Role of type 1 and type 3 fimbriae in Klebsiella pneumoniae biofilm formation

<p>Abstract</p> <p>Background</p> <p><it>Klebsiella pneumoniae </it>is an important gram-negative opportunistic pathogen causing primarily urinary tract infections, respiratory infections, and bacteraemia. The ability of bacteria to form biofilms on medical devices, e.g. catheters, has a major role in development of many nosocomial infections. Most clinical <it>K. pneumoniae </it>isolates express two types of fimbrial adhesins, type 1 fimbriae and type 3 fimbriae. In this study, we characterized the role of type 1 and type 3 fimbriae in <it>K. pneumoniae </it>biofilm formation.</p> <p>Results</p> <p>Isogenic fimbriae mutants of the clinical <it>K. pneumoniae </it>isolate C3091 were constructed, and their ability to form biofilm was investigated in a flow cell system by confocal scanning laser microscopy. The wild type strain was found to form characteristic biofilm and development of <it>K. pneumoniae </it>biofilm occurred primarily by clonal growth, not by recruitment of planktonic cells. Type 1 fimbriae did not influence biofilm formation and the expression of type 1 fimbriae was found to be down-regulated in biofilm forming cells. In contrast, expression of type 3 fimbriae was found to strongly promote biofilm formation.</p> <p>Conclusion</p> <p>By use of well defined isogenic mutants we found that type 3 fimbriae, but not type 1 fimbriae, strongly promote biofilm formation in <it>K. pneumoniae </it>C3091. As the vast majority of clinical <it>K. pneumoniae </it>isolates express type 3 fimbriae, this fimbrial adhesin may play a significant role in development of catheter associated <it>K. pneumoniae </it>infections.</p

MS bladder check tool:Development and validation of a patient awareness tool to facilitate timely management of lower urinary tract dysfunction due to multiple sclerosis

Background: Lower urinary tract dysfunction impacts quality of life of people with MS; often, symptoms are ‘lived with’ or deprioritised by healthcare providers (HCPs). Consequently, patients must be given the skills they need to become confident in managing their illness and enhance their involvement in the process. Objective: To develop and validate a self-assessment tool to help people with MS become more aware of their bladder symptoms and prompt contact with their HCP to facilitate timely management and specialist referral, if required. Methods: The ‘MS bladder check tool’ was developed by a multidisciplinary panel of specialist advisors. Consensus meetings and pilot testing were conducted to design and evolve the tool into a series of nine questions, using population-appropriate language, and covering all aspects of bladder dysfunction in MS. The tool was then validated by an international, multidisciplinary team of experts. Results: Validity was rated ‘excellent’ for all questions indicating that the MS bladder check tool is an appropriate method of highlighting bladder problems in people with MS. Conclusion: The MS bladder check tool is simple, easy-to-use, and empowers patients to take charge of their urinary tract health, aiming to improve the management of MS and, ultimately, patient quality of life.</p

MS bladder check tool:Development and validation of a patient awareness tool to facilitate timely management of lower urinary tract dysfunction due to multiple sclerosis

Background: Lower urinary tract dysfunction impacts quality of life of people with MS; often, symptoms are ‘lived with’ or deprioritised by healthcare providers (HCPs). Consequently, patients must be given the skills they need to become confident in managing their illness and enhance their involvement in the process. Objective: To develop and validate a self-assessment tool to help people with MS become more aware of their bladder symptoms and prompt contact with their HCP to facilitate timely management and specialist referral, if required. Methods: The ‘MS bladder check tool’ was developed by a multidisciplinary panel of specialist advisors. Consensus meetings and pilot testing were conducted to design and evolve the tool into a series of nine questions, using population-appropriate language, and covering all aspects of bladder dysfunction in MS. The tool was then validated by an international, multidisciplinary team of experts. Results: Validity was rated ‘excellent’ for all questions indicating that the MS bladder check tool is an appropriate method of highlighting bladder problems in people with MS. Conclusion: The MS bladder check tool is simple, easy-to-use, and empowers patients to take charge of their urinary tract health, aiming to improve the management of MS and, ultimately, patient quality of life.</p

Quantitative miRNA expression analysis: comparing microarrays with next-generation sequencing

