Malformaţiile congenitale de cord cianogene la copil: protocol clinic naţional PCN-194

Acest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii al Republicii Moldova, constituit din specialiştii cardiologi pediatri în colaborare cu Departamentul de Pediatrie USMF „Nicolae Testemiţanu”. Protocolul naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind malformaţiile congenitale de cord cianogene la copil şi va servi drept bază pentru elaborarea protocoalelor instituţionale. La recomandarea MS RM, pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în protocolul clinic naţional

Miocardita acută virală la copil: protocol clinic naţional PCN-145

USMF „Nicolae Testemiţanu”, IMSP Institutul Mamei şi CopiluluiAcest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii al Republicii Moldova (MS RM), constituit din specialiştii Departamentului Pediatrie a Universităţii de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” şi IMSP Institutul Mamei şi Copilului. Protocolul naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind miocardita acută la adult şi miocardita acută la copil şi va servi drept bază pentru elaborarea protocoalelor instituţionale, în baza posibilităţilor reale ale fiecărei instituţii în anul curent. La recomandarea MS pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în protocolul clinic naţional

Insuficienţa cardiacă cronică la copil: protocol clinic naţional PCN-144

IMSP Institutul Mamei şi Copilului, Departamentul Pediatrie USMF „Nicolae Testemiţanu”Acest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii al Republicii Moldova (MS RM), constituit din specialiştii IMSP Institutul Mamei şi Copilului, Departamentului Pediatrie a Universităţii de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”. Protocolul naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind Insuficienţa cardiacă cronică la copil şi va servi drept bază pentru elaborarea protocoalelor instituţionale. La recomandarea MS RM, pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în protocolul clinic naţional

Hipertensiunea arterială esenţială la copil: protocol clinic naţional PCN-193

IMSP Institutul Mamei şi Copilului, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, IMSP Institutul de CardiologieAcest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii al Republicii Moldova, constituit din specialiştii Departamentului Pediatrie al Universităţii de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, secţia de cardiologie pediatrică din cadrul IMSP IM şi C şi ai laboratorului de Cardiologie Pediatrică, din cadrul IMSP Institutul de Cardiologie. Protocolul naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind managementul copiilor şi adolescenţilor cu cifre înalte ale tensiunii arteriale (SEC 2009, 2016) şi a al 4-lea ghid de hipertensiune arterială la copii (AAH, 2004) şi va servi drept bază pentru elaborarea protocoalelor instituţionale, în baza posibilităţilor reale ale fiecărei instituţii în anul curent. La recomandarea MS pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în protocolul clinic naţional

The Prebiotic Effect of an Organic Acid Mixture on Faecalibacterium prausnitzii Metabolism and Its Anti-Pathogenic Role against Vibrio parahaemolyticus in Shrimp

Publication history: Accepted - 27 December 2022; Published - 29 December 2022.Increasing the abundance of probiotic bacteria in the gut requires either direct dietary supplementation or the inclusion of feed additives able to support the growth of beneficial commensal bacteria. In crustaceans, the increased presence of probiotic-like bacteria in the gut, including of Faecalibacterium prausnitzii (F. prausnitzii), will guarantee a positive health status and a gut environment that will ensure enhanced performance. The aim of this study was to investigate if a mixture of organic acids, AuraAqua (Aq) can stimulate the growth and the anti-pathogenic efficacy of F. prausnitzii through a combination of in vitro and ex vivo models. The results showed that 0.5% Aq was able to improve the growth rate of F. prausnitzii in vitro and in an ex vivo shrimp gut model. Moreover, we were able to demonstrate that Aq increases butyrate production and cellulose degradation in culture or in the shrimp gut model. The growth-stimulating effect of Aq also led to an improved and anti-pathogenic effect against Vibrio parahaemolyticus in a co-culture experiment with shrimp gut primary epithelial cells (SGP). In conclusion, our work demonstrates that Aq can stimulate the growth of F. prausnitzii, increase the production of short-chain fatty acid (SCFA) butyrate, improve substrate digestion, and prevent V. parahaemolyticus invasion of SGP cells.We acknowledge Environtech, Dublin, Ireland for funding the PhD of Eugenia Butucel. Grant number 49650

The Effect Citrox BCL on Legionella pneumophila Mechanisms of Biofilm Formation, Oxidative Stress and Virulence

