Therapeutic program for the learning disabled child.

Thirty-two children, diagnosed as having learning disabilities, were evaluated according to developmental scales for problems in perceptual-motor, visual, and auditory skills by a physical therapist. Of these children, 12 had significant deficits in all these areas and remedial therapy was prescirbed. Short-term goals and long-term goals were defined. Parents were instructed in home programs to be carried out three times a week which were designed to supplement the w-ekly therapy sessions. After eight weeks, significant improvements were seen in identification of body parts, movement in space, gross motor activities (activities without rhythm components), and shape constancy. Appropriate classroom recommendations were made based on these results and the evaluations of other professionals as the child reached school age.

A large-scale field trial of ultra-low-volume fenitrothion applied by a portable mist blower for the control of Aedes aegypti.

Long-term control of Aedes aegypti, the vector of dengue haemorrhagic fever in Thailand, was obtained by 2 thorough applications of fenitrothion mist applied at a target dosage rate of 0.1 ml per m(3) of room space. Perfect control lasted for 6-7 months after treatment and densities were substantially reduced for up to a year after treatment. Recovery of the population was still slow up to almost 16 months after treatment. This degree of control was achieved by the immediate mortalities produced by 2 treatments spaced about 2 weeks apart, the larvicidal effect of the fenitrothion aerosol, and a limited residual effect that prevented oviposition for a period, so that the recovery potential was greatly diminished. It appears that aerosol and mist treatments designed as epidemic control measures can be adapted to long-term preventive control of A. aegypti. However, the equipment used and the method of application require further improvement.

Sequential application of ultra-low-volume ground aerosols of fenitrothion for sustained control of Aedes aegypti.

A trial was carried out of the efficacy of fenitrothion ultra-low-volume aerosol applied by vehicle-mounted cold aerosol generator for the control of Aedes aegypti. Five applications of fenitrothion at intervals of 11-49 days at dosages of 511-1 095 ml/ha gave sustained control for 4-5 months in an area of some 14 ha containing 1 300 houses. Immediate killing of adult mosquitos and some larvicidal effect interrupted oviposition and retarded the recovery of the mosquito population. Sequential treatments applied in advance can evidently suppress the population throughout the rainy season, when epidemics of dengue haemorrhagic fever occur, and have operational advantages over larvicidal treatment. The Culex pipiens fatigans population was suppressed for only a few days after each treatment.