In the first days of life, the newborns' intestinal microbiota develops simultaneously with the intestinal gut barrier and follows intestinal immunity. The mode of delivery shows significant impact on microbial development and, thus, the initiation of the tryptophan catabolism pathway. Further antibiotics (ATB) treatment of mothers before or during delivery affects the microbial and tryptophan metabolite composition of stool of the caesarean- and vaginal-delivered newborns. The determination of microbiome and levels of tryptophan microbial metabolites in meconium and stool can characterize intestinal colonization of a newborn. From 134 samples from the Central European Longitudinal Studies of Parents and Children: The Next Generation (CELSPAC: TNG) cohort study, 16S rRNA gene sequencing was performed, and microbial tryptophan metabolites were quantified using ultra-high-performance liquid chromatography with triple-quadrupole mass spectrometry. Microbial diversity and concentrations of tryptophan metabolites were significantly higher in stool compared to meconium. Treatment of mothers with ATB before or during delivery affects metabolite composition and microbial diversity in stool of vaginal- and caesarean-delivered newborns. Correlation of microbial and metabolite composition shows significant positive correlations of indol-3-lactic acid, N-acetyl-tryptophan and indol-3-acetic acid with Bifidobacterium, Bacteroides and Peptoclostridium. The positive effect of vaginal delivery on newborns' microbiome development is degraded when mother is treated with ATB before or during delivery. KEY POINTS: • Antibiotic treatment diminishes the positive effects of vaginal delivery. • Antibiotic treatment affects metabolite and microbial composition in newborns. • Bifidobacterium and Peptoclostridium could be the producer of indole-lactic acid.
- MeSH
- antibakteriální látky * MeSH
- Bifidobacterium metabolismus růst a vývoj MeSH
- feces * mikrobiologie chemie MeSH
- indoly metabolismus MeSH
- kyseliny indoloctové metabolismus MeSH
- lidé MeSH
- longitudinální studie MeSH
- mekonium * mikrobiologie chemie MeSH
- novorozenec MeSH
- RNA ribozomální 16S * genetika MeSH
- střevní mikroflóra * účinky léků MeSH
- tryptofan * metabolismus MeSH
- vysokoúčinná kapalinová chromatografie MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
In the last decade there has been a dramatic increase in the availability and abuse of synthetic cathinones - new amphetamine-like stimulants. Even though their abuse during pregnancy could have serious adverse effects on the fetus, cathinones are not readily included in neonatal toxicological screenings. Meconium (first neonatal stool) is the specimen of choice to reveal long term drug exposure, however as it is a highly complex matrix, the sample preparation is a critical step before the instrumental analysis. The aim of this work was to develop a suitable meconium sample extraction technique using the advantages of salting-out assisted liquid-liquid extraction (SALLE) and using only MS-friendly organic ammonium salts. We further developed and validated liquid chromatography tandem-mass spectrometry method for the determination of 'traditional' stimulants (methamphetamine, amphetamine, MDMA) and cathinones (mephedrone, methylenedioxypyrovalerone (MDPV), α-pyrrolidinopentiophenone (α-PVP), methylone, butylone, flephedrone, and naphyrone). Matrix-matched calibration was prepared in the concentration range 10-2000 ng/g. The limits of quantification were determined as 10 ng/g, recoveries ranged from 48.2% to 94.3% and the matrix effect was between 60.2% and 101.4%. Accuracy (86.1-114.5%) and precision (4.9-14.9%) were determined and all validation criteria were met for all analytes except for naphyrone. Finally, our analytical method was tested on a set of real meconium samples, which were found positive for amphetamine, methamphetamine and methylone, thus demonstrating the validity of the method.
- MeSH
- amfetaminy analýza MeSH
- amoniové sloučeniny chemie MeSH
- extrakce kapalina-kapalina metody MeSH
- komplikace těhotenství diagnóza MeSH
- lidé MeSH
- limita detekce MeSH
- mekonium chemie MeSH
- novorozenec MeSH
- odhalování abúzu drog metody MeSH
- poruchy spojené s užíváním psychoaktivních látek diagnóza MeSH
- stimulanty centrálního nervového systému analýza MeSH
- studie proveditelnosti MeSH
- tandemová hmotnostní spektrometrie metody MeSH
- těhotenství MeSH
- vysokoúčinná kapalinová chromatografie metody MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Enterolithiasis (multiple calcifications of intraluminal meconium) is a rare, prenatal ultrasonographic finding. In this study, our aim was to evaluate the prenatal diagnostic features and discuss the management of the patients. METHODS: The data of two cases of prenatally diagnosed fetal enterolithiasis were collected from ultrasound scan, magnetic resonance imaging (MRI) and neonatal or postnatal autopsy records. The findings were evaluated in both prenatal and postnatal periods. Chromosomal analysis was performed in one case. An evaluation of primary and secondary malformations was done. Coexisting anomalies were searched for via radiology, neonatal surgery and histopathology. RESULTS: Malformations in two cases (both males) with partial and complete urorectal septum malformation (URSM) sequence were described. The absence of an anal opening and presence of a fistula between the urinary and gastrointestinal tract were common findings. These features were considered as primary malformations contributing to the formation of enterolithiasis. Secondary anomalies (urinary and gastrointestinal system malformations, pulmonary hypoplasia, genital and other coexisting anomalies) were evaluated. CONCLUSIONS: The prenatal detection of enterolithiasis carries a poor prognosis. Most of the previously reported cases were invariably associated with major fetal malformations of the urinary and gastrointestinal tract. It is a warning sign for large bowel obstruction with or without enterourinary fistula. Therefore, adequate gastrointestinal and urologic studies must be undertaken after birth for the final diagnosis. There is a high mortality rate in the reported cases, mostly attributed to associated anomalies, and all survivors required neonatal surgery. It is important to differentiate the partial from the full URSM sequence because the prognosis in the partial URSM sequence is generally good, with long-term survival being common. Copyright 2006 John Wiley & Sons, Ltd.
