D espite advancements in medicine, preterm infants continue to experience high neonatal mortality and morbidity, with many having lifelong neurodevelopmental deficits, such as cerebral palsy (CP) and impaired cognitive abilities. The risk of impairment increases with decreasing gestational age at birth and many studies of short-term and long-term outcomes have focused on infants born at <33-week gestation. There are few data, however, on neonates born at 33 or 34 weeks. Issues include optimal places for delivery of preterm infants and the optimal gestational age for delivery in women with such pregnancy complications as gestational hypertension, intrauterine growth restriction (IUGR), and preterm premature rupture of membranes. In this population-based study of infants born at 30 to 34 weeks, neonatal mortality and morbidity and 5-year neurodevelopmental outcomes were assessed.All live and stillbirths occurring between 30 and 32 weeks in 1997 (n = 2020) and all between 33 and 34 weeks in April and October of 1997 (n = 457) in all maternity units in 9 French regions were included in the EPIPAGE study. Data on the mother, pregnancy, and neonate were recorded on standardized forms and included maternal complications, gestational age at birth, adverse neonatal outcomes, and treatments used in the neonatal unit. Survivors had a medical and neuropsychological assessment at 5 years of age.Of the 2467 infants enrolled in the study, 2018 were eligible for follow-up and 1461 were evaluated at 5 years. The distribution of pregnancy complications varied with gestational age in that the proportion of pregnancies with singletons and IUGR or hypertension decreased from 26% at 30 weeks to 18% at 34 weeks. On the other hand, the proportion with preterm premature rupture of membranes increased from 19% at 30 weeks to 26% at 34 weeks. The rate of cesarean births, antenatal corticosteroid therapy, and birth in tertiary-care facilities decreased as gestational age increased. So did the rate of adverse neonatal outcomes, although such morbidities as respiratory distress syndrome and bronchopulmonary dysplasia continued through all birth ages. Hospital length of stay also decreased with increasing gestational age; however, 27% of infants born at 34 weeks required admission to the neonatal intensive care unit; 7% needed endotracheal ventilation; 16% received antibiotics for >7 d and 5%, parenteral nutrition for >10 d; 9% received caffeine for apneas; and 47% had phototherapy for jaundice. The CP rate was 6.3% in the 30-week group, 8.7% at 31 weeks, 4.1% at 32 weeks, 3.7% at 33weeks, and 0.7% at 34 weeks (P<0.01). The proportion of children with Mental Processing Composite scores below 70 ranged from 10% in the 30-week and 31-week groups to 5% in the 34-week group, with the mean Mental Processing Composite score increasing significantly from 94 at 30 weeks to 98 at 34weeks. There was little difference among age groups as to visual and hearing deficiencies. In multivariate analysis, only gestational age at birth and pregnancy complication...

Bacteriocin production is a widespread phenomenon among bacteria. Bacteriocins hold great promise for the treatment of diseases caused by pathogenic bacteria and could be used in the future as alternatives to existing antibiotics. The anti-infective potential of bacteriocins for inhibiting pathogens has been shown in various food matrices including cheese, meat, and vegetables. However, their inhibition of pathogens in vivo remains unclear and needs more investigation, due mainly to difficulties associated with demonstrating their health benefits. Many bacteriocins produced by established or potential probiotic organisms have been evaluated as potential therapeutic agents and interesting findings have been documented in vitro as well as in a few in vivo studies. Some recent in vivo studies point to the efficacy of bacteriocin-based treatments of human and animal infections. While further investigation remains necessary before the possibilities for bacteriocins in clinical practice can be described more fully, this review provides an overview of their potential applications to human and veterinary health.

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The bacteriocin microcin J25 (MccJ25) inhibits the growth of Gram-negative pathogens including Salmonella and Shigella species, and Escherichia coli. This 21-amino acid peptide has remarkable stability to heat and extreme pH values and resistance to many proteases, thanks to a characteristic lasso structure. In this study, we used the dynamic simulator TIM-1 as gastro-intestinal tract model to evaluate the stability and antibacterial activity of MccJ25 during passage through the proximal portion of the human gastrointestinal tract. MccJ25 concentration was measured in the different simulator sections by HPLC, and inhibition of Salmonella enterica serotype Enteritidis was evaluated using qualitative and quantitative assays. LC-MS/MS analysis and subsequent molecular networking analysis on the Global Natural Product Social Molecular Networking platform (GNPS) and analysis of the peptide degradation in the presence of proteolytic enzymes mimicking the gastro-intestinal conditions permitted to delineate the fate of MccJ25 through identification of the main degradation products. MccJ25 was relatively stable under gastric conditions, but degraded rapidly in the compartment mimicking the duodenum, notably in the presence of pancreatin. Among pancreatin components, elastase I appeared primarily responsible for MccJ25 breakdown, while α-chymotrypsin was less efficient.

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