There have been many advances in modern medicine, many due to the better understanding of how humans and microorganisms interact.  Something that is particularly interesting is how many infectious agents could be to blame for chronic illness.  Often times a chronic illness could be caused by a harmful immune response to parasites or bacteria. An overview written by Bennett Lorber in this months Microbe Magazine, reminds us that there is a link between parasites and central nervous system disorders, as well as, other infections tied to things from heart and kidney disease to obesity.

“During the past few decades, a fundamental change has taken place in our understanding of human-microorganism interactions. We are learning that transmissible agents might cause chronic illnesses that were not thought to have anything to do with infectious processes. In some instances, becoming infected is a sine qua non for developing a chronic illness. In others, illness can occur without infection, but infection increases the risk of that illness. In still other cases, an immune response that continues after a short-lived infection produces chronic health problems.” Read More…

Laura Sahnow and Dr. Icenhour finishing up evaluations. Thanks to Linh Nguyen for taking the picture.

The Phthisis Team attended the Charlottesville Catholic School Science Night last Friday.  We were asked to participate and evaluate 37, 8th grade student projects.  Everyone did an amazing job, and we were glad to see so many students interested in science.  The projects could be on anything the students wanted to identify or understand. They were supposed to use techniques they had learned to eliminate variables, establish controls, and test their hypothesis. There were a wide variety of topics from polarization of everyday objects to your sense of smell when it comes to jelly beans.  Different activities were present for all students such as making slime and a discussion on microscopes.  Job well done to the 8^th graders on their presentations and thanks to CCS for a fun night of science!

Well, I bet you never thought that using a color chart and your poop could reach a quick diagnosis.  Again we are surprised by amazing advances in science.  In the Mad Science section of io9.com “a designer color coded bacteria made from E. coli” was featured. The possibilities for the use of E. chromi could span from testing groundwater to having a red stool sample showing an infection of Rotavirus.

“The idea is that, someday soon, you’ll be able to drink a probiotic shake filled with E. chromi. The modified E. coli contain genes capable of producing color. When the bacteria react with certain enzymes, proteins, and chemicals in your gastrointestinal tract, they will produce certain colors, making diagnosis as simple as reading a color chart.” Read More…

Recently in Microbe magazine, Carol Potera wrote an article about squalamine which is a compound, found in sharks, that has been found to have anticancer activity, but Michael Zasloff of Georgetown University Medical Center conducted studies that have found squalamine may also have antiviral properties.

“Squalamine prevents both DNA and RNA viruses from entering host cells in vitro, and shows promising activity protecting several species of mammals against viral infections, according to Zasloff and his collaborators. For instance, the compound protects human endothelial cells against infection by dengue virus, and it blocks the hepatitis B virus in human primary hepatocytes.” Read More…

A new and possibly life changing discovery was made through a study of gut bacteria and the possible role it has in predicting a heart attack.  Medical Xpress published an article and summarized the study. This new research is suggesting that different types and levels of gut bacteria could be used to treat or diagnose heart conditions.  This study was published online in the FASEB journal, “Intestinal microbiota determine severity of myocardial infarction in rats.” The research was a collaborative effort by many groups and disciplines at The Medical College of Wisconsin.

“New research published online in the FASEB Journal suggests that the types and levels of bacteria in the intestines may be used to predict a person’s likelihood of having a heart attack, and that manipulating these organisms may help reduce heart attack risk. This discovery may lead to new diagnostic tests and therapies that physicians use to prevent and treat heart attacks. In addition, this research suggests that probiotics may be able to protect the heart in patients undergoing heart surgery and angioplasty.“ Read more…

In the January issue of the Microbe, J. Michael Miller and Patricia M. Griffin wrote an article on the need for collaboration of many scientific disciplines to give us all a better understanding of infectious diseases.  “One Health throught the Eyes of Clinical and Public Health Microbiology,” is about the benefits of bringing together different people with varying specialties, scientific backgrounds, and skills to find ways to combat infectious disease, both human and veterinary. The concept, One Health, was summarized below by the authors, it offers a variety of different collaborations and investigations into understanding and preventing infectious diseases.

