IEEEMost malware are introduced into a computer system by applications that communicate with the outside world. These applications (called portals) are key components for system security. This paper presents an efficient anti-malware framework un

Prevaes, S.M.P.J.

de Winter-de Groot, K.M.

Tramper-Stranders, G.A.

Tiddens, H.A.W.M.

van Westreenen, M.

Janssens, H.M.

Wyllie, A.

van der Ent, C.K.

Sanders, E.A.M.

Bogaert, D.

Elsevier - Publisher Connector 

Oral Presentations Workshop 1. Infection in the clinic S1
WS1.1 Evolutionary pathways in two dominant clinical Pseudomonas
aeruginosa clones
H.K. Johansen1, T. Markussen2, S. Damkiær2, R.L. Marvig2, T. Pressler3,
N. Høiby1, L. Jelsbak2, S. Molin2. 1Rigshospitalet, Dept. Clin. Microbiology,
Copenhagen, Denmark; 2Technical University of Denmark, Dept. Systems Biology,
Lyngby, Denmark; 3Rigshospitalet, Copenhagen CF Center, Copenhagen, Denmark
Objectives: P. aeruginosa constitutes a particular problem in CF patients due to its
ability to persist in the airways. Two dominating clones with different genotypes,
DK1 and DK2, have been found to infect many CF patients in the Copenhagen CF
clinic. We investigated the adaptation and evolution in patient of these transmissible
P. aeruginosa clones.
Methods: Since 1973 P. aeruginosa isolates from sputum of CF patients have been
stored. These isolates represent bacterial evolution and adaptation covering up to
200,000 bacterial generations of growth in CF airways. We have combined full-
genome sequencing of longitudinal isolates of P. aeruginosa from a number of
chronically infected patients with global gene expression analysis and other types
of phenotypic characterization.
Results: Genome sequencing showed that mutations in regulatory genes were
frequent. Generation of AlgT regulated population diversity and colonization of
different niches in the CF airways was found to constitute a speciﬁc route of
adaptation for DK1. In contrast, generation of AlgT variants with conditional
phenotypes and colonization of different niches in the CF airways was found to
be the dominant platform for DK2 adaptation.
Conclusion: The two transmissible clones have followed different evolutionary
trajectories, suggesting that there could be several routes towards persistence of
colonization of the CF airways. In the DK1 clone several genetic alterations in
regulatory genes have resulted in diverse populations within the same patient. In
the DK2 clone a small number of early mutations in global regulatory genes ﬁxed
in the population seem to be important for the colonization success.
WS1.2 Three clinically distinct chronic pediatric airway infections
share a common core microbiota
C.J. van der Gast1, L. Cuthbertson1, C.E. Pope2, R.L. Marsh3, G.B. Rogers4,
H.C. Smith-Vaughan3, G.J. Redding2, K.D. Bruce4, A.B. Chang3, L. Hoffman2,5.
1Centre for Ecology and Hydrology, Wallingford, United Kingdom; 2University
of Washington, Pediatrics, Seattle, United States; 3Menzies School of Health
Research, Child Health Division, Darwin, Australia; 4King’s College London,
Institute of Pharmaceutical Science, London, United Kingdom; 5University of
Washington, Microbiology, Seattle, United States
Background: Sequence-based methods have detected many microbes in CF secre-
tions that are not routinely cultured. Those microbes can be further classiﬁed as
those that are common and abundant in CF (core species) and those that are rare
and scarce (satellite species). This categorization provides a vital foundation for
investigating disease pathogenesis and to improve therapy. However, whether the
core microbiota of children with CF are unique or are shared with those of other
lung infections is not well known.
Objective and Methods: Using 16S bacterial rRNA pyrosequencing and ecological
statistical tools, we compared the core respiratory microbiota from three cohorts
of children with distinct airway diseases: Protracted bacterial bronchitis, non-CF
bronchiectasis, and CF. The subject groups also differed in age, geography, antibiotic
and steroid use, culture results, and lung function.
Conclusion: Despite the above cohort differences, we found the average core respi-
ratory microbiota of all three groups of children to be strikingly similar in diversity
and species constituency, arguing against airway disease-speciﬁc microbiota during
early infection. The shared core microbiota included both traditional pathogens and
species not identiﬁed by standard laboratory culture methods. These results suggest
that these different airway infections share common origins, and that disease-speciﬁc
microbes are not selected at an early stage. Each infection likely begins as a result
of impaired clearance of the same airway microbiota, and early infection treatments
successful for one of these diseases may be beneﬁcial in the others, and perhaps
for many other chronic lung infections.
WS1.3 Respiratory microbiota dynamics in newborns with cystic
ﬁbrosis and healthy controls: A longitudinal study
S.M.P.J. Prevaes1, K.M. de Winter-de Groot1, G.A. Tramper-Stranders1,
H.A.W.M. Tiddens2, M. van Westreenen2, H.M. Janssens2, A. Wyllie1, C.K. van
