Autologous vaccines (short: autovaccines) have been used since the beginning of the 20th century to treat chronic staphylococcal infections, but their mechanisms of action are still obscure. This prospective pilot study involved four patients with furunculosis who were vaccinated with autologous formalin-killed Staphylococcus aureus cells. Vaccines were individually prepared from the infecting S. aureus strain and repeatedly injected subcutaneously in increasing doses over several months. We characterized the virulence gene repertoire and spa genotype of the infecting and colonising S. aureus strains. Serum antibody responses to secreted and surface-bound bacterial antigens were determined by two-dimensional immunoblotting and flow-cytometry based assays (Luminex®). All patients reported clinical improvement. Molecular characterization showed that all strains isolated from one patient over time belonged to the same S. aureus clone. Already before treatment, there was robust antibody binding to a broad range of staphylococcal antigens. Autovaccination moderately boosted the IgG response to extracellular antigens in two patients, while the antibody response of the other two patients was not affected. Similarly, vaccination moderately enhanced the antibody response against some staphylococcal surface proteins, e.g. ClfA, ClfB, SdrD and SdrE. In summary, autovaccination only slightly boosted the pre-existing serum antibody response, predominantly to bacterial surface antigens.Electronic supplementary materialThe online version of this article (doi:10.1007/s10096-010-1136-3) contains supplementary material, which is available to authorized users.
Presence of ADPKD in patients with normal kidney function is associated with impaired beta cell function after an oral glucose load, without a significant decrease in insulin sensitivity.
IntroductionThe aim of this study was to assess calcium-phosphate metabolism of autosomal dominant polycystic kidney disease (ADPKD) patients with a special consideration to the following serum parameters: calcium (Ca2+), inorganic phosphate (Pi), parathyroid hormone (PTH) and intracellular erythrocyte calcium ([Ca2+]i) concentrations.Material and methodsThe study included 49 adult ADPKD patients (19 males, 30 females) aged 36 ±11 years with normal renal function and no diagnosis of diabetes as well as 50 healthy controls (22 males, 28 females) matched for age and gender. Serum concentrations of sodium (Na+), potassium (K+) and magnesium (Mg2+) ions and Pi were determined with an indirect ion-selective method, while Ca2+ concentration was measured with a direct ion-selective method. The PTH was detected using a radioimmunometric method. [Ca2+]i concentration was determined with the Ca2+ sensitive fluorescent dye Fura-2 method.ResultsIn the ADPKD group, when compared to controls, the following concentrations were significantly higher: serum Ca2+ (1.18 ±0.06 mmol/l vs. 1.15 ±0.06 mmol/l, p = 0.0085), [Ca2+]i (146.9 ±110.0 nmol/l vs. 96.5 ±52.7 nmol/l, p = 0.0075), serum Na+ (139.4 ±2.7 mmol/l vs. 138.5 ±2.1 mmol/l, p = 0.060, borderline significance), and PTH (15.5 ±6.8 pg/ml vs. 13.6 ±5.3 pg/ml, p = 0.066, borderline significance), while serum Mg2+ was significantly lower (0.81 ±0.09 mmol/l vs. 0.85 ±0.05 mmol/l, p = 0.021). In the ADPKD group we observed significant negative correlations of PTH with Ca2+ serum concentrations (Rs = –0.32, p = 0.025) and with estimated glomerular filtration rate (Rs = –0.31, p = 0.033).ConclusionsThe erythrocyte Ca2+ concentration is elevated in ADPKD patients with normal renal function. It may result from a dysfunction of mutated polycystins which can affect various aspects of electrolyte metabolism.
The aim of this study was to analyse the resistance patterns, serotypes and genetic diversity of Streptococcus pneumoniae-resistant strains isolated in the West Pomerania region of Poland. They were clinical isolates obtained during a 5-year study (2001-2005) mainly from ambulatory patients with upper respiratory tract infections. The strains showed resistance to 8 out of 9 tested antibiotics (except vancomycin) and 53.8% of the strains were multidrug-resistant (MDR). The increase over time in the number of MDR strains and in resistance degrees was not statistically significant. Resistance to cotrimoxazole was the most frequent (86.7%). Penicillin nonsusceptibility was shown in 38% of the strains and resistance to macrolides in 36.7% of the strains, mainly of MLS(B) phenotype (94.1%). A significant resistance increase was only observed for beta-lactam antibiotic. The population of S. pneumoniae-resistant strains in our region presented 31 resistance patterns, 13 serotypes and a high genetic diversity-70 pulse field gel electrophoresis (PFGE) profiles have been described: 44 of them were unique and 26 clusters consisted of 2 to 30 strains similar by more than 87%. Cluster I, grouping 30 strains of similar resistant patterns (TSH: 70%, SH, TH, T, H, S) and mainly serotype 19F, isolated over the 5 years of the study, could represent a new national clone. The polysaccharide 23-valent vaccine covers 83.5%, while the conjugated 7-, 9- and 11-valent vaccines cover 79.1-79.7% of the resistant strains collected in our region. A statistically significant decrease of vaccine coverage in time has been noted.
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