- MeSH
- dospělí MeSH
- financování organizované MeSH
- kalcinóza diagnóza MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mekonium chemie ultrasonografie MeSH
- močové ústrojí abnormality MeSH
- nemoci plodu diagnóza ultrasonografie MeSH
- nemoci střev diagnóza MeSH
- nemoci u dvojčat diagnóza ultrasonografie MeSH
- oligohydramnion ultrasonografie MeSH
- prenatální diagnóza MeSH
- rektum abnormality MeSH
- střeva abnormality MeSH
- těhotenství MeSH
- ultrasonografie prenatální MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Cíl práce: Shrnutí významu mekonia a jeho působení na výskyt perinatální infekce.Typ studie: Přehledný článek.Název a sídlo pracoviště: Gynekologicko-porodnická klinika LF UK a FN v Plzni, Čapkovo náměstí 1,307 08 Plzeň.Metoda: Incidence mekoniem zkalené plodové vody se udává mezi 7 - 22 %. Patofyziologie přítom-nosti mekonia v plodové vodě je stále nedostatečně objasněna, mekonium je pod hormonálníma nervovým vlivem. Přítomnost mekonia v plodové vodě byla vždy považována za rizikový faktorpro další vývoj plodu a novorozence. Souhrnný článek je dále rozdělen do tří kapitol. (II. Mekoni-um a mekoniový aspirační syndrom, III. Mekonium a postnatální neurologický handicap).Výsledky a závěr: První kapitola zpracovává vliv mekonia na výskyt perinatální infekce: intraam-niální infekci/chorioamnionitis, puerperální endometritis, infekci rány po císařském řezu a neo-natální infekci. Incidence klinické chorioamnionitis je v přítomnosti mekonia 15% ve srovnání se3 % u kontrol. Výskyt poporodní endometritis je 10% ve srovnání se 3 % v normální populaci. Jsouzmíněny dva hlavní mechanismy vzniku (či koincidence) intraamniální infekce při přítomnostimekonia. 1) Infekce může působit mekoniovou pasáž. 2A) Změna poměru Zn/P v amniové tekutiněpři přítomnosti mekonia může podporovat bakteriální růst. 2B) Mekonium přichycené na stěnumakrofágů či absorbované fagocytózou může zhoršit buněčnou imunitní odpověď. V závěru jediskutována antibiotická profylaxe.
Objective: A review of meconium patophysiology and its contribution to the incidence of perinatalinfection.Design: Review article.Setting: Department of Gynaecology and Obstetrics, Charles University and Faculty HospitalPlzeň, Czech Republic.Method: The reported incidence of meconium-stained amniotic fluid varies between 7 and 22 %.The patophysiology of the presence of meconium in the amniotic fluid is not sufficiently explai-ned. Meconium in fetal bowels is under hormonal and neurol control. The presence of the meconi-um-stained amniotic fluid was always considered to be a potential risk for the fetal and neonatalwell-being. The review is further divided in to three chapters. (II. Meconium and meconiumaspiration syndrome, III. Meconium and postnatal neurological handicap).Results and conclusion: The first chapter on deals with meconium risk in the development ofperinatal infection: intraamniotic infection/chorioamnionitis, postnatal endometritis, infection ofthe abdominal wound after Caesarean and neonatal infection. The incidence of clinical chorioam-nionitis is 15% with the presence of meconium compared to 3% in controls. The incidence ofpuerperal endometritis is 10% in comparison to 3% under normal conditions. Two main mecha-nisms of development (or coincidence) of intraamniotic infection in the presence of meconiumexist. 1) Infection may be a cause of meconium passage. 2A) Alteration of Zn/P ratio in the amnio-tic fluid can promote bacterial growth. 2B) Meconium attached to macrophages or absorbed byphagocytosis can impair cellular immune response. The antibiotic prophylaxis is discussed.
- MeSH
- chorioamnionitida diagnóza etiologie MeSH
- dítě MeSH
- dospělí MeSH
- endometritida etiologie prevence a kontrola MeSH
- infekce etiologie farmakoterapie MeSH
- kontrola infekce MeSH
- lidé MeSH
- mekonium chemie MeSH
- nemoci novorozenců etiologie MeSH
- nemoci plodu etiologie MeSH
- novorozenec MeSH
- plodová voda chemie patologie MeSH
- těhotenství MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
