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ABSTRACTBackgroundMultiple myeloma is one of the most common hematologic malignancies. Acquired factor X deficiencies are often observed in primary (AL) amyloidosis and rarely in multiple myeloma.ObjectiveWe report a case of an acquired factor X deficiency in a patient with a newly diagnosed IgA lambda multiple myeloma, without any evidence of concomitant amyloidosis.MethodsWe present the patient’s medical history, clinical and physical examinations, laboratory analysis, and outcome.ResultsA 76-year-old male presented at the emergency department with ongoing gingival bleeding. Several analytical problems with blood sample analysis arose, which eventually led to the diagnosis of a multiple myeloma. Further exploration revealed an acquired factor X deficiency, explaining the ongoing bleeding. There was no evidence of concomitant amyloidosis. The multiple myeloma was treated, leading to complete remission of the malignancy and bleeding tendency.ConclusionWhile coagulopathy is rarely observed in patients diagnosed with multiple myeloma, considering an acquired factor X deficiency becomes relevant when such patient present with bleeding diathesis.

ABSTRACTObjectivesData on Helicobacter pylori(HP) resistance in Belgium are largely based on the patient population of Brussels and Wallonia. Notably Brussels harbours a large proportion of patients with a migration background which might not be representative for other parts of the country.MethodsAn observational cross-sectional study was performed in the province of West Flanders, Belgium for collecting gastric biopsies to examine the resistance of HP. The study population consisted of patients who underwent a gastroduodenoscopy for any medically indicated purpose. Rapid urease testing (RUT) was performed on all biopsies and cultures were only started if the RUT showed positive.Results512 patients participated of whom 495 were eligible for analysis: 438 in first line testing and 57 in second line. The growth of HP was successful in 88.9% (n = 88/99) of which 52.3% (n = 46/88) resulted in an antibiogram. The resistance rate in first line was based on 37 succeeded antibiograms and showed 13.5% resistance for clarithromycin (95% confidence interval; 2.5% to 24.5%); 29.7% for metronidazole; 29.7% for levofloxacin; 11.4% for rifampicin; 2.7% for amoxicillin and 0% for tetracycline.ConclusionThe primary clarithromycin resistance rate of HP could still be slightly under 15% in West Flanders, Belgium. This might implicate a clarithromycin-based triple therapy is an option for first line empiric eradication in this region according to the Maastricht V/Florence consensus although conclusions must be interpreted with caution due to the rather small sample size. Further testing in Flanders is recommended to confirm these results.

ABSTRACTBackgroundSyphilis is a systemic, infectious disease caused by Treponema pallidumand is notorious for the variety of its clinical presentations.ObjectiveWe report a case of secondary syphilis with thyroid gland and ocular involvement in a human immunodeficiency virus (HIV) negative patient.MethodsWe present the patient’s history, clinical findings, laboratory test results, imaging and management.ResultsA 39-year-old Caucasian, HIV unaffected woman presented with acute midline neck swelling, dyspnea and difficulty to talk or swallow. Serologic tests for syphilis were positive. PCR performed on a thyroid fine needle aspiration cytology (FNAC) aspirate was positive for Treponema pallidum. Skin lesions and unilateral loss of vision were present. Treatment with intravenous benzyl-penicillin showed a good regression of symptoms.ConclusionWe report an unusual case of thyroid swelling in a secondary syphilis infection. Awareness of syphilis as a differential diagnosis is important in a risk population.

The present article deals with the calibration and validation of a biological model of SMBR for hospital wastewater treatment using respirometry. In a first part, the stoichiometric and kinetic parameters are estimated and validated using the experimental oxygen uptake rate (OUR) profiles from the sodium acetate degradation process, according two kinetic theories: one considering that microorganisms use the carbon reserve and easily biodegradable substrates simultaneously for growth; and the other that microorganisms use the carbon reserve only when easily biodegradable substrate is depleted. In this study, the first theory proved to be the most adequate to predict the experimental OUR profile. In the second part, the hospital wastewater degradation process simulated using the theory determined as the more suitable. The stoichiometric parameters obtained for acetate were used for the hospital wastewater COD fractionation process, considering simultaneous growth and substrate storage. These COD fractions and the stoichiometric parameters obtained for acetate were employed for the simulation process of hospital wastewater degradation, where only kinetic parameters were calibrated. Good correspondence was obtained between experimental data and the model outputs. The values obtained for kinetic parameters were different from those obtained for sodium acetate, evidencing the influence of the substrate nature. Through the calibration of stoichiometric and kinetic parameters using the proposed procedure, the activated sludge models proved their capacity and usefulness for the simulation of a hospital wastewater degradation process

