week 9 1/2

Question 1

What has been the effect of antibiotics the past 10 years?

Answer 1

The amount of infection diseases has decreased and the amount of auto-immune diseases increased.

Question 2

The colon has … bacteria, which consists of … different species. This is …% of the feces

Answer 2

The colon has 100 bilion bacteria, which conists of >1000 different species. This is 60% of the feces

Question 3

Microbiome has more than … genes, while human has 23.000

Answer 3

Microbiome has more than a million genes.

Question 4

Why is more possible with respect to the microbiome?

Answer 4

First it was only possible to grow the bacteria (kweek), now we have DNA techniques.

Question 5

What are the three functions of the intestinal microbiota?

Answer 5

1. Metabolic: fermentation, production vitamins and essential aminoacids.
2. Protective role against infections: Prevention colonisation pathogens (bc of low pH, antimicrobial factors, anti-oxidants and pro-inflammatory cytokins).
3. Immunity: IgA induction, cellular and mucosal immunity

Question 6

What are some diseases linked to microbiota?

Answer 6

Crohns disease, obesity, depression, allergies, RA, coeliakie.

Question 7

what are partum factors that can effect the microbiomes diversity?

Answer 7

A ceaserian section, home birth, formula food.

Question 8

What is the Barker hypothesis?

Answer 8

Risk factors for diseases in a mature age can exist at a young age and even in the foetal stage.

Question 9

What are “critical windows”?

Answer 9

A stimulus in a critical window has a permanent effect on the structure and function of the microbiome.

Question 10

What are things that can effect the microbial compositian (and there for symbiosis or dysbiosis)?

Answer 10

Diet, intake of fiber, obesity, Host genetics, Maternal transfer and early colonization, antibiotics and medication, infection, inflammation, stress, hygiene, age.

Question 11

What is the difference between horizontal and vertical transmission?

Answer 11

Horizontal transmission: Transfer of microbiome after birth.
Vertical transmission: transfer of microbiome from mother to child during birth.

Question 12

How can you measure the microbiome? (3 ways)

Answer 12

1. Culture
2. Sequencing
3. IS-pro

Question 13

What are the pro’s and con’s of culturing microbiome?

Answer 13

Pro: living organisms, characterization of ab-resistence.
Con: >90% of the intestinal microbiota are not cultivable

Question 14

What are the pro’s and con’s of sequencing?

Answer 14

Pro: loads of information
Con: Complex to standardize, time consuming, expensive.

Question 15

What are the pro’s and con’s of IS-pro?

Answer 15

Pro: Standardized, fast
Con: New technique, Limited expierence, not all detected peaks can be linked to known species yet.

Question 16

What are perinatal factors influencing the microbiota?

Answer 16

- Feeding
Skin contact
- Genetics
- Gestational age
- Perinatal antibiotics!
- Route of delivery!

Question 17

Why are the use of perinatal antibiotics and the route of delivery so important?

Answer 17

Both are associated with increased risk for clinical conditions later in life.

Question 18

What is the effect of maternal intrapartum antibiotic profylaxis?

Answer 18

In vaginal born infants it leads to less diversity, more pathogens and less commensals.
In C-sectio women there isn’t done a lot of research. Since 2014 every woman doing a C-sectio gets antibiotics a half hour beofre delivery. Decreasing the maternal infection risk with only 3%

Question 19

What is the MAMI-study?

Answer 19

The Influence of Maternal administration of antibiotics during CS on the intestinal Microbiome in Infants

Question 20

What method was used in MAMI study?

Answer 20

3 groups: mothers receiving antibiotics 30 min prior to CS (1), mothers receiving AB after clamping the umbilical cord (2) and vaginal born children (3).
Excl. criteria: AB use 1 month after birth by mother or child, child <37 weeks, alcohol, drugs, tabacco during pregnancy and neonatal GI anomalies.
Sample collection of feces on day 1, 7, 28 and after 3 years.

Question 21

What were the results?

Answer 21

AB concentration in umbilical cord in group 1 was 14 mg/L. There were no statistical differences found on day 1, 7 en 28 or after 3 years.

Question 22

What conclusions can be made from the MAMI study?

Answer 22

Bacterial colonization is a very complex process. Intestinal microbiome plays an important role in the development and maintenance of a healthy immune system. Microbiota disturbances are associated with an increased risk on nummerous clinical conditions later in life.

Question 23

What do NEC and sepsis both have in common?

Answer 23

Are both short-term morbidity/ mortality effects of pre-term birth. Also both take a long time to diagnose.

Question 24

NEC:

• Prevalence
• Diagnosis
• Therapy
• Mortality

Answer 24

Prevalence: 3-7% in preterm infants
Diagnosis: clinical signs + lab + X-ray
Therapy: antibiotics + surgery
Mortality: 15-40%

Question 25

LOS:

• Prevalence
• Diagnosis
• Therapy
• Mortality

Answer 25

Prevalence: 21% in preterm infants
Diagnosis: Clinical signs + lab + blood culture
Therapy: surgery
Mortality: 20%

Question 26

The diagnostic challenges in both sepsis and NEC are that:

Answer 26

The symptoms are asymptomatic, diagnosis is invasive and therapy is delayed.

Question 27

What is a possible solution for NEC and LOS?

Answer 27

Early biomarker research. With metabolomics.

Question 28

What can be used for early biomarker research?

Answer 28

voliates, like smell. For this a electronic nose.

Question 29

What is the working mechanism of electronic nose?

Answer 29

Sensor array -> pre-processing -> database -> pattern recognition.