Risk stratification and management of QuantiFERON-positive solid-organ living donors.

Purpose Of Review: Donor-derived disease with Mycobacterium tuberculosis (MTB) is likely to become more common as donor pools expand due to increasing transplant volume coupled with patterns of migration and global mobility. Our article reviews the current literature and provides a rational approach for clinicians managing the scenario of a living donor who has epidemiologic risk factors for tuberculosis exposure.

Recent Findings: Tuberculous bacilli, formerly thought to exist latently only in pulmonary granulomas, are now known reside dormant in nonpulmonary organs.

Clostridium difficile disease in solid organ transplant recipients: a recommended treatment paradigm.

Purpose Of Review: Organ transplant recipients have an increased incidence of Clostridium difficile disease and lower clinical response rates compared with the general population. Transplant specific treatment approaches are not defined. Therefore, a review of therapeutics in the transplant population is needed.

Carriage of antibiotic resistant bacteria flora and its role in the guidance of clinical decision making.

There is considerable literature on the threat of antibiotic resistance and its impact on morbidity. However, an under-studied consideration is how carriage of these antibiotic resistant bacteria persist in an individual. The duration that a person harbors a resistant organism is critical in guiding future antimicrobial therapy.

Natural history of Acinetobacter baumannii infection in mice.

In 2017, the WHO identified Acinetobacter baumannii as the top priority for the development of new antibiotics. Despite the need for new antibiotics, there remains a lack of well validated preclinical tools for A. baumannii.

Vaccines targeting Staphylococcus aureus skin and bloodstream infections require different composition.

Staphylococcus aureus infections represent a major public health threat, but previous attempts at developing a universal vaccine have been unsuccessful. We attempted to identify a vaccine that would be protective against both skin/soft tissue and bloodstream infections. We first tested a panel of staphylococcal antigens that are conserved across strains, combined with aluminum hydroxide as an adjuvant, for their ability to induce protective immunity in both skin and bacteremia infection models.

Adjunctive transferrin to reduce the emergence of antibiotic resistance in Gram-negative bacteria.

Background: New strategies are needed to slow the emergence of antibiotic resistance among bacterial pathogens. In particular, society is experiencing a crisis of antibiotic-resistant infections caused by Gram-negative bacterial pathogens and novel therapeutics are desperately needed to combat such diseases. Acquisition of iron from the host is a nearly universal requirement for microbial pathogens-including Gram-negative bacteria-to cause infection.

Carbapenemase-producing organisms in solid organ transplantation.

Purpose Of Review: Carbapenem-resistant enterobacteriaceae (CRE) are a critical healthcare threat. Infections caused by CRE disproportionately affect transplant patients. Retrospective case studies suggest that up to 10% of transplant recipients develop a CRE infection.

The diagnostic value of FNA biopsy in grading pancreatic neuroendocrine tumors.

Background: There has been much controversy regarding the accuracy of grading pancreatic neuroendocrine tumors (PNETs) on fine-needle aspiration (FNA) biopsy. The objectives of this study were to evaluate whether grading according to the fraction of Ki-67-positive tumor cells (the Ki-67 proliferation index) on material from endoscopic ultrasound-guided FNA biopsies correlated with grading on surgical resection specimens and to evaluate the minimum amount of FNA material needed.

Methods: A case series of 27 PNETs with FNA biopsies and corresponding surgical resection specimens at the authors' institution were evaluated.

Diabetes Exacerbates Infection via Hyperinflammation by Signaling through TLR4 and RAGE.

For more than a century, diabetic patients have been considered immunosuppressed due to defects in phagocytosis and microbial killing. We confirmed that diabetic mice were hypersusceptible to bacteremia caused by Gram-negative bacteria (GNB), dying at inocula nonlethal to nondiabetic mice. Contrary to the pervasive paradigm that diabetes impedes phagocytic function, the bacterial burden was no greater in diabetic mice despite excess mortality.

Novel Beta-Lactamase Inhibitors: Unlocking Their Potential in Therapy.

Carbapenem-resistant Enterobacteriaceae are amongst the most feared pathogens due to severely limited treatment options. In response to this threat, three novel β-lactamase inhibitors have been developed in an attempt to reinvigorate and sustain our current antimicrobial therapies. Avibactam, vaborbactam, and relebactam are inhibitor agents with high affinity to Ambler class A and C β-lactamases and favorable outcomes in current clinical trials.

Ly6G-mediated depletion of neutrophils is dependent on macrophages.

Antibody-mediated depletion of neutrophils is commonly used to study neutropenia. However, the mechanisms by which antibodies deplete neutrophils have not been well defined. We noticed that mice deficient in complement and macrophages had blunted neutrophil depletion in response to anti-Ly6G monoclonal antibody (MAb) treatment.

Cryopreservation of virulent Acinetobacter baumannii to reduce variability of in vivo studies.

Background: Microbiological assays require accurate and reproducible preparation of bacterial inocula. Inocula prepared on different days by different individuals can vary significantly from experiment to experiment. This variance is particularly problematic for Gram-negative bacterial infections, for which threshold effects can result in marked variations in host outcome with minor differences in inocula.

Transferrin-mediated iron sequestration as a novel therapy for bacterial and fungal infections.

Pathogenic microbes must acquire essential nutrients, including iron, from the host in order to proliferate and cause infections. Iron sequestration is an ancient host antimicrobial strategy. Thus, enhancing iron sequestration is a promising, novel anti-infective strategy.

The future of antibiotics and resistance: a tribute to a career of leadership by John Bartlett.

The ways we have developed, used, and protected antibiotics have led, predictably, to our current crisis of rising antibiotic resistance and declining new treatments. If we want to stave off a postantibiotic era, we need to fundamentally change our approach. We need to challenge long-standing assumptions and cherished beliefs.

Popular exclusionary diets for inflammatory bowel disease: the search for a dietary culprit.

The evolving understanding of the role of the microbiome and environmental factors in the pathogenesis of inflammatory bowel disease makes diet an interesting and potentially powerful tool in the treatment of disease. However, at this time, evidence is limited but anecdotal reports of success abound. There is a bewildering array of new diets being tried by patients in an attempt to control diseases.