AbstractObjective and Importance: Lemierre’s syndrome (LS) is a rare condition that typically starts with a bacterial oropharyngeal infection complicated by a thrombophlebitis of the internal jugular vein and septic emboli to the lungs or other organs. The most common organism isolated is Fusobacterium necrophorum, although other causative organisms are isolated in rare cases.Case presentation: We discuss a case of LS in a 44-year-old, previously healthy man presenting with an oropharyngeal infection. F. necrophorumwas isolated from blood cultures and Computed tomography of the chest demonstrated septic emboli in the lungs. Magnetic resonance imaging showed a thrombophlebitis of the sigmoid and transverse vein with continuity to the internal jugular vein.Methods: Case report and literature review.Results: F. necrophorumisolates show in vitrosusceptibility to metronidazole, clindamycin, beta-lactam/beta-lactamase inhibitor combinations and carbapenems with no signs of resistance or reduced sensitivity. Anticoagulation is believed to play a favourable role in recovery of the disease because of the potential for faster resolution of thrombophlebitis and bacteraemia. Conflicting results exist in literature with many studies or reviews indicating a favourable outcome both with and without anticoagulation. Anticoagulation for LS consists in most cases of Warfarin or Low molecular weight heparins, with the last being the first choice in children. Indications for the use of anticoagulation in literature are significant clot burden, complication of septic emboli, arterial ischemic stroke, poor response to antibiotics, thrombophilia and cerebral infarction.Conclusions: Antibiotics are considered the mainstay of treatment, although statistically valid trials to evaluate optimal treatment regimens have not yet been conducted due to the low incidence of the infection. The use of anticoagulation in LS is still heavily debated as a result of conflicting results in literature. Due to the disease’s low incidence, statistically valid trials that evaluate anticoagulation are lacking. Further prospective and randomized research is needed to establish the benefit of anticoagulation in the treatment of LS.

AbstractObjectives: The roundworm Ascaris lumbricoidesis one of the most prevalent parasites belonging to the class of the soil-transmitted helminths. Infections are most common in developing countries with a tropical climate where sanitation and hygiene are poor. However, prevalence of ascariasis in industrialized countries is increasing because of immigration and increasing number of refugees.Methods: We report a case of ascariasis in a female patient who was admitted to our hospital after she had left the informal refugee camp of Calais in the north of France.Results: After colonoscopic removal of the worm and treatment with mebendazole during three days the patient’s symptoms had completely resolved. Medical treatment with benzimidazole derivatives is easy and inexpensive. To prevent parasitic infections in larger populations, mass drug administration should be repeated periodically and must be implemented along with additional measures such as improvements to water, sanitation and hygiene (WASH). These WASH programs have been proven to be highly effective, but access and follow-up are expensive and very difficult to organize in refugee camps, even in wealthy, industrialized countries.Conclusions:Despite being an old, well-known parasitic disease, ascariasis might reappear in certain populations at risk in industrialized countries. Detection, treatment and follow-up of these patients, and the organization of preventive measures remain challenging.

The aim of the study was to evaluate the effects of infant formula supplemented with 2 human milk oligosaccharides (HMOs) on infant growth, tolerance, and morbidity. Healthy infants, 0 to 14 days old, were randomized to an intact-protein, cow's milk–based infant formula (control, n =87) or the same formula with 1.0 g/L 2'fucosyllactose (2'FL) and 0.5 g/L lacto-N-neotetraose (LNnT) (test, n =88) from enrollment to 6 months; all infants received standard follow-up formula without HMOs from 6 to 12 months. Primary endpoint was weight gain through 4 months. Secondary endpoints included additional anthropometric measures, gastrointestinal tolerance, behavioral patterns, and morbidity through age 12 months. Weight gain was similar in both groups (mean difference [95% confidence interval] test vs control: -0.30 [-1.94, 1.34] g/day; lower bound of 95% confidence interval was above noninferiority margin [-3 g/day]). Digestive symptoms and behavioral patterns were similar between groups; exceptions included softer stool (P= 0.021) and fewer nighttime wake-ups (P= 0.036) in the test group at 2 months. Infants receiving test (vs control) had significantly fewer parental reports (P= 0.004–0.047) of bronchitis through 4 (2.3% vs 12.6%), 6 (6.8% vs 21.8%), and 12 months (10.2% vs 27.6%); lower respiratory tract infection (adverse event cluster) through 12 months (19.3% vs 34.5%); antipyretics use through 4 months (15.9% vs 29.9%); and antibiotics use through 6 (34.1% vs 49.4%) and 12 months (42.0% vs 60.9%). Infant formula with 2'FL and LNnT is safe, well-tolerated, and supports age-appropriate growth. Secondary outcome findings showing associations between consuming HMO-supplemented formula and lower parent-reported morbidity (particularly bronchitis) and medication use (antipyretics and antibiotics) warrant confirmation in future studies.

