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Late-onset sepsis (LOS) affects a large proportion of pre-term neonates in neonatal intensive care units (NICUs) worldwide, with high morbidity and related mortality, and frequent occurrence of severe late neurodevelopmental impairment. Due to the frequency, severity and difficulties in early diagnosis and prompt therapy, prevention is crucial for decreasing the burden of infection-related complications in NICUs. It is well known that feeding with fresh maternal milk, hygiene measures and the cautious use of H2-blockers are related with a decreased risk of developing sepsis. However, evidence from randomised clinical trials exists only for fluconazole in the prevention of fungal infections in the NICU. Lactoferrin is the main whey protein in mammalian milk, and is involved in innate immune host defences. Notably, human lactoferrin can be found at increased concentrations in colostrum and in milk from mothers of premature neonates. Human (hLF) and bovine lactoferrin (bLF) share a high (77%) amino-acid homology, and the same N-terminal peptide responsible for antimicrobial activity, called lactoferricin. In vitro, bLF shows potent direct antimicrobial activity against all types of pathogens, which occurs via anti-cell wall actions and leads to disintegration of the micro-organism's membranes. bLF is also synergistic with many antimicrobials and antifungals, and promotes growth and differentiation of the immature gut. Based on this background data, a randomised clinical trial was recently conducted in very low birth weight pre-term neonates given bLF alone or with the probiotic Lactobacillus GG. The aim of the trial was to assess the ability of bLF to prevent late-onset sepsis of any origin in the studied infants during their stay in the NICU. This article discusses the preliminary data from this study, along with the proposed mechanisms of action of bLF in pre-term infants.

Coagulase-positive Staphylococcus aureus colonizes eczematous lesions in 78-100% of children and adults with atopic dermatitis (AD), whereas it is found on skin of healthy subjects in only 2-25% of cases. On unaffected skin of subjects with AD the bacterium has been isolated in 51-100% of cases.This paper examines rate and density of S. aureus colonization, using the swab technique and the contact plate method, respectively, on affected and unaffected skin in 72 infants with AD (age 3-24 months) and in a control group, to determine if there are significant differences with respect to what is reported for children and adults with AD.The main differences is that on unaffected skin of our infants with AD, bacterium colonization rate is significantly lower than on affected skin.

A cross section study was performed on 1060 healthy children living in the Torino district to examine the modalities followed for weaning during infancy. Mothers were asked to fill in a questionnaire which contained questions concerning the family, allergic and metabolic diseases in relatives, type of food given to infants before, during and after weaning, and source of dietary counselling. A score was given for each answer. Data indicate generally correct trends though major fields of error concerns prevention of food allergy and coeliac disease. Scores were correlated with family type and area of origin of the family.

This study presents the outcome of a multidisciplinary approach to the infants with atopic dermatitis. Forty six patients, 40 males and 6 females, afflicted with atopic dermatitis, aged 3 months-2 years, were examined. A careful history was taken for each case to identify possible allergic disease and particular attention was placed on the relation between food assumption and appearance of lesions. The association of diet, dermatological therapy, elimination of environmental stimulus where possible, treatment of lesions and pruritus and good psychological support enable the Authors to obtain 57% of complete remission of atopic dermatitis. In 43% improvement was observed.

Tuberous sclerosis was suspected in a 2 months old infant with hemilateral convulsions and typical skin lesions. C.A.T. and fundus exams confirmed the diagnosis. The case is interesting because of the very young age at which diagnosis was possible.

All cases personally observed over a period of 18 months have been considered as possible cases A.A.R., beginning from january 1980. The results show that diseases simulating A.A.R. do exist, but they are probably of viral origin and have different clinical and laboratory characteristics.