Publication history: Accepted - 1 November 2022; Published online - 4 November 2022Legionella pneumophila is responsible for causing Legionnaires’ disease and Pontiac fever, also known as legionellosis. The aim of this study was to investigate the mechanistic effect of a mixture of natural antimicrobials (Citrox BCL) in preventing L. pneumophila biofilm formation and reducing its in vitro virulence. The minimum inhibitory concentrations were detected at 0.06%, and the MBC was established at 0.125%. Based on the growth curve profile, the sub-inhibitory concentration of 0.02% was further used to study the mechanistic implications in the absence of a cytotoxic effect on A549 cells. At 24 h post-infection, Citrox BCL reduced (p = 0.005) the intracellular growth of L. pneumophila when the A549 cells or the bacteria were pre-treated with 0.02% Citrox BCL. This result was replicated when Citrox BCL was added during the 24 h infection assay leading to a reduction in intracellular growth (p = 0.003). Herein we show that at the sub-inhibitory concentration of 0.02%, Citrox CBL lowers the ROS levels in infected A549 cells and causes a 45% reduction in L. pneumophila EPS production, a reduction associated with the decline in biofilm formation. Overall, our results corroborate the low c-di-GMP production with the decrease in biofilm formation and low EPS levels. The low EPS levels seemed to be caused by the downregulation of the tatB and tatC gene expressions. Moreover, inhibition of pvcA and pvcB gene expressions, leading to lower siderophore levels, suggests that Citrox BCL reduces the ability of L. pneumophila to sequester iron and reduce biofilm formation through iron starvation.We acknowledge Environtech, Dublin, Ireland, for funding the Ph.D. of Eugenia Butucel. Grant number 49650

The in vitro and in vivo anti-virulent effect of organic acid mixtures against Eimeria tenella and Eimeria bovis.

Eimeria tenella and Eimeria bovis are complex parasites responsible for the condition of coccidiosis, that invade the animal gastrointestinal intestinal mucosa causing severe diarrhoea, loss of appetite or abortions, with devastating impacts on the farming industry. The negative impacts of these parasitic infections are enhanced by their role in promoting the colonisation of the gut by common foodborne pathogens. The aim of this study was to test the anti-Eimeria efficacy of maltodextrin, sodium chloride, citric acid, sodium citrate, silica, malic acid, citrus extract, and olive extract individually, in vitro and in combination, in vivo. Firstly, in vitro infection models demonstrated that antimicrobials reduced (p < 0.05), both singly and in combination (AG), the ability of E. tenella and E. bovis to infect MDBK and CLEC-213 epithelial cells, and the virulence reduction was similar to that of the anti-coccidial drug Robenidine. Secondly, using an in vivo broiler infection model, we demonstrated that AG reduced (p = 0.001) E. tenella levels in the caeca and excreted faeces, reduced inflammatory oxidative stress, improved the immune response through reduced ROS, increased Mn-SOD and SCFA levels. Levels of IgA and IgM were significantly increased in caecal tissues of broilers that received 0.5% AG and were associated with improved (p < 0.0001) tissue lesion scores. A prophylactic approach increased the anti-parasitic effect in vivo, and results indicated that administration from day 0, 5 and 10 post-hatch reduced tissue lesion scores (p < 0.0001) and parasite excretion levels (p = 0.002). Conclusively, our in vitro and in vivo results demonstrate that the natural antimicrobial mixture (AG) reduced parasitic infections through mechanisms that reduced pathogen virulence and attenuated host inflammatory events

Mixtures of natural antimicrobials can reduce Campylobacter jejuni, Salmonella enterica and Clostridium perfringens infections and cellular inflammatory response in MDCK cells

Publication history: Accepted - 1 June 2021; Published online - 7 June 2021Background: The classification of natural antimicrobials as potential antibiotic replacements is still hampered by the absence of clear biological mechanisms behind their mode of action. This study investigated the mechanisms underlying the anti-bacterial effect of a mixture of natural antimicrobials (maltodextrin, citric acid, sodium citrate, malic acid, citrus extract and olive extract) against Campylobacter jejuni RC039, Salmonella enterica SE 10/72 and Clostridium perfringens ATCC® 13124 invasion of Madin–Darby Canine Kidney cells (MDCK). Results: Minimum sub-inhibitory concentrations were determined for Campylobacter jejuni (0.25%), Salmonella enterica (0.50%) and Clostridium perfringens (0.50%) required for the in vitro infection assays with MDCK cells. The antimicrobial mixture significantly reduced the virulence of all three pathogens towards MDCK cells and restored the integrity of cellular tight junctions through increased transepithelial resistance (TEER) and higher expression levels of ZO-1 (zonula occludens 1) and occludin. This study also identified the ERK (external regulated kinase) signalling pathway as a key mechanism in blocking the pro-inflammatory cytokine production (IL-1β, IL-6, IL-8, TNF-α) in infected cells. The reduction in hydrogen peroxide ( H2O2) production and release by infected MDCK cells, in the presence of the antimicrobial mixture, was also associated with less tetrathionate formed by oxidation of thiosulphate (p < 0.0001). Conclusion: The present study describes for the first time that mixtures of natural antimicrobials can prevent the formation of substrates used by bacterial pathogens to grow and survive in anaerobic environments (e.g. tetrathionate).This study was supported by a grant awarded to NC by Environtech, Dublin, Ireland