Supplemental Digital Content is available in the text

Supplemental Digital Content is available in the text

The prevalence of disease-related undernutrition in hospitalized children has not decreased significantly in the last decades in Europe. A recent large multicentric European study reported a percentage of underweight children ranging across countries from 4.0% to 9.3%. Nutritional screening has been put forward as a strategy to detect and prevent undernutrition in hospitalized children. It allows timely implementation of adequate nutritional support and prevents further nutritional deterioration of hospitalized children. In this article, a hands-on practical guideline for the implementation of a nutritional care program in hospitalized children is provided. The difference between nutritional status (anthropometry with or without additional technical investigations) at admission and nutritional risk (the risk of the need for a nutritional intervention or the risk for nutritional deterioration during hospital stay) is the focus of this article. Based on the quality control circle principle of Deming, a nutritional care algorithm, with detailed instructions specific for the pediatric population was developed and implementation in daily practice is proposed. Further research is required to prove the applicability and the merit of this algorithm. It can, however, serve as a basis to provide European or even wider guidelines.

The Belgian registry for paediatric Crohn disease (BELCRO) cohort is a prospective, multicentre registry for newly diagnosed paediatric patients with Crohn disease (CD) (<18 years) recruited from 2008 to 2010 to identify predictive factors for disease activity and growth. Data from the BELCRO database were evaluated at diagnosis, 24 and 36 months follow-up. At month 36 (M36), data were available on 84 of the 98 patients included at diagnosis. Disease activity evolved as follows: inactive 5% to 70%, mild 19% to 24%, and moderate to severe 76% to 6%. None of the variables such as age, sex, diagnostic delay, type of treatment, disease location, disease activity at diagnosis, and growth were associated with disease activity at M36. Paediatricians studied significantly less patients with active disease at M36 compared with adult physicians. Sixty percent of the patients had biologicals as part of their treatment at M36. Adult gastroenterologists initiated biologicals significantly earlier. They were the only factor determining biologicals’ initiation, not disease location or disease severity at diagnosis. Median body mass index (BMI) zscore evolved from -0.97 (range -5.5–2.1) to 0.11 (range -3.4–2) and median height zscore from -0.15 (range -3.4–1.6) to 0.12 (range -2.3–2.3) at M36. None of the variables mentioned above influenced growth over time. Present treatment strategies lead to good disease control in the BELCRO cohort after 3 years. Logistic regression analysis did not show any influence of disease location or present treatment strategy on disease activity and growth, but patients under paediatric care had significantly less severe disease at M36.

AbstractMembrane bioreactor technology has become relatively widespread as an advanced treatment for both industrial and municipal wastewaters. The main problem of these installations is that they do not operate at the maximum of their potential, mainly because of membrane fouling. Experimental research with this kind of installation requires resources and is time consuming. The use of a computer simulator, as in the present work, allows the fouling behaviour in a bench-scale submerged membrane bioreactor to be investigated over a wide range of operating parameters: average specific aeration intensity (0.041–0.277 L m−2 s−1), filtration flux (0.032–0.160 m3 m−2 d−1) and filtration and coarse bubble aeration cycles (filtration and aeration times: 60–1080 s, with/without ratio: 0.33/10). A quadratic optimization method applied to the energy consumption (EC) was first carried out: minimum values of 0.27 and 0.32 kW h m−3were obtained for EC in the sequential and non-sequential operating modes, respectively. Using the optimal operating conditions and the most influent parameters found in the first part, the second part details their influence on both membrane fouling and EC for each operating mode. The mean filtration flux and the mean aeration intensity have opposite effects on fouling and EC, which implies that a more global, economic optimization, including chemical cleaning, is needed. The detailed study of filtration and coarse bubble aeration cycles showed that they had little influence for a with/without ratio superior to 1. Using the quadratic optimization method with in silicoexperiments gave reliable first approximation results.

