Enterobacter sakazakii é um bacilo Gram-negativo, pertencente à família Enterobacterieceae. Este microrganismo vem ganhando a atenção das autoridades de saúde pública ao redor do mundo, não tanto pela morbidade, que é baixa, mas pela elevada taxa de mortalidade que varia de 40-80%. O patógeno afeta principalmente recém-nascidos de baixo peso e bebês com até seis meses de idade. Em comum, estas crianças têm o fato de serem alimentadas com fórmula infantil desidratada, a base de leite. Em nosso país ainda não existem muitos estudos sobre a ocorrência deste patógeno em fórmulas infantis, nem no ambiente de preparo das mesmas. O objetivo deste trabalho foi avaliar as condições de produção de mamadeiras para recém-nascidos em maternidades da Grande São Paulo, além de determinar a população de E. sakazakii em fórmulas infantis desidratadas e reidratadas. A população de Enterobacteriaceae e a presença de E. sakazakii também foram avaliadas em amostras ambientais, de utensílios e mão de manipuladores. Avaliou se ainda o comportamento do patógeno em fórmula infantil reidratada simulando as condições de oferecimento aos bebês. Coletou-se amostras de três hospitais maternidades diferentes (A-escola/B-público/C-particular) e analisou-se a presença de E. sakazakii usando método ISO. Para fórmulas desidratadas e reidratadas usou-se a mesma metodologia e a técnica de número mais provável (NMP). A população de Enterobacteriaceae foi determinada usando-se PetrifilmTM 3M. E. sakazakii foi detectada em duas amostras do Hospital A (na sobra da mamadeira que voltou do berçário e de uma amostra da lata lacrada da fórmula infantil desidratada. A população nesta amostra foi de 0,03 NMP/100g.) No Hospital B, foi detectada em apenas uma amostra (na esponja de lavagem das mamadeiras contaminadas). No Hospital C, E. sakazakii não foi detectada nas amostras analisadas. Quanto à população de Enterobacteriaceae nos lactários, observou-se uma variação, sendo que as amostras colhidas no hospital C foram as que apresentaram populações mais elevadas. As cepas de E. sakazakii isoladas apresentaram comportamento similar àquele da cepa padrão, ocorrendo um aumento de 2 log na população do patógeno quando simulou-se as condições de serviço das fórmulas, via naso-gástrica, aos bebês nos berçários. / Enterobacter sakazakii is a bacillus belonging to the Enterobacteriaceae family. It is considered an opportunistic pathogen that has been gaining attention from health authorities all over the world. While morbidity associated with this bacterium is low, mortality rates can range from 40-80%. The pathogen affects mainly low-birth-weight neonates (first 28 days), but babies less than 6 month old are also at risk. Powdered infant formula has been incriminated as the possible source of the microorganism to the infected babies. ln Brazil, as in several other countries, there is scarce information regarding the incidence of E. sakazakii in powdered infant formula, in reconstituted formula, and in milk kitchens areas in hospitals. The objective of this study was to evaluated the presence of E. sakazakii in the environment, utensils, handlers, powdered and rehydrated infant formula from milk kitchens from different maternity wards in Sao Paulo, Brazil. Moreover, it was evaluated the behavior of the pathogen in rehydrated infant formula. Samples were collected from 3 hospitals maternities (A-school/B-public/C-particular) and analyzed for E. sakazakii using the ISO method. For formula (powdered or rehydrated) the MPN technique was used. Enterobacteriaceae population was determined using PetrifilmTM 3M. E. sakazakii was found in one unopened formula can collected from Hospital A (0,03 MPN/100g), although the pathogen could not be detected in other cans from the same lot. E. sakazakii was also found in leftovers from one nursing bottle from the same hospital and from one cleaning sponge from Hospital B. E. sakazakii was not detected in none of the samples from Hospital C. A variation in Enterobacteriaceae population in milk kitchens was observed. Samples collected in Hospital C presented the highest population. Isolated strains of E. sakazakii presented similar behavior to standard strains, When spiked in rehidrated infant formula. A 2 log increase in the population of the pathogen was observed when simulating the conditions of formula administration to the babies by naso-gastric tubing.

