Archive for October 1, 2015

Distinct but spatially overlapping intestinal niches for vancomycin-resistant Enterococcus faecium and carbapenem-resistant Klebsiella pneumoniae. 

PLoS Pathog 2015 Sep 3; 11:e1005132.

Silvia Caballero, Rebecca Carter, Xu Ke, Bože Sušac, Ingrid M. Leiner, Grace J. Kim, Liza Miller, Lilan Ling, Katia Manova, Eric G. Pamer

Silvia Caballero, Rebecca Carter, Bože Sušac, Ingrid M. Leiner, Eric G. Pamer

Immunology Program and Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America

Silvia Caballero, Eric G. Pamer

Immunology and Microbial Pathogenesis Program, Weill Cornell Graduate School of Medical Sciences, New York, New York, United States of America

Xu Ke, Katia Manova

Molecular Cytology Core Facility, Sloan-Kettering Institute, New York, New York, United States of America

Grace J. Kim, Liza Miller, Lilan Ling, Eric G. Pamer

Lucille Castori Center for Microbes, Inflammation and Cancer, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America

Corresponding Author: pamere@mskcc.org

Antibiotic resistance among enterococci and γ-proteobacteria is an increasing problem in healthcare settings. Dense colonization of the gut by antibiotic-resistant bacteria facilitates their spread between patients and also leads to bloodstream and other systemic infections.

Antibiotic-mediated destruction of the intestinal microbiota and consequent loss of colonization resistance are critical factors leading to persistence and spread of antibiotic-resistant bacteria.

The mechanisms underlying microbiota-mediated colonization resistance remain incompletely defined and are likely distinct for different antibiotic-resistant bacterial species.

It is unclear whether enterococci or γ-proteobacteria, upon expanding to high density in the gut, confer colonization resistance against competing bacterial species.

Herein, we demonstrate that dense intestinal colonization with vancomycin-resistant Enterococcus faecium (VRE) does not reduce in vivo growth of carbapenem-resistant Klebsiella pneumoniae.

Reciprocally, K. pneumoniae does not impair intestinal colonization by VRE. In contrast, transplantation of a diverse fecal microbiota eliminates both VRE and K. pneumoniae from the gut.

Fluorescence in situ hybridization demonstrates that VRE and K. pneumoniae localize to the same regions in the colon but differ with respect to stimulation and invasion of the colonic mucus layer.

While VRE and K. pneumoniae occupy the same three-dimensional space within the gut lumen, their independent growth and persistence in the gut suggests that they reside in distinct niches that satisfy their specific in vivo metabolic needs.

FULL TEXT

http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005132

PDF

http://www.plospathogens.org/article/fetchObject.action?uri=info:doi/10.1371/journal.ppat.1005132&representation=PDF

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October 1, 2015 at 12:39 pm

Recommended composition of influenza virus vaccines for use in the 2016 southern hemisphere influenza season – September 2015

 

The World Health Organization (WHO) convenes technical consultations1 in February and September each year to recommend viruses for inclusion in influenza vaccines2 for the influenza season in northern and southern hemispheres, respectively. This recommendation relates to the influenza vaccines for the forthcoming 2016 southern hemisphere influenza season. A recommendation will be made in February 2016 relating to vaccines that will be used for the 2016-2017 northern hemisphere influenza season. For countries in equatorial regions, epidemiological considerations influence which recommendation (February or September) individual national and regional authorities consider appropriate…..

 

PDF

http://www.who.int/influenza/vaccines/virus/recommendations/201509_recommendation.pdf?ua=1

 

October 1, 2015 at 8:17 am

GUIDELINE ON WHEN TO START ANTIRETROVIRAL THERAPY AND ON PRE-EXPOSURE PROPHYLAXIS FOR HIV – SEPT 2015 78 pag.

World Health Organization (WHO)

This early-release guideline will form part of the revised updated WHO consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection due to be published in 2016

CONTENTS
Abbreviations and acronyms 6
Definition of key terms 7
Acknowledgements 9
Executive summary 12
Summary of new recommendations 13

1. Introduction 16
1.1 Health sector response to HIV 16
1.2 Objectives 16
1.3 Target audience 17
1.4 Guiding principles 17
1.5 Methods for developing the guidelines 17
1.5.1 Competing interests 17
1.5.2 Guideline contributors 18
1.5.3 Methods for evidence synthesis 19
1.5.4 Peer review 21

2. Recommendations 24
2.1 When to start antiretroviral therapy 24
2.1.1 When to start ART among adults (>19 years old) 24
2.1.2 When to start ART among pregnant and breastfeeding women 30
2.1.3 When to start ART among adolescents (10–19 years of age) 35
2.1.4 When to start ART among children (younger than 10 years of age) 38
2.2 Oral pre-exposure prophylaxis for preventing the acquisition of HIV infection 42
2.3 Programmatic note on the recommendations 50

3. Publication, dissemination and evaluation 54

References 55

Annex 1. Declaration of interests, Clinical Guideline Development Group, June 2015 68

Annex 2. Evidence to decision-making tables and supporting evidence (available in web annex)

PDF
http://apps.who.int/iris/bitstream/10665/186275/1/9789241509565_eng.pdf

October 1, 2015 at 8:02 am


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