CTX-M β-Lactamase Production and Virulence of Escherichia coli K1

We report a patient with neonatal meningitis caused by a CTX-M-1–producing Escherichia coli K1 strain. The influence of CTX-M production on virulence was investigated in cell culture and a newborn mouse model of meningitis. CTX-M production had no influence on virulence but was a major factor in clinical outcome

Recommendations for surveillance of pulmonary dysfunction among childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group

\ua9 2024. Childhood, adolescent, and young adult (CAYA) cancer survivors are at risk of pulmonary dysfunction. Current follow-up care guidelines are discordant. Therefore, the International Late Effects of Childhood Cancer Guideline Harmonization Group established and convened a panel of 33 experts to develop evidence-based surveillance guidelines. We critically reviewed available evidence regarding risk factors for pulmonary dysfunction, types of pulmonary function testing, and timings of surveillance, then we formulated our recommendations. We recommend that CAYA cancer survivors and healthcare providers are aware of reduced pulmonary function risks and pay vigilant attention to potential symptoms of pulmonary dysfunction, especially among survivors treated with allogeneic haematopoietic stem cell transplantation, thoracic radiotherapy, and thoracic surgery. Based on existing limited evidence and current lack of interventions, our panel recommends pulmonary function testing only for symptomatic survivors. Since scarce existing evidence informs our recommendation, we highlight the need for prospective collaborative studies to address pulmonary function knowledge gaps among CAYA cancer survivors

Pituitary and systemic autoimmunity in a case of intrasellar germinoma

Germinomas arising in the sella turcica are difficult to differentiate from autoimmune hypophysitis because of similar clinical and pathological features. This differentiation, nevertheless, is critical for patient care due to different treatments of the two diseases. We report the case of an 11-year-old girl who presented with diabetes insipidus and growth retardation, and was found to have an intra- and supra-sellar mass. Initial examination of the pituitary biopsy showed diffuse lymphocytic infiltration of the adenohypophysis and absent placental alkaline phosphatase expression, leading to a diagnosis of hypophysitis and glucocorticoid treatment. Because of the lack of clinical and radiological response, the pituitary specimen was re-examined, revealing this time the presence of scattered c-kit and Oct4 positive germinoma cells. The revised diagnosis prompted the initiation of radiotherapy, which induced disappearance of the pituitary mass. Immunological studies showed that the patient’s serum recognized antigens expressed by the patient’s own germinoma cells, as well as pituitary antigens like growth hormone and systemic antigens like the Sjögren syndrome antigen B and alpha-enolase. The study first reports the presence of pituitary and systemic antibodies in a patient with intrasellar germinoma, and reminds us that diffuse lymphocytic infiltration of the pituitary gland and pituitary antibodies does not always indicate a diagnosis of autoimmune hypophysitis

IL-10 administration reduces PGE-2 levels and promotes CR3-mediated clearance of Escherichia coli K1 by phagocytes in meningitis

Ineffectiveness of antibiotics in treating neonatal Escherichia coli K1 meningitis and the emergence of antibiotic-resistant strains evidently warrants new prevention strategies. We observed that administration of interleukin (IL)-10 during high-grade bacteremia clears antibiotic-sensitive and -resistant E. coli from blood of infected mice. Micro-CT studies of brains from infected animals displayed gross morphological changes similar to those observed in infected human neonates. In mice, IL-10, but not antibiotic or anti-TNF antibody treatment prevented brain damage caused by E. coli. IL-10 administration elevated CR3 expression in neutrophils and macrophages of infected mice, whereas infected and untreated mice displayed increased expression of FcγRI and TLR2. Neutrophils or macrophages pretreated with IL-10 ex vivo exhibited a significantly greater microbicidal activity against E. coli compared with cells isolated from wild-type or IL-10−/− mice. The protective effect of IL-10 was abrogated when CR3 was knocked-down in vivo by siRNA. The increased expression of CR3 in phagocytes was caused by inhibition of prostaglandin E-2 (PGE-2) levels, which were significantly increased in neutrophils and macrophages upon E. coli infection. These findings describe a novel modality of IL-10–mediated E. coli clearance by diverting the entry of bacteria via CR3 and preventing PGE-2 formation in neonatal meningitis

Enterohaemorrhagic Escherichia coli and Shigella dysenteriae type 1-induced haemolytic uraemic syndrome

Haemolytic uraemic syndrome (HUS) can be classified according to the aetiology of the different disorders from which it is composed. The most prevalent form is that induced by shigatoxin producing Escherichia coli (STEC) and, in some tropical regions, by Shigella dysenteriae type 1. STEC cause a zoonosis, are widely distributed in nature, enter the food chain in different ways, and show regional differences. Not all STEC are human pathogens. Enterohaemorrhagic E. coli usually cause attachment and effacing lesions in the intestine. This is not essential, but production of a shigatoxin (Stx) is. Because Stx are encoded by a bacteriophage, this property is transferable to naïve strains. Laboratory methods have improved by identifying STEC either via the toxin or its bacteriophage. Shigella dysenteriae type 1 produces shigatoxin, identical to Stx-1, but also has entero-invasive properties that enterohaemorrhagic Escherichia coli (EHEC) do not. Shigella patients risk bacteremia and benefit from early antibiotic treatment, unlike those with EHEC

Microbiote intestinal et développement de l'allergie alimentaire Microbiote et développement de l'asthme

International audienceConsiderable important progress has been made in recent decades concerning description of the components of human microbiota. Changes in microbiota are closely linked with the environment and certain of these changes may be associated with the onset of atopic diseases. However, large gaps remain, offering pathways for active research at present.Des progrès importants ont été réalisés ces dernières années dans la description de la composition du microbiote humain. Les changements du microbiote sont très fortement liés à l’environnement et certaines de ces modifications semblent avoir un lien avec le développement de pathologies atopiques. Cependant, des lacunes importantes persistent et constituent des voies de recherche active à l’heure actuelle

What is the impact of outdoor pollution on children's asthma?

International audiencea Inserm U 1149, e´quipe INSIGHT, service de pneumologie et d'allergologie pe´diatrique, hôpital universitaire Robert-Debre´, 48, boulevard Serrurier

Tabagisme pendant la grossesse : impact sur l’enfant, de la naissance à l’âge adulte — Rapport d’experts et recommandations CNGOF-SFT sur la prise en charge du tabagisme en cours de grossesse

National audienceIntroduction - Smoking during pregnancy leads to fetal passive smoking. It is associated with several obstetrical complications and is a major modifiable factor of maternal and fetal morbidity. Long-term consequences also exist but are less well known to health professionals and in the general population. Methods - Consultation of the Medline® database. Results - Maternal smoking during pregnancy is associated in the offspring with sudden infant death syndrome (NP2), impaired lung function (NP2), lower respiratory infections and asthma (NP2), overweight and obesity (NP2), cancers (NP3), risk of tobacco use, nicotine dependence and early smoking initiation (NP2). Unadjusted analyses show associations between in utero tobacco exposure and cognitive deficits (NP3), impaired school performance (NP3) and behavioral disorders in children (NP2), which are in a large part explained by environmental factors. There is a cross-generational effect of smoking during pregnancy. For example, an increased risk of asthma is observed in the grandchildren of smoking women (NP4). The respective roles of ante- and post-natal smoking remain difficult to assess. Conclusion - These results highlight the importance of prevention measures against tobacco use in the general population, as well as screening measures and support for smoking cessation before or at the beginning of the pregnancy