Enterobacter sakazakii é um bacilo Gram-negativo, pertencente à família Enterobacterieceae. Este microrganismo vem ganhando a atenção das autoridades de saúde pública ao redor do mundo, não tanto pela morbidade, que é baixa, mas pela elevada taxa de mortalidade que varia de 40-80%. O patógeno afeta principalmente recém-nascidos de baixo peso e bebês com até seis meses de idade. Em comum, estas crianças têm o fato de serem alimentadas com fórmula infantil desidratada, a base de leite. Em nosso país ainda não existem muitos estudos sobre a ocorrência deste patógeno em fórmulas infantis, nem no ambiente de preparo das mesmas. O objetivo deste trabalho foi avaliar as condições de produção de mamadeiras para recém-nascidos em maternidades da Grande São Paulo, além de determinar a população de E. sakazakii em fórmulas infantis desidratadas e reidratadas. A população de Enterobacteriaceae e a presença de E. sakazakii também foram avaliadas em amostras ambientais, de utensílios e mão de manipuladores. Avaliou se ainda o comportamento do patógeno em fórmula infantil reidratada simulando as condições de oferecimento aos bebês. Coletou-se amostras de três hospitais maternidades diferentes (A-escola/B-público/C-particular) e analisou-se a presença de E. sakazakii usando método ISO. Para fórmulas desidratadas e reidratadas usou-se a mesma metodologia e a técnica de número mais provável (NMP). A população de Enterobacteriaceae foi determinada usando-se PetrifilmTM 3M. E. sakazakii foi detectada em duas amostras do Hospital A (na sobra da mamadeira que voltou do berçário e de uma amostra da lata lacrada da fórmula infantil desidratada. A população nesta amostra foi de 0,03 NMP/100g.) No Hospital B, foi detectada em apenas uma amostra (na esponja de lavagem das mamadeiras contaminadas). No Hospital C, E. sakazakii não foi detectada nas amostras analisadas. Quanto à população de Enterobacteriaceae nos lactários, observou-se uma variação, sendo que as amostras colhidas no hospital C foram as que apresentaram populações mais elevadas. As cepas de E. sakazakii isoladas apresentaram comportamento similar àquele da cepa padrão, ocorrendo um aumento de 2 log na população do patógeno quando simulou-se as condições de serviço das fórmulas, via naso-gástrica, aos bebês nos berçários. / Enterobacter sakazakii is a bacillus belonging to the Enterobacteriaceae family. It is considered an opportunistic pathogen that has been gaining attention from health authorities all over the world. While morbidity associated with this bacterium is low, mortality rates can range from 40-80%. The pathogen affects mainly low-birth-weight neonates (first 28 days), but babies less than 6 month old are also at risk. Powdered infant formula has been incriminated as the possible source of the microorganism to the infected babies. ln Brazil, as in several other countries, there is scarce information regarding the incidence of E. sakazakii in powdered infant formula, in reconstituted formula, and in milk kitchens areas in hospitals. The objective of this study was to evaluated the presence of E. sakazakii in the environment, utensils, handlers, powdered and rehydrated infant formula from milk kitchens from different maternity wards in Sao Paulo, Brazil. Moreover, it was evaluated the behavior of the pathogen in rehydrated infant formula. Samples were collected from 3 hospitals maternities (A-school/B-public/C-particular) and analyzed for E. sakazakii using the ISO method. For formula (powdered or rehydrated) the MPN technique was used. Enterobacteriaceae population was determined using PetrifilmTM 3M. E. sakazakii was found in one unopened formula can collected from Hospital A (0,03 MPN/100g), although the pathogen could not be detected in other cans from the same lot. E. sakazakii was also found in leftovers from one nursing bottle from the same hospital and from one cleaning sponge from Hospital B. E. sakazakii was not detected in none of the samples from Hospital C. A variation in Enterobacteriaceae population in milk kitchens was observed. Samples collected in Hospital C presented the highest population. Isolated strains of E. sakazakii presented similar behavior to standard strains, When spiked in rehidrated infant formula. A 2 log increase in the population of the pathogen was observed when simulating the conditions of formula administration to the babies by naso-gastric tubing.