Recently, next-generation sequencing has been introduced as a promising, new platform for assessing the copy number of transcripts, while the existing microarray technology is considered less reliable for absolute, quantitative expression measurements. Nonetheless, so far, results from the two technologies have only been compared based on biological data, leading to the conclusion that, although they are somewhat correlated, expression values differ significantly. Here, we use synthetic RNA samples, resembling human microRNA samples, to find that microarray expression measures actually correlate better with sample RNA content than expression measures obtained from sequencing data. In addition, microarrays appear highly sensitive and perform equivalently to next-generation sequencing in terms of reproducibility and relative ratio quantification

The impact of bladder problems on well-being in multiple sclerosis – A cross-sectional study:Awareness of Bladder Problems in Multiple Sclerosis

Background: Persons with multiple sclerosis (pwMS) frequently suffer from bladder problems that are not identified and managed optimally, reducing quality of life and increasing risk of health consequences. Objective: This study aimed to investigate associations between bladder problems and well-being of pwMS. Methods: The study included 1872 pwMS from France, Germany, Italy, and the UK self-reporting on demographics, MS status, bladder problems and management, and well-being. Logistic regression analyses were performed to investigate associations with self-reported well-being. Results: Population mean age was 51 years and 79 % were women. Among pwMS, 55 % reported bladder problems indicating overactive bladder (OAB), and 40 % reported self-experienced urinary retention. Self-management of bladder problems was reported by 32 %, 33 % were yet to have problem resolution, and 45 % reported a wish to receive bladder management help. Additionally, 35 % of pwMS reported that bladder problem onset preceded awareness of a link to MS. OAB, problem self-management, and urinary complications were significantly associated with lower well-being. Conclusion: Bladder problems affect pwMS across disease subtypes and many attempt self-management. Consequently, pwMS with bladder problems are more likely to experience lower well-being, suggesting an unmet need. Raising awareness of the link between bladder problems and well-being could benefit pwMS living with bladder problems.</p

The impact of bladder problems on well-being in multiple sclerosis – A cross-sectional study:Awareness of Bladder Problems in Multiple Sclerosis

Background: Persons with multiple sclerosis (pwMS) frequently suffer from bladder problems that are not identified and managed optimally, reducing quality of life and increasing risk of health consequences. Objective: This study aimed to investigate associations between bladder problems and well-being of pwMS. Methods: The study included 1872 pwMS from France, Germany, Italy, and the UK self-reporting on demographics, MS status, bladder problems and management, and well-being. Logistic regression analyses were performed to investigate associations with self-reported well-being. Results: Population mean age was 51 years and 79 % were women. Among pwMS, 55 % reported bladder problems indicating overactive bladder (OAB), and 40 % reported self-experienced urinary retention. Self-management of bladder problems was reported by 32 %, 33 % were yet to have problem resolution, and 45 % reported a wish to receive bladder management help. Additionally, 35 % of pwMS reported that bladder problem onset preceded awareness of a link to MS. OAB, problem self-management, and urinary complications were significantly associated with lower well-being. Conclusion: Bladder problems affect pwMS across disease subtypes and many attempt self-management. Consequently, pwMS with bladder problems are more likely to experience lower well-being, suggesting an unmet need. Raising awareness of the link between bladder problems and well-being could benefit pwMS living with bladder problems.</p

Intermittent catheterization: A patient-centric approach is key to optimal management of neurogenic lower urinary tract dysfunction

The value of disposable, single-use catheters has come under scrutiny in recent years with a growing attention on environmental sustainability. Intermittent catheterization (IC) is a widely available and minimally invasive technique for management of lower urinary tract dysfunction. Effective IC for individuals with neurogenic lower urinary tract dysfunction can promote their independence and improve quality of life. Are there alternative options within IC that could minimize environmental impact without compromising the safety and effectiveness of single-use catheters? How does the future of IC look – environmentally friendly, biodegradable, disposable catheters may be complementary to certified reusable catheters? In the midst of this debate, it is important to emphasize that individuals have the right to choose the best evidence-based treatment available. Here we consider the current landscape for IC with a focus on chronic use in individuals with neurogenic lower urinary tract dysfunction