Salmonella typhimurium meningitis in an exclusively breast fed infant: A case report

Salmonella-related meningitis brings greater morbidity and mortality than that caused by other bacteria. We report a case of Salmonella typhimurium meningitis in a male child aged 5½ months who presented with fever, poor feeding, and irritability. Anterior fontanelle was bulged. S. typhimurium was isolated from cerebrospinal fluid. Child was treated with intravenous antibiotics for 4 weeks and he recovered completely.

Acceptability of “High sn-2” Infant Formula in Non-Breast Fed Healthy Term Infants Regarding Gastrointestinal Tolerability by Both Parents and Pediatrician: An Open-Label Pilot Study in the Gulf Cooperation Council (GCC) Countries

Recent studies have highlighted the positive impact of high sn-2 formulas on gastrointestinal (GI) tolerance. We assessed the GI tolerance, acceptability, and safety of high sn-2 infant formula among non-breastfed healthy term infants in the Gulf countries. A multicenter observational study was conducted on 227 healthy-term infants who were prescribed high sn-2 palmitate infant formula and received a minimum of two formula feedings per day for the past two weeks prior to the study’s initiation. The number of stools per day decreased significantly from a median of four (interquartile range [IQR] = 4) at baseline to 3.0 (2) stools per day at the end of follow-up (p = 0.015). The percentage of stool amount changed significantly, where 61.2% and 33.7% of the infants had an amount of 25–50% of the diaper and >50% of the diaper, respectively (p < 0.001) at the end of the follow-up. Similarly, the percentage of hard stool decreased significantly from 17.4% at baseline to 0.4% of the population at week 12 (p < 0.00). The prevalence of colic and abdominal distention declined from 21.4% and 39.9% at baseline to 2.9% and 9.4% at week 12, respectively (p < 0.05). The same decline was observed in abdominal distension and regurgitation score (p < 0.05).

Phenotypic and Molecular Characterization of Commensal, Community-Acquired and Nosocomial Klebsiella spp.

Klebsiella spp. is a relevant pathogen that can present acquired resistance to almost all available antibiotics, thus representing a serious threat for public health. While most studies have been focused on isolates causing community-acquired and nosocomial infections, little is known about the commensal isolates colonizing healthy subjects. We describe the molecular identification and the phenotypic characterization of commensal Klebsiella spp. from breast milk of healthy women and faeces from healthy breast-fed infants, which were compared with isolates from community-acquired infections and from a nosocomial NICU outbreak. The phylogenetic analysis of a 454-bp sequence of the rpoB gene was useful for species identification (K. pneumoniae, K. variicola, K. quasipneumoniae, K. oxytoca, K. grimontii, K. michiganensis, Raoultella planticola and R. ornithinolytica), previously misidentified as K. pneumoniae or K. oxytoca by biochemical methods. Globally, we report that commensal strains present virulence traits (virulence genes, siderophores and biofilms) comparable to community-acquired and NICU-infective isolates, thus suggesting that the human microbiota could constitute a reservoir for infection. Isolates causing NICU outbreak were multi-drug resistant (MDR) and ESBLs producers, although an imipenem-resistant commensal MDR K. quasipneumoniae isolate was also found. A commensal K. pneumoniae strain showed a potent bacteriocin-like inhibitory activity against MDR Klebsiella isolates, thus highlighting the potential role of commensal Klebsiella spp. in health and disease.

Association between Mother’s Literacy and INFANT & Young Child Feeding (IYCF) Practices and Nutritional Status of Urban under 5 Year Children

Aim: To assess the association of mother’s literacy status with infant & young child feeding (IYCF) practices and nutritional status of urban under 5 year children. Methods: A community based cross- sectional study was carried out among 356 urban children under 5 years from 30 randomly selected Anganwadi Centres (AWCs) in Hyderabad, during 2017-18. The information regarding infant & young child feeding (IYCF) practices was obtained from the mothers of under 5 year children. Anthropometric measurements such as height and weight of all the children were measured adopting standard procedures and using standard anthropometric equipment. Results: About half of the mothers reportedly initiated breast feeding to their newborns within one hour of birth. The proportion of mothers fed pre-lacteals and colostrum to newborn was 35% and 96% respectively. A higher proportion of literate mothers (45.1%) exclusively breast fed their infants for the first 6 months as compared to their illiterate counterparts (32.9%). Significantly a higher proportion (63.3%) of literate mothers initiated complementary feeding to their infants soon after completion of 6 months as against 50% in illiterate mothers (p<0.05). The proportion of children with undernutrition i.e. underweight, stunting and wasting was 38.5%, 40.6% and 16.8%, respectively. The prevalence of underweight and stunting was significantly (p<0.05) higher among the children of illiterate mothers as compared to literate mothers. Conclusion: In general, mother’s literacy was significantly associated with the IYCF practices as well as nutritional status of their children. Therefore, respective Governments should initiate appropriate measures to increase female literacy levels in India.

Association of Cesarean Delivery and Formula Supplementation with the Stool Metabolome of 6-Week-Old Infants

Cesarean delivery and formula feeding have both been implicated as important factors associated with perturbations to the infant gut microbiome. To investigate the functional metabolic response of the infant gut microbial milieu to these factors, we profiled the stool metabolomes of 121 infants from a US pregnancy cohort study at approximately 6 weeks of life and evaluated associations with delivery mode and feeding method. Multivariate analysis of six-week stool metabolomic profiles indicated discrimination by both delivery mode and diet. For diet, exclusively breast-fed infants exhibited metabolomic profiles that were distinct from both exclusively formula-fed and combination-fed infants, which were relatively more similar to each other in metabolomic profile. We also identified individual metabolites that were important for differentiating delivery mode groups and feeding groups and metabolic pathways related to delivery mode and feeding type. We conclude based on previous work and this current study that the microbial communities colonizing the gastrointestinal tracts of infants are not only taxonomically, but also functionally distinct when compared according to delivery mode and feeding groups. Further, different sets of metabolites and metabolic pathways define delivery mode and diet metabotypes.