L’optimisation du statut tissulaire en acides gras polyinsaturés à longues chaines n-3 (AGPILC n-3) fait partie des objectifs actuels en nutrition humaine. En effet, de nombreux effets bénéfiques sur la santé humaine ont été démontrés pour ces différents AGPILC n-3. Néanmoins, la bioconversion de ces dérivés à partir de leur précurseur alimentaire, l’acide α-linolénique, est limitée chez l’Homme et ne permet pas de subvenir aux besoins. Parmi cette famille d’acides, l’acide docosahexaénoïque (DHA) et de l’acide eicosapentaénoïque (EPA) ont été largement étudiés à l’inverse de ceux de l’acide docosapentaénoïque n-3 (DPA). Le premier objectif de ces travaux a été d’étudier l’impact d’une supplémentation nutritionnelle en DPA sur le métabolisme des acides gras et le métabolisme lipidique chez le rat sain. Pour cela, une méthode de purification du DPA à haute pureté et en grande quantité par chromatographie liquide a tout d’abord été mise en place. Ce résultat participe à faciliter la recherche future des effets in vivo du DPA dont la disponibilité commerciale est faible. Après sa supplémentation nutritionnelle, le DPA a été incorporé dans de multiples tissus et a impacté les compositions tissulaires en AGPILC n-3 de certains organes spécifiques comme le foie, le cœur, le poumon, la rate et le rein. Ainsi, la supplémentation en DPA pourrait être une source d’EPA, de DPA, et dans une moindre mesure de DHA. Enfin, comparé à une supplémentation en EPA ou en DHA, le DPA a été l’AGPILC n-3 le plus puissant pour améliorer la triglycéridémie et la cholestérolémie des animaux. Ces informations participeront certainement à une prise en compte plus importante du DPA tant dans les études nutritionnelles ainsi que dans l’installation des futures recommandations nutritionnelles. Le deuxième axe de recherche a porté sur la capacité d’une incorporation partielle de lipides laitiers dans le régime à augmenter le statut tissulaire en AGPI-LC n-3. L’incorporation de lipides laitiers a augmenté le statut en DHA cérébral et rétinien et le statut en DPA dans les autres tissus étudiés. De plus, l’induction de la conversion des AGPILC n-3 à partir de leur précurseur par les lipides laitiers a été complémentaire avec la supplémentation en DPA pour augmenter le statut tissulaire en AGPI-LC n-3. Ces résultats s’insèrent dans un contexte de nutrition infantile, période pendant laquelle l’incorporation des AGPI-LC n-3 est maximale dans les tissus nerveux. Ainsi, ces résultats apportent des données intéressantes tant pour les entreprises que pour les professionnels de santé pour recommander à la consommation des formules infantiles contenant des lipides laitiers. / The optimization of tissue status in n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) is one of the current goals in human nutrition. Indeed, many beneficial effects on human health have been demonstrated for these different n-3 LCPUFA. However, the bioconversion of these derivatives from their food precursor, α-linolenic acid, is limited in humans and it does not meet the needs of the organism. Among this family of fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have been widely studied in contrast to those of n-3 docosapentaenoic acid (DPA). The first objective of this work was to study the impact of dietary supplementation with DPA on fatty acid metabolism and lipid metabolism in healthy rats. For this, a method for purifying DPA with high purity and in large quantities by liquid chromatography was first established. This result helps future research of the in vivo effects of DPA, poorly commercially available. After its nutritional supplementation, DPA was incorporated into multiple tissues and it has affected the n-3 LCPUFA tissue compositions of specific organs such as the liver, heart, lung, spleen and the kidney. Thus, supplementation with DPA could be a source of EPA, DPA, and to a lesser extent DHA. Finally, compared to supplementation with EPA or DHA, DPA was the most potent n-3 LCPUFA to improve triglyceridemia and cholesterolemia in animals. This information will certainly contribute to a greater consideration of DPA both in nutritional studies and in the direction of future nutritional recommendations. The second area of ​​research focused on the ability of a partial incorporation of dairy lipids in the diet to increase the tissue status in n-3 LCPUFA. Incorporation of dairy lipids in the diet increased DHA status in brain and retina and DPA status in the other studied tissues. In addition, the induction of conversion of n-3 LCPUFA from their precursor by dairy lipid was complementary with the DPA supplementation to increase n-3 LCPUFA status in tissues. These results fit into a context of infant nutrition, during which the incorporation of n-3 LCPUFA is maximal in nervous tissues. Thus, these results provide interesting data for both companies and health professionals to recommend infant formulas containing dairy lipids for consumption.