der Ent1, E.A.M. Sanders1, D. Bogaert1. 1Wilhelmina’s Childrens Hospital,
Utrecht, Netherlands; 2Erasmus MC − Sophia Children’s Hospital, Rotterdam,
Netherlands
Background: In Cystic Fibrosis (CF) patients, irreversible lung damage seems
to begin in the ﬁrst months of life, even if asymptomatic. Detailed colonization
dynamics of the respiratory tract for this patient group have never been investigated
this early in life.
Objective: To investigate the developing respiratory microbiota in CF infants and
healthy age-matched controls in relation to respiratory health.
Methods: Case-control study cohort. Questionnaires and nasopharyngeal (NP)
samples are collected at monthly to three-monthly intervals from CF patients and
controls. In this preliminary analysis we studied the microbiota composition of 165
NP samples of 7 CF and 21 controls that were followed for at least 6 months, by
16SrRNA-based sequencing.
Results: Preliminary results show comparable bacterial density of respiratory
microbiota in CF patients and controls, but higher diversity in controls at all
time points. This coincided with a more stable colonization pattern over time
in controls compared to CF infants. Predominant bacteria in both groups were
Corynebacteria, Dolosigranulum, Staphylococcus, Moraxella and Streptococcus. In
CF infants Corynebacterium, Dolosigranulum and Staphylococcus predominated in
the ﬁrst 3 months of life followed by Streptococcus and Moraxella. In controls
Moraxella, Corynebacterium and Haemophilus predominated throughout the ﬁrst
6 months of life.
Conclusion: We observed differences in bacterial colonization dynamics between
CF and control infants especially in the ﬁrst months of life. The inﬂuence of
CF, antibiotic usage, and environmental exposure on microbiota composition and
subsequent susceptibility to infections will be explored.
WS1.4 Signiﬁcant bacterial infection missed using cough swabs
compared to bronchoalveolar lavage in 1-year old newborn
screened CF infants
L.P. Thia1, S. Rand1,2, L. Hill2, S.A. Prasad2, A. Bush3, I.M. Balfour-Lynn3, C. Pao4,
G. Ruiz5, J. Stocks1, C. Wallis2, R. Suri2, London Cystic Fibrosis Collaboration
(LCFC). 1UCL Institute of Child Health, Portex Respiratory Unit, London, United
Kingdom; 2Great Ormond Street Hospital for Children NHS Foundation Trust,
Respiratory Unit, London, United Kingdom; 3Imperial College and Royal Brompton
and Hareﬁeld Hospital NHS Foundation Trust, Department of Paediatric Respiratory
Medicine, London, United Kingdom; 4Barts and the London Children’s Hospital,
Department of Paediatric Respiratory Medicine, London, United Kingdom; 5Kings
College Hospital, Department of Paediatric Respiratory Medicine, London, United
Kingdom
Introduction: Oropharyngeal cultures from cough swabs in children with CF are
routinely used in clinical settings despite conﬂicting reports on their diagnostic
accuracy [1,2]. While bronchoalveolar lavage (BAL) is an alternative diagnostic tool,
BAL-directed therapy did not improve outcome in CF children at age 5 years [3].
Objective: To compare microbiological results obtained from BAL and oropharyngeal
cough swabs at age 1-year in NBS CF infants.
Methods: As part of a multicentre observational study, elective bronchoscopic BAL
sampled from at least 2 pulmonary lobes was obtained from asymptomatic NBS CF
infants at 1 y. Corresponding cough swabs were obtained prior to the bronchoscopy.
Results: 39 BAL and swabs were obtained. Signiﬁcant bacterial growth was found in
6/39 (15%) of BAL, (1 with Pseudomonas aeruginosa, 2 with Staphylococcus aureus
(SA) and 3 with Haemophilus inﬂuenzae. Only 1 of these infections (1 with SA) was
correctly detected by the swab with 2 further positive swabs not detected in BAL.
Overall, swabs undertaken revealed only half of the infection (3/39; 8%) detected
through BAL samples.
Conclusions: In NBS CF infants, vigilance and early treatment are likely to secure
better long term outcomes but cough swabs predict lower airway infection poorly. While
BAL may provide valuable information in speciﬁc clinical scenarios, better methods
of detecting lower airway infection in NBS infants with CF are urgently required.
Reference(s)
[1] Equi et al ADC 2001.
[2] Rosenfeld et al Ped Pulm 1999.
[3] Wainright et al JAMA 2011.


WS1.3 Respiratory microbiota dynamics in newborns with cystic fibrosis and healthy controls: A longitudinal study 

Wu Yanjun

Shi Wenchang

Institute Of Software, Chinese Academy Of Sciences

portal monitoring based anti-malware framework: design and     implementation

S.M.P.J. Prevaes

K.M. de Winter-de Groot

G.A. Tramper-Stranders

H.A.W.M. Tiddens

M. van Westreenen

H.M. Janssens

A. Wyllie

C.K. van der Ent

E.A.M. Sanders

D. Bogaert

Crossref

Journal of Cystic Fibrosis

WS1.3 Respiratory microbiota dynamics in newborns with cystic fibrosis and healthy controls: A longitudinal study

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WS1.3 Respiratory microbiota dynamics in newborns with cystic fibrosis and healthy controls: A longitudinal study

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