Profiles of microorganisms isolated from neonates’ blood cultures, incubators, cradles, ventilators, washbasins, and health-workers of Libreville University Hospital Neonatal Service: focus on infection prevention and control measures

Background: Nosocomial infection outbreaks in neonatal services are a serious healthcare concern in both developed and developing countries, but few studies have been conducted in sub-Saharan Africa. Objective: This study explored the etiology of septicemia in neonates and associated patterns of antimicrobial susceptibility in Gabon. Methods: We analyzed cultures from neonates’ blood and swabs from medical personnel and equipment located in the neonatology service. Results: Sixty-eight microorganisms were isolated from the medical personnel and equipment; 46 microorganisms were isolated from neonates’ blood culture. Klebsiella pneumoniae spp pneumoniae was the most common bacteria found in both (30.6% and 26.9%, respectively). All Klebsiella pneumoniae spp pneumonia isolates were resistant to amoxicillin with clavulanic acid, gentamycin resistance ranged from 93% to 100%, and cephalosporin resistance ranged from 33.3% to 47%. Conclusions: Awareness of the etiology, prevalence, and outcome of nosocomial infection is the first and most important step to appropriate intervention

Vitamin D2 versus vitamin D3 as a risk factor in compromised bone health

Background: Vitamin D plays an important role in the prevention of many diseases. More than 1 billion people worldwide suffer from vitamin D deficiency. Vitamin D deficiency can contribute to the development of 16 types of cancer (breast, colon, prostate, etc.), cardiovascular diseases, stroke, autoimmune diseases, periodontal pathologies, transplant failure in endo-alveolar surgery, etc. There are several risk factors that would prevent the achievement of treatment objectives. The national protocol for deficiency rickets prevention privileges vitamin D2 versus vitamin D3 , which creates a medical risk factor compromising oral health in both children and adults. The article provides sufficient arguments in favour of vitamin D3 vs vitamin D2 prescription for prophylactic and treatment purposes. Conclusions: Considering that vitamin D deficiency is currently a global public health problem, it can be proposed to declare vitamin D deficit/deficiency a priority public health problem at the national level. Vitamin D3 should be elective in preventing deficit. Taking into account the multitude of acute and chronic diseases related to vitamin D deficiency, in order to improve the status of vitamin D in all population categories, it is necessary to include vitamin D3 in the list of molecules fully subsidized by the state and distributed free of charge at least to children under the age of 5 years and adolescents in the period of intensive growth

Altered Toll-Like Receptor-4 Response to Lipopolysaccharides in Infants Exposed to HIV-1 and Its Preventive Therapy

Pathogen sensing and recognition through pattern recognition receptors, and subsequent production of pro-inflammatory cytokines, is the cornerstone of the innate immune system. Despite the fact that HIV-exposed uninfected (HEU) infants are prone to serious bacterial infections, no study has focused on the functionality of their bacteria recognition system. This is the first study to investigate baseline levels of three critically important immune response molecules in this population: complement component (C)-3, toll-like receptor (TLR)-4, and C-reactive protein (CRP). We enrolled 16 HEU and 6 HIV-unexposed (HU) infants. TLR4 function was investigated by stimulating whole blood with increasing concentrations of TLR4-agonist ultrapure lipopolysaccharides. TLR4/TLR4-agonist dose response were assessed by measuring IL-6 secretion. Complement C3 and CRP were measured by photo spectrometry. Data showed no significant differences in baseline concentration of CRP between HEU and HU infants. Complement C3 was significantly higher in HEU infants than HU infants. TLR4 anergy was observed in 7 of 12 HEU infants, whereas the rest of HEU infants (n = 4) and the control HU infants tested (n = 3) showed responsive TLR4. None of the HEU infants investigated in this study had severe infections in the year after their birth. In conclusion, TLR4 anergy can occur in HEU infants without necessarily translating to increased vulnerability to infectious diseases