Volume 4 Supplement 1

Antimicrobial Resistance and Infection Control: Abstracts from the 3rd International Conference on Prevention and Infection Control (ICPIC 2015)

Open Access

Noma disease: 10 years of research in the quest of a microbial etiology

  • P François1,
  • K Whiteson2,
  • D Baratti Mayer3,
  • J Schrenzel4,
  • D Pittet5 and
  • the GESNOMA study group
Antimicrobial Resistance and Infection Control20154(Suppl 1):P258

https://doi.org/10.1186/2047-2994-4-S1-P258

Published: 16 June 2015

Introduction

Noma is a devastating ancient illness that causes severe facial disfigurement in >140,000 children every year mainly in Africa, South America and India. The cause of noma remains unknown but infection, oral hygiene and immune status likely all contribute

Objectives

Efforts have been deployed over the 2 past decades to identify microbial agents (fungal, bacterial and viral) responsible for noma

Methods

Research in the field of microbial identification has benefited from dramatic technical improvements. Until the late 90’s culture based methods were predominantly used. More recently, culture-independent methods were used to identify bacteria in noma patients. We present three approaches used to study hundreds of gingival samples from noma patients and local control samples collected from villages near Zinder, Niger (Africa): large-scale cloning sequencing methods used at the beginning of 2000, high-density microarrays and high-throughput sequencing (HTS) devices

Results

Culture-based methods identified Fusobacterium necrophorum as the causative agent of noma, while culture-independent methods identify higher levels of Fusobacteriales in healthy controls. Cloning-sequencing strategies identify disequilibrium in microbial communities from noma patients particularly in Fusobacteria, Prevotella intermedia and Peptostreptococcus genus abundance. This was also detected in studies using semi-quantitative microarrays. More recently, the utilization of HTS provided a detailed analysis of microbial flora in noma patients and identified Clostridiales, Bacteroidales, and Spirochaetales as indicators of noma. Our epidemiological investigations excluded the possible role of viruses such as cytomegalovirus or morbillivirus as possible significant contributor of noma disease

Conclusion

Although we identify a unique distribution and composition of microbial communities in noma wound sites compared to unaffected samples from the same mouths and healthy controls, the etiology of noma disease remains elusive. Future studies should include longitudinal sampling in high risk areas and detailed exploration of microbiota before and during development of lesions

Disclosure of interest

None declared.

Authors’ Affiliations

(1)
Medical Specialties, Univ Hosp of Geneva
(2)
Mol Biol & Biochem, Unive of California
(3)
Plastic Surgery, Univ Hosp of Geneva
(4)
Dep. Medical Specialties, Univ Hosp of Geneva
(5)
Cont & Prev Infection, Univ Hosp of Geneva

Copyright

© François et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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