Membrane bioreactor technology has become relatively widespread as an advanced treatment for both industrial and municipal wastewaters. The main problem of these installations is that they do not operate at the maximum of their potential, mainly because of membrane fouling. Experimental research with this kind of installation requires resources and is time consuming. The use of a computer simulator, as in the present work, allows the fouling behaviour in a bench-scale submerged membrane bioreactor to be investigated over a wide range of operating parameters: average specific aeration intensity (0.041–0.277 L m−2 s−1), filtration flux (0.032–0.160 m3 m−2 d−1) and filtration and coarse bubble aeration cycles (filtration and aeration times: 60–1080 s, with/without ratio: 0.33/10). A quadratic optimization method applied to the energy consumption (EC) was first carried out: minimum values of 0.27 and 0.32 kW h m−3were obtained for EC in the sequential and non-sequential operating modes, respectively. Using the optimal operating conditions and the most influent parameters found in the first part, the second part details their influence on both membrane fouling and EC for each operating mode. The mean filtration flux and the mean aeration intensity have opposite effects on fouling and EC, which implies that a more global, economic optimization, including chemical cleaning, is needed. The detailed study of filtration and coarse bubble aeration cycles showed that they had little influence for a with/without ratio superior to 1. Using the quadratic optimization method with in silicoexperiments gave reliable first approximation results.

To assess the practical usefulness of arraycomparative genomic hybridization aCGH when supernumerary marker chromosomes SMCs are detected during prenatal diagnosis, we retrospectively studied SMC management in our laboratory before aCGH availability. In this 11year study, SMCs were observed in 2016,810 routine karyotypes 0.12. Their chromosomal origin, ascertained in 13 cases, remained elusive in seven using conventional cytogenetics and FISH. In the literature, most of SMCs 23 are easily identified through conventional cytogenetics and targeted FISH, and in these cases aCGH would have been unneeded. This technique would have been less helpful in nine cases, that is, bisatellited SMC, isochromosomes and translocation derivatives. On the other hand, aCGH would have been helpful for the 11 remaining cases. It would have improved diagnostic accuracy of six SMC whom chromosomal origin was ascertained by cytogenetics and FISH and for which prognosis was only based on literature and ultrasonographic data. Among five unidentified SMCs, aCGH would have been more reassuring for four heterochromatic SMCs than normal ultrasonography alone and would have characterized the unidentified case associated with malformations that was interrupted. However potential pitfalls should be outlined. Using high level resolution chip expose to polymorphism detection and misinterpretation, a very sensitive problem in prenatal diagnosis. Moreover, low grade mosaicism could remain undetectable with this technique, leading to erroneous conclusions. Wisest use of aCGH should be a complementary approach in prenatal management of SMC. It is specifically appropriate when SMC interpretation remains equivocal and only indirectly based on mode of inheritance, literature data and ultrasonography. © 2008 WileyLiss, Inc.

Three different powders were studied by image analysis. Shadow casting was used to generate information on particle orientation. It was discovered that orientation effects can distort the data generated in size characterization studies and as a consequence of these studies it is suggested that, in any image analysis study intended to be used to generate reference data, shadow casting-orientation studies should be carried out to specify the orientation of the fineparticles.

Three different powders were studied by image analysis. Shadow casting was used to generate information on particle orientation. It was discovered that orientation effects can distort the data generated in size characterization studies and as a consequence of these studies it is suggested that, in any image analysis study intended to be used to generate reference data, shadow casting‐orientation studies should be carried out to specify the orientation of the fineparticles.

In an aerosol spectrometer the size of a powder grain is measured from the time-of-flight of the fineparticle between two laser beams. Due to the flow conditions, irregularly shaped fineparticles align themselves along the direction of flow of the air stream carrying them across the gap between the laser beams. The size distribution measured therefore varies with the shape of the fineparticles. This fact is demonstrated by comparing size distributions generated by image analysis, electrozone stream counter, diffractometer, and time-of-flight aerosol spectrometer.

In an aerosol spectrometer the size of a powder grain is measured from the time‐of‐flight of the fineparticle between two laser beams. Due to the flow conditions, irregularly shaped fineparticles align themselves along the direction of flow of the air stream carrying them across the gap between the laser beams. The size distribution measured therefore varies with the shape of the fineparticles. This fact is demonstrated by comparing size distributions generated by image analysis, electrozone stream counter, diffractometer, and time‐of‐flight aerosol spectrometer.

