Objective:Transplant a liver from an HIV-positive mother to her HIV-negative child to save the child's life.Design:A unique case of living donor liver transplantation from an HIV-positive mother to her HIV-negative child in South Africa. Two aspects of this case are ground-breaking. First, it involves living donation by someone who is HIV-positive and second it involves controlled transplant of an organ from an HIV-positive donor into an HIV-negative recipient, with the potential to prevent infection in the recipient.Methods:Standard surgical procedure for living donor liver transplantation at our centre was followed. HIV-prophylaxis was administered preoperatively. Extensive, ultrasensitive HIV testing, over and above standard diagnostic assays, was undertaken to investigate recipient serostatus and is ongoing.Results:Both mother and child are well, over 1 year posttransplantation. HIV seroconversion in our recipient was detected with serological testing at day 43 posttransplant. However, a decline in HIV antibody titres approaching undetectable levels is now being observed. No plasma, or cell-associated HIV-1 DNA has been detected in the recipient at any time-point since transplant.Conclusion:This case potentially opens up a new living liver donor pool which might have clinical relevance in countries where there is a high burden of HIV and a limited number of deceased donor organs or limited access to transplantation. However, our recipient's HIV status is equivocal at present and additional investigation regarding seroconversion events in this unique profile is ongoing.

Of 103 strains of Haemophilus ducreyi isolated in Johannesburg, 96 produced ,Blactamase and were resistant to penicillin and ampicillin. Most strains showed resistance to tetracycline, sulfisoxazole, and sulfamethoxazole. All isolates were susceptible to rifampin, erythromycin, and cefoxitin, moderately susceptible to trimethoprim-sulfamethoxazole (1:19) and minocycline, and somewhat less susceptible to doxycycline.

We investigated Bacillus cereus-positive tracheal aspirates from infants on ventilators in a neonatal intensive care unit. Multilocus sequence typing determined a genetic match between strains isolated from samples from a casepatient and from the air flow sensor in the ventilator. Changing the sterilization method for sensors to steam autoclaving stopped transmission.

We investigated Bacillus cereus–positive tracheal aspirates from infants on ventilators in a neonatal intensive care unit. Multilocus sequence typing determined a genetic match between strains isolated from samples from a case-patient and from the air flow sensor in the ventilator. Changing the sterilization method for sensors to steam autoclaving stopped transmission.

Children who undergo liver transplantation and subsequently develop BSI are at risk for adverse outcomes. Research from high‐income settings contrasts the dearth of information from transplant centers in low‐ and middle‐income countries, such as South Africa. Therefore, this study from Johannesburg aimed to describe the clinical and demographic profile of children undergoing liver transplantation, and determine the incidence and pattern of BSI and associated risk factors for BSI during the first year after liver transplant. Pediatric liver transplants performed from 2005 to 2014 were reviewed. Descriptive analyses summarized donor, recipient, and post‐transplant infection characteristics. Association between BSI and sex, cause of liver failure, age, nutritional status, PELD/MELD score, graft type, biliary complications, and acute rejection was determined by Fisher's exact test; and association with length of stay by Cox proportional hazards regression analysis. Survival estimates were determined by the Kaplan‐Meier method. Sixty‐five children received one transplant and four had repeat transplants, totaling 69 procedures. Twenty‐nine BSI occurred in 19/69 (28%) procedures, mostly due to gram‐negative organisms, namely Klebsiella species. Risk for BSI was independently associated with biliary atresia (44% BSI in BA compared to 17% in non‐BA transplants; P = .014) and post‐operative biliary complications (55% BSI in transplants with biliary complications compared to 15% in those without; P = .0013). One‐year recipient and graft survival was 78% (CI 67%‐86%) and 77% (CI 65%‐85%), respectively. In Johannesburg, incident BSI, mostly from gram‐negative bacteria, were associated with biliary atresia and post‐operative biliary complications in children undergoing liver transplantation.