Summary
● The One Health concept integrates human, animal, and environmental health to provide valuable insights when dealing with infectious agents.
● Investigating emerging pathogens benefits when the skills and knowledge of those specializing in human and animal infectious diseases are brought together, thus increasing the likelihood of identifying ways to prevent such illnesses.
● The One Health concept is illustrated well by approaches to dealing with foodborne diseases because many agents have zoonotic sources.
● Recognizing that fluoroquinolone use in poultry led to fluoroquinolone-resistant Campylobacter infections in humans, officials at the FDA in 2005 withdrew approval for the use of these antimicrobial agents in the drinking water of poultry.
● Several case studies trace how investigations of bacterial isolates from patient specimens, when sent from clinical laboratories to public health laboratories for serotyping and subtyping, can provide critical insights for those analyzing public health problems. Read More…

According to a study by J.H. Lee and colleagues, “Apple flavonoid phloretin inhibits Escherichia coli O157:H7 biofilm formation and ameliorates colon inflammation in rats”, there is a compound that inhibits E. coli O157:H7 but does not effect the beneficial E. coli found in the gut. The American Society for Microbiology(ASM) has a synopsis of the study that was released in December 2011. The full study was published in Infection and Immunity.

“E. coli O157:H7 causes hemorrhages in the intestine. To date, no effective therapy for O157:H7 biofilms has been found. Biofilms generally are notoriously resistant to antimicrobial therapy. So in the study, Lee screened a dozen flavonoids, including phloretin, for their ability to inhibit these biofilms. “We found that phloretin markedly reduced E. coliO157:H7 biofilm formation on abiotic surface and human colon epithelial cells, while phloretin did not harm commensal E. coli K-12 biofilms,” says Lee. Commensal E. coli can actually fortify the human immune system, he says.” Read more…

In the January issue of the EID (Emerging Infectious Diseases) Journal from the CDC (Centers for Disease Control) there was a study presented about MDR TB (Multi-drug resistant M. tuberculosis),” Multistate Outbreak of MDR TB Identified by Genotype Cluster Investigation.” Although most cases of MDR-TB are from foreign born persons, it still presents a problem worldwide because it does occur in the US although far less often than in other countries with a high burden of TB. In this study they want to bring attention to the fact that domestic transmission is a very real possibility. New diagnostics are necessary to shorten the time it takes to reach diagnosis of a MDR-TB case.

“In 2008, diagnosis and investigation of 2 multidrug-resistant tuberculosis cases with matching genotypes led to identification of an outbreak among foreign-born persons who performed short-term seafood production work in Alaska during 2006. Tuberculosis control programs should consider the possibility of domestic transmission even among foreign-born patients.” Read More…

In Mescape Education Clinical Briefs this week an article by James Brice, “Short-Term TB Combination as Successful as Standard Regimen,” gives a synopsis of a recently published study by Sterline and colleagues about reducing the frequency and length of
treatment for a latent Tuberculosis infection. Treatment adherence is often the greatest problem with Tb infection. So, if the medications can be taken for a shorter period of time, more people are likely to complete treatment and stop a re-infection with possibly a more drug resistant form of Tuberculosis.

“In the current study by Sterline and colleagues, treatment of latent TB with 3 months of directly observed rifapentine/isoniazid yielded similar or better rates of active TB vs treatment with self-administered isoniazid for 9 months. More participants completed rifapentine/isoniazid therapy, despite a higher risk for adverse events with the combination treatment.” Read More…

Hospital acquired Clostridium difficile infections are a continuing problem in our health care systems today.  The longer the hospital stay, the more likely you are to become infected by C. diff.  Quick diagnosis is key to correctly treating and making a patients stay at the hospital no longer than necessary.  While in previous studies, it was thought that a hospital acquired case of C. diff would cause a patient to stay up to 3 extra weeks in the hospital. Recent studies have given a shorter time frame with a median stay of 6 days.

Alan J. Forster, MD, and colleagues from the Ottawa Hospital Research Institute and University of Ottawa, Ontario, Canada, conducted a study that was published online on December 5, 2011 in the Canadian Medical Association Journal. Neil Osterweil of Medscape wrote an article, “Hospital-Acquired C difficile Infection Prolongs Length of Stay”, summarizing the study and showing the new findings related to C. diff infections and hospital stays.

“Clostridium difficile infections are associated with poor outcomes for patients, with 1 in 10 patients dying from this infection. It is also associated with increased healthcare costs because of the increase in the length of time patients spend in the hospital. Previous studies have reported that hospital-acquired infection with C difficile increases a patient’s length of stay by 1 to 3 weeks. However, these estimates are potentially biased. Overall, the effect of hospital-acquired infection with C difficile on length of stay in the hospital is not yet fully understood.” Read more…