Abstract: We describe two infants in whom MRI diagnosed osteomyelitis of the cuboid bone when conventional X-rays were negative. Neoplastic, traumatic and ischaemic aetiologies could be excluded with the initial MR examinations.

The simulation of a chemical process is usually a long and complex task. This paper presents the current stage of development of a general environment for steady state process simulation. First, the progress of a simulation session is detailed and the difficulty of a complex process simulation is analysed. Then a study of the potential help is developed. Finally, the structure of the environment is described.

The objective of this work is to help the user of a simulation software to prepare a simulation run. To this end, the user has to supply the simulator with numerous data of various kinds and our goal is to help him to define a set of coherent data. In this paper, we indicate on the example of a stream specification how constraint propagation techniques can be used to reach this objective. After a brief description of the basic principles of constraint propagation, we give an algorithm for the good specification of a stream. This algorithm relies on the transformation of the equations linking the various properties of a stream into a set of constraints expressing necessary conditions for a stream being correctly specified. By the end, we show how to advise the user on specifying a stream from constraint propagation. Future works will consist in extending constraint propagation to the assignment of the other variables required for a simulation run.

In recent years, powder technologists have been increasingly concerned with powder systems having irregular grain shape and texture. Of particular concern is the effect of the shape of the powder grains on the size distribution data generated by characterization methods based on various physical principles. In particular, as many laboratories switched to modern procedures based on analysis of diffraction patterns, the need to know the effect of particle shape on the data generated by the newer methods, as compared to information gathered using classical methods such as sieving or image analysis, has grown. In this study comparative data generated by sieving, image analysis, and diffractometer studies of four iron powders, arc reported and discussed.

The KHT sarcoma is a model system in which metastases can be studied in multiple organs without prior clonal selection. The present series of experiments were designed to evaluate and compare the extent of potentiation of chemotherapeutic agent activity by radiosensitizers when KHT sarcoma cells were grown in different anatomical sites. In these studies the effect of combining misonidazole (MISO) and 1-(2-chloroethyl)-3-cyclohexyl-l-nitrosourea (CCNU) on KHT lung nodules and ovarian metastases was determined. Ovarian metastases were a consequence of the direct spread of tumor cells growing as lung nodules. Once established, KHT cells in the lungs and ovaries grew with a similar doubling time (1–2 days). Response of tumors at either site to chemotherapy in the presence or absence of a sensitizer was assessed using an in vivoto in vitroexcision assay. MISO (1·0 mmol/kg) was administered simultaneously with a range of CCNU doses and survival of clonogenic tumor cells was measured 24 h after treatment. The results demonstrate that the addition of MISO to CCNU treatment potentiated the action of this chemotherapeutic agent at both tumor sites although greater cell kill enhancement occurred in the ovarian metastases. In the lung nodules, when combined with CCNU, a 1·0 mmol/kg dose of MISO was found to yield a dose modifying factor (DMF) of ∼1·3. The same combination resulted in a DMF of ∼1·8 in the ovarian metastases. This difference in DMF was not a result of an intrinsic difference in sensitivity to CCNU since cells grown at either site gave rise to the same dose response curve. Rather the difference in dose modification by MISO appears to be a consequence of the larger fraction of radiobiologically hypoxic cells in the ovarian tumors (∼50 per cent) than in the lung nodules (∼5 per cent) at the time of treatment. These findings suggest the use of drug-sensitizer combinations to treat disseminated disease and provide further evidence for the requirement of hypoxia in chemopotentiation by radiosensitizers.

Organic plasticizers were added to plastics to improve flow and reduce brittleness by lowering the glass transition temperature. The amount of plasticizer added to the base resin determined its efficiency in bringing about these desired changes in properties. Analytical gel permeation chrornatography (GPC) was utilized to quantitatively determine the amount of organic plasticizers in poly(styrene) mixtures. The internal standard method was applied to the determination of triethyleneglycol-dibenzoate and tricyclohexylcitrate over the concentration range of 5.0 to 30.0 wt% in poly(styrene). Linear calibration curves and excellent precision between measurements was demonstrated over the concentration range investigated. GPC analysis has the advantage over spectrophoto-metric techniques in its ability to separate low molecular weight plasticizers: from higher molecular weight resins. In addition to the potential of making quantitative measurements from the detected peak, the associated material can be separated from the polymer, collected, and separately analyzed by UV or IR techniques.

