Over the last 60 years, accumulating evidence has suggested that acute, chronic, and maternal Toxoplasma gondii infections predispose to schizophrenia. More recent evidence suggests that chronically infected patients with schizophrenia present with more severe disease. After acute infection, parasites form walled cysts in the brain, leading to lifelong chronic infection and drug resistance to commonly used antiparasitics. Chronic infection is the most studied and closely linked with development and severity of schizophrenia. There are currently four published randomized controlled trials evaluating antiparasitic drugs, specifically azithromycin, trimethoprim, artemisinin, and artemether, in patients with schizophrenia. No trials have demonstrated a change in psychopathology with adjunctive treatment. Published trials have either selected drugs without evidence against chronic infection or used them at doses too low to reduce brain cyst burden. Furthermore, trials have failed to achieve sufficient power or account for confounders such as previous antipsychotic treatment, sex, age, or rhesus status on antiparasitic effect. There are currently no ongoing trials of anti-Toxoplasma therapy in schizophrenia despite ample evidence to justify further testing.
BackgroundIntestinal epithelial integrity is influenced by short‐chain fatty acids (SCFAs) and is of critical importance for children with intestinal failure (IF) given the known devastating infectious and gastrointestinal complications. The composition of the microbiome in IF represents an important variable in the physiology and prognosis of this disease.AimWe sought to compare the intestinal microbiome and SCFA concentration of children who require parenteral nutrition (PN) with that of children with short‐bowel syndrome (SBS) who have discontinued PN and with age‐matched controls, using high‐throughput sequencing to investigate host‐microbe interactions.MethodsFifty‐three samples were submitted over 6–15 months. Six children with SBS + IF submitted 34 samples, and 6 children with SBS with discontinued PN submitted 15 samples; these were compared with samples from 5 control children. Fecal samples were analyzed by 16S ribosomal RNA partial gene sequencing using the MiSeq Illumina sequencer. SCFAs were measured in stool samples by mass spectrometry.ResultsButyrate quantity was near absent in children with IF compared with that in controls (median 0.37 nmol/mg vs 10.92 nmol/mg; P < .0001). Similarly, commensal anaerobes known to produce SCFA, including Ruminococcaceae and Lachnospiraceae, were reduced in those with SBS. SBS + IF enteric samples demonstrated a 168‐fold increase in the relative abundance of the Escherichia genus seemingly attributable to the species Escherichia coli.ConclusionThe reduced relative abundance of butyrate‐producing Clostridia as well as decreased intestinal butyrate concentration in children with IF support further investigation in therapeutic options that target butyrate‐producing bacterial communities or butyrate supplementation.
A ccurate and timely antimicrobial susceptibility testing (AST) of Staphylococcus aureus is crucial for patient management. In our laboratory, S. aureus AST is performed using the BD Phoenix automated microbiology system (BD Diagnostic Systems, Sparks, MD) and cefoxitin disk diffusion (DD). A discrepancy between trimethoprim-sulfamethoxazole (SXT) on Phoenix and SXT DD (BD BBL Sensi-Disc) was observed on a clinical methicillin-resistant S. aureus (MRSA) isolate. This discrepancy prompted us to evaluate a set of clinical isolates (6 nonrelated by spa typing MRSA isolates and 3 methicillin-susceptible S. aureus [MSSA] isolates) using Phoenix, SXT DD, Etest (bioMérieux, Marcy l'Etoile, France), and MIC test strips (MTS; Liofilchem, Italy) locally and broth microdilution (BMD) (Sensititre; Thermo Fisher Scientific) at the National Microbiology Laboratory. SXT DD and the 2 gradient diffusion tests were tested using Mueller-Hinton agar (Oxoid), and all tests were quality controlled, conducted, and interpreted according to the manufacturers' recommendations and CLSI standards (1). All 9 isolates tested resistant by Phoenix but susceptible by DD, the 2 gradient diffusion strips, and BMD. To examine whether the observed discrepancies were related to instrument or reagent issues, another set of S. aureus isolates (n ϭ 15) that was also SXT resistant by Phoenix but susceptible by DD was sent to Becton, Dickinson and Company for testing using 6 different lots from Phoenix panel PMIC 84 (BD catalog number 448420) and SXT DD. BD reported that 13/15 (86.7%) were resistant by Phoenix, but all 15 isolates were susceptible by SXT DD. As a result of these findings, we prospectively added SXT DD to routine S. aureus AST. Between 25 May 2018 and 30 November 2018, 642 S. aureus isolates were tested using both methods (Table 1). Using DD as the reference method, categorical agreement was 91.9% with 50 (7.9%) major errors (MEs) and 2 (0.3%) minor errors (mEs). When we examined the MRSA subgroup (n ϭ 70), the categorical agreement was 82.9% with 12 (17.6%) MEs and 0 mEs. There was a significantly greater number of any error type within the MRSA subgroup compared to the MSSA subgroup (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.2 to 5.7; P ϭ 0.008; Fisher's exact test), and this difference is represented solely by MEs. In our experience, Phoenix achieved less than the recommended 90% categorical agreement with the reference AST method when testing MRSA against SXT (2), which is of particular concern given the limited antibiotic options for MRSA infection. The performance of the BD Phoenix automated system for SXT AST of S. aureus has been described previously (3-6). Carroll et al. (5) looked at 218 S. aureus isolates using agar dilution as the reference and found 98.6% categorical agreement and a lower rate of MEs (1.5%). Fahr et al. (6) included 114 isolates of Staphylococcus species using BMD as Citation Al-Rawahi GN, Chorlton S, Dhaliwal S, Golding GR, Tilley P. 2020. Performance of the BD Phoenix automated microbiology syste...
BackgroundThe advent of high-throughput technologies to profile human tumors has generated unprecedented insight into our molecular understanding of cancer. However, analysis of such high dimensional data is challenging and requires significant expertise which is not routinely available to many cancer researchers.ResultsTo overcome this limitation, we developed a freely accessible and user friendly Program to Identify Molecular Signatures (PIMS). Importantly, such signatures allow important insight into cancer biology, as well as provide clinical tools to identify potential biomarkers that might provide means to accurately stratify patients into different risk or treatment groups. We evaluated the performance of PIMS by identifying and testing predictive and prognostic gene signatures for breast cancer, using multiple breast tumor microarray cohorts representing hundreds of patients. Importantly, PIMS identified signatures classified patients into high and low risk groups with at least similar performance to other commonly used gene signature selection techniques.ConclusionsOur program is contained entirely within a Microsoft Excel file and therefore requires no installation of any additional programs or training. Hence, PIMS provides an accessible tool for cancer researchers to identify predictive and prognostic gene signatures to advance their research.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-0500-7-546) contains supplementary material, which is available to authorized users.
The gut microbiota is linked to intestinal epithelial cell metabolism and influences health of the host. Gut microbial disorders influence host health, as exemplified by the associations with metabolic syndrome, diarrhea obesity-related disease and cancer. Intake of dietary fiber or plantbased foods can alter gut microbiota and then modulate these disorders. This review summary the relationship between the gut microbiota and healthy, which could assist the development of effective manipulations in enhancing mammality health and productivity.
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