Monitoring the epidemiology of bloodstream infections: aims, methods and importance

Bloodstream infections (BSI) are a major cause of mortality, morbidity and medical cost. Even though monitoring activities have been on-going for decades, it is difficult to depict a full picture of the burden of BSI. The main reasons for shortcomings include varying study aims, definitions and inclusion criteria for both microorganisms and patients. Incidence studies are commonly hampered by difficulties in delineating the population at risk. The objective of this review was to provide a framework for comprehensive BSI monitoring systems in the future. We highlight the importance of standardized definitions and acquisition of data combined with cautious statistical analyses. Hereby, valid data on BSI can be provided for clinicians and decision makers and ultimately contribute to improvement of the quality of care for BSI patients.</p

IBD—what role do Proteobacteria play?

The gastrointestinal microbiota has come to the fore in the search for the causes of IBD. This shift has largely been driven by the finding of genetic polymorphisms involved in gastrointestinal innate immunity (particularly polymorphisms in NOD2 and genes involved in autophagy) and alterations in the composition of the microbiota that might result in inflammation (so-called dysbiosis). Microbial diversity studies have continually demonstrated an expansion of the Proteobacteria phylum in patients with IBD. Individual Proteobacteria, in particular (adherent-invasive) Escherichia coli, Campylobacter concisus and enterohepatic Helicobacter, have all been associated with the pathogenesis of IBD. In this Review, we comprehensively describe the various associations of Proteobacteria and IBD. We also examine the importance of pattern recognition in the extracellular innate immune response of the host with particular reference to Proteobacteria, and postulate that Proteobacteria with adherent and invasive properties might exploit host defenses, drive proinflammatory change, alter the intestinal microbiota in favor of dysbiosis and ultimately lead to the development of IBD