Human milk is the sole and recommended nutrition for the newborn infant and contains one of the largest constituents of diverse oligosaccharides, dubbed human milk oligosaccharides (HMOs). Preclinical and clinical association studies indicate that HMOs have multiple physiological functions largely mediated through the establishment of the gut microbiome. Until recently, HMOs were not available to investigate their role in randomized controlled intervention trials. To our knowledge, this is the first report on the effects of 2 HMOs on establishing microbiota in newborn infants. We provide a detailed description of the microbiota changes observed upon feeding a formula with 2 HMOs in comparison to breastfed reference infants' microbiota. Then, we associate the microbiota to long-term health as assessed by prescribed antibiotic use.

Summary: We report the case of a 16-year-old patient with osteopetrosis major, complaining of transient sensory and motor disturbances in the left upper limb and diziness on changing the position of his head. Selective angiography of the cerebral vessels showed severe narrowing of the internal carotid artery within the petrous carotid canal and in its supraclinoid portion. The cervical vertebral arteries showed multiple stenosis within the vertebral canal. These findings are explained by narrowing of the basal foramina by the osteopetrotic bone.

Twelve neurologically normal infants (age 2.9 +/- 0.9 months) with peptic esophagitis (grade 2) who did not respond to cimetidine (in addition to positioning, cisapride, and Gaviscon) were treated with omeprazole, 0.5 mg/kg once a day, for 6 weeks. The effectiveness of omeprazole was evaluated in all infants by clinical assessment and endoscopy before and after treatment and by 24-hour gastric pH monitoring during treatment in seven infants. Omeprazole therapy led to a marked decrease in symptoms, endoscopic and histologic signs of esophagitis, and intragastric acidity. (J Pediatr 1998;132:352-4)

Human milk oligosaccharides (HMOs) are thought to influence early intestinal microbiota establishment and may thereby provide benefits to formula‐fed infants. We evaluated the effect of infant formula with 2 HMOs (2'Fucosyllactose [2'FL] and Lacto‐N‐neotetraose [LNnT]) on the establishment of the intestinal microbiota in infants (ClinicalTrials.govNCT01715246). Healthy term infants, who were 0–14 days old at enrolment, were randomized to intact protein cow's milk‐based infant formula (Control, n87) or the same formula with 1.0 g/L 2'FL and 0.5 g/L LNnT (Test, n88). Fully breastfed infants were also studied as a reference group (n38). Stool samples were collected at 3 months of age for microbiota assessment using 16S rRNA gene sequencing and metagenomics; metabolic signature in stool was assessed using proton NMR. The global average microbial composition profile was established for infants from whom stool samples were available and who adhered to the protocol. A similar formula‐fed pattern for Control (n65) and Test (n58) was seen at the genus level, although Test appeared closer to breastfed (n34) than Control. Calculation of microbial alpha diversity and comparison of the global microbiota composition using random permutations of the redundancy analysis (RDA) confirmed that Test was different from Control at genus level (p < 0.001) and closer to the breastfed group. By statistical analyses we identified several taxa differentially present in Control and Test. These were Bifidobacterium(p = 0.01), Escherichia(p = 0.008), unclassified Coprobacillaceae(p = 0.01), unclassified Peptostreptococcaceae(p = 0.026), Dorea(p = 0.033), and Megamonas(p = 0.035). Correction for False Discovery Rate confirmed the first three taxa. Main discriminants between Test and Control by random forest analysis were Bifidobacterium, Escherichiaand Peptostreptococcaceae. Clinically relevant pathogens were very rarely found; however, Clostridium difficiletoxin A/B was detected in 14% of Test and 26% Control (OR 0.47, CI 0.17–1.27, p = 0.15). Multivariate stool metabolite analysis identified influential metabolites that discriminate between Test, Control and breastfed group. These were the amino acids phenylalanine, isoleucine, tyrosine, fecal organic acids and fucosylated compounds. Globally, the metabolic signatures observed in Test were more similar to those observed in stool of breastfed infants than Control. The observed profiles may indicate reduced protein fermentation in Test compared to Control. Together the stool microbiota and metabolic signature show that the addition of 2'FL and LNnT to a starter infant formula shift the stool microbiota towards that observed in breastfed infants, both in composition and function. Further studies are warranted to evaluate whether such a shift in gut ecology towards the breastfed standard leads to health benefits.

No abstract.