​Probiotics for Augmenting Health

Background: The probiotic microorganism consists mostly of the strains of the genera Lactobacillus and Bifidobacteria. Bifidobacterial species are common members of the infant gut where they form up to 91 per cent of the total micro flora in breast-fed babies and up to 75 per cent in formula fed infants Methods: Bifidobacterial species were isolated and identified from the faeces of breast fed infants by molecular techniques. Molecular tools like 16S rDNA targeted genus and species specific mPCR primers were used for confirmation. A total of 4 isolates were identified namely B. longum (IB10 and IB12) B. breve (IB39) and B. bifidum (IB42). The identified species were screened for probiotic properties like bile tolerance, antimicrobial activity and tolerance to acidity. Ideal isolate of B. longum was incorporated in the preparation of whey based malted nutraceutical spray dried food and fed to weaned piglets. Result: B. longum (IB10) was the ideal probiotic when compared to other isolates as it had maximum antimicrobial activity and tolerance to bile and acidity. It was noted that isolate IB10 (B. longum) had an inhibitory zone ranging from 3.03 to 2.95 mm against B. cereus, S. aureus, E. coli and P. aeruginosa due to acid and antibacterial compounds. Isolate B. longum (IB10) was incorporated in the preparation of whey based malted nutraceutical spray dried food. The influence of feeding five grams of the spray dried nutraceutical malt food containing B. longum at 107cfu/g per day on animal production, gut health and gut architecture in young weaned piglets were also investigated. The probiotic regime had positive effects on the health of piglets when compared to the control group. A significant two log reduction in the coliform count was observed in the faeces of weaned piglets fed with Bifidobacterial nutraceutical powder than that of control. Thus, these probiotic bifidobacteria can be considered as safe adjuncts for preparation of dairy nutraceuticals.

Vitamin D status in exclusively breastfed infants and their mothers

Background: The prevalence of hypovitaminosis D in exclusively breastfed infants was found to be 82%, 52% and 20 % from UAE, Pakistan and China respectively but there is a paucity of data from India regarding the same.Methods: Prevalence of subclinical Hypovitaminosis D in exclusive breastfed babies and their mothers. This study was a descriptive study conducted among breastfed infants and their mothers to reconnoitre the vitamin D level status. All exclusively breast fed healthy term babies with birth weight >2.5 kg who are less than 6 months of age and its mothers. The existence of correlation in the mean vitamin D level between the exclusively breastfed mothers and its infants.Results: The infants status of vitamin D deficiency and insufficient was 91.9% and 8.1% respectively. The mothers status of vitamin D deficiency and insufficient was 78.3% and 21.7% respectively.Conclusions: Hypovitaminosis D was highly prevalent among mothers living in tropical area irrespective of diet habits or socioeconomic group. There was a significant positive correlation in the mean Vitamin D level of the mothers and their exclusively breastfed infants.

Overview of epidemiology and management of rickets among children in Saudi Arabia

Rickets is a common bone disease worldwide that is associated with disturbances in calcium and phosphate homeostasis and can lead to short stature and joint deformities. The study aimed to summarize the updated evidence as regards: Epidemiology, risk factors, etiology, pathophysiology, clinical manifestation, diagnosis and management. Rickets can be diagnosed based on history and physical examination, radiological features, and biochemical tests. The acquired rickets (nutritional) is the most common cause of rickets among children in Saudi Arabia which is due to vitamin D deficiency. Risk factors include, exclusively breast fed, immigrant adults in industrialized countries, decreased exposure to sunlight, use of sunscreen, old age of the housebound, morbid obesity and certain medications. Treatment strategies of rickets depend on the underlying etiology. There are several regimens utilized to treat rickets, all of them comprise some form of vitamin D administration and presence of adequate calcium and phosphate levels.

Bifidobacteria and Escherichia coli Microbiota of Healthy Indonesian Infants in Andalas Village: Profile of Infant Diet Given Exclusive Breastfed and Formula-fed

INTRODUCTION : Inbalance of microbiota in gastrointestinal tract have the risk of getting gastrointestinal infections, one of them is diarrhea. AIM : The aim of this study was to determine bifidobacterium and eschericia coli microbiota and compare the microbiota obtained between exclusive breast fed and formula fed Indonesian infants village andalas. METHODS : This study was an observational study with cross sectional comparative design. Samples faeses of infant was taken by Multistage Simple Random Sampling with total sample of 28 infants in range 0-6 months. This study was conducted in Pauh community health center areas, Village Andalas . The infant’s feces was taken then send to Microbiology Laboratorium of Dr. M. Djamil Hospital Padang city, Indonesia. The instruments used were a questionnaire and a colony counter. Data were processed and analyzed by using independent t test and Mann Whitney test. RESULTS : The fecal microbiota of the 0-6 months Indonesian infants village andalas two species including bifidobacterium and eschericia coli were common commensal intestinal microbiota in all infants. The predominant intestinal microbiota in the breast fed infants bifidobacterium average 3,59 x 109 CFU/g (p < 0,05). the mean eschericia coli microbiota from the formula fed infants 66,8 x 109 CFU/g (p < 0,05) CONCLUSION : Exclusive breastfeeding infant’s faeses contain more bifidobacteria and formula breastfed infant’s faeces contain more escherichia coli bacteria. These findings advance our understanding of the gut microbiota in healthy infants. They also provide new evidence infant diet as determinants of this essential microbial community in early life