week 9 1/2 Flashcards
What has been the effect of antibiotics the past 10 years?
The amount of infection diseases has decreased and the amount of auto-immune diseases increased.
The colon has … bacteria, which consists of … different species. This is …% of the feces
The colon has 100 bilion bacteria, which conists of >1000 different species. This is 60% of the feces
Microbiome has more than … genes, while human has 23.000
Microbiome has more than a million genes.
Why is more possible with respect to the microbiome?
First it was only possible to grow the bacteria (kweek), now we have DNA techniques.
What are the three functions of the intestinal microbiota?
- Metabolic: fermentation, production vitamins and essential aminoacids.
- Protective role against infections: Prevention colonisation pathogens (bc of low pH, antimicrobial factors, anti-oxidants and pro-inflammatory cytokins).
- Immunity: IgA induction, cellular and mucosal immunity
What are some diseases linked to microbiota?
Crohns disease, obesity, depression, allergies, RA, coeliakie.
what are partum factors that can effect the microbiomes diversity?
A ceaserian section, home birth, formula food.
What is the Barker hypothesis?
Risk factors for diseases in a mature age can exist at a young age and even in the foetal stage.
What are “critical windows”?
A stimulus in a critical window has a permanent effect on the structure and function of the microbiome.
What are things that can effect the microbial compositian (and there for symbiosis or dysbiosis)?
Diet, intake of fiber, obesity, Host genetics, Maternal transfer and early colonization, antibiotics and medication, infection, inflammation, stress, hygiene, age.
What is the difference between horizontal and vertical transmission?
Horizontal transmission: Transfer of microbiome after birth.
Vertical transmission: transfer of microbiome from mother to child during birth.
How can you measure the microbiome? (3 ways)
- Culture
- Sequencing
- IS-pro
What are the pro’s and con’s of culturing microbiome?
Pro: living organisms, characterization of ab-resistence.
Con: >90% of the intestinal microbiota are not cultivable
What are the pro’s and con’s of sequencing?
Pro: loads of information
Con: Complex to standardize, time consuming, expensive.
What are the pro’s and con’s of IS-pro?
Pro: Standardized, fast
Con: New technique, Limited expierence, not all detected peaks can be linked to known species yet.
What are perinatal factors influencing the microbiota?
- Feeding Skin contact - Genetics - Gestational age - Perinatal antibiotics! - Route of delivery!
Why are the use of perinatal antibiotics and the route of delivery so important?
Both are associated with increased risk for clinical conditions later in life.
What is the effect of maternal intrapartum antibiotic profylaxis?
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%
What is the MAMI-study?
The Influence of Maternal administration of antibiotics during CS on the intestinal Microbiome in Infants
What method was used in MAMI study?
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.
What were the results?
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.
What conclusions can be made from the MAMI study?
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.
What do NEC and sepsis both have in common?
Are both short-term morbidity/ mortality effects of pre-term birth. Also both take a long time to diagnose.
NEC:
- Prevalence
- Diagnosis
- Therapy
- Mortality
Prevalence: 3-7% in preterm infants
Diagnosis: clinical signs + lab + X-ray
Therapy: antibiotics + surgery
Mortality: 15-40%
LOS:
- Prevalence
- Diagnosis
- Therapy
- Mortality
Prevalence: 21% in preterm infants
Diagnosis: Clinical signs + lab + blood culture
Therapy: surgery
Mortality: 20%
The diagnostic challenges in both sepsis and NEC are that:
The symptoms are asymptomatic, diagnosis is invasive and therapy is delayed.
What is a possible solution for NEC and LOS?
Early biomarker research. With metabolomics.
What can be used for early biomarker research?
voliates, like smell. For this a electronic nose.
What is the working mechanism of electronic nose?
Sensor array -> pre-processing -> database -> pattern recognition.
