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      Relevance of anaerobic bacteremia in adult patients: A never-ending story?

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          Abstract

          Obligate anaerobic bacteria are considered important constituents of the microbiota of humans; in addition, they are also important etiological agents in some focal or invasive infections and bacteremia with a high level of mortality. Conflicting data have accumulated over the last decades regarding the extent in which these pathogens play an intrinsic role in bloodstream infections. Clinical characteristics of anaerobic bloodstream infections do not differ from bacteremia caused by other pathogens, but due to their longer generation time and rigorous growth requirements, it usually takes longer to establish the etiological diagnosis. The introduction of matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) has represented a technological revolution in microbiological diagnostics, which has allowed for the fast, accurate and reliable identification of anaerobic bacteria at a low sample cost. The purpose of this review article is to summarize the currently available literature data on the prevalence of anaerobic bacteremia in adults for physicians and clinical microbiologists and to shed some light on the complexity of this topic nowadays.

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          MALDI-TOF MS for the diagnosis of infectious diseases.

          First introduced into clinical microbiology laboratories in Europe, MALDI-TOF MS is being rapidly embraced by laboratories around the globe. Although it has multiple applications, its widespread adoption in clinical microbiology relates to its use as an inexpensive, easy, fast, and accurate method for identification of grown bacteria and fungi based on automated analysis of the mass distribution of bacterial proteins.
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            Emerging roles of the microbiome in cancer.

            Gene-environment interactions underlie cancer susceptibility and progression. Yet, we still have limited knowledge of which environmental factors are important and how they function during tumorigenesis. In this respect, the microbial communities that inhabit our gastrointestinal tract and other body sites have been unappreciated until recently. However, our microbiota are environmental factors that we are exposed to continuously, and human microbiome studies have revealed significant differences in the relative abundance of certain microbes in cancer cases compared with controls. To characterize the function of microbiota in carcinogenesis, mouse models of cancer have been treated with antibiotics. They have also been maintained in a germfree state or have been colonized with specific bacteria in specialized (gnotobiotic) facilities. These studies demonstrate that microbiota can increase or decrease cancer susceptibility and progression by diverse mechanisms such as by modulating inflammation, influencing the genomic stability of host cells and producing metabolites that function as histone deacetylase inhibitors to epigenetically regulate host gene expression. One might consider microbiota as tractable environmental factors because they are highly quantifiable and relatively stable within an individual compared with our exposures to external agents. At the same time, however, diet can modulate the composition of microbial communities within our gut, and this supports the idea that probiotics and prebiotics can be effective chemoprevention strategies. The trajectory of where the current work is headed suggests that microbiota will continue to provide insight into the basic mechanisms of carcinogenesis and that microbiota will also become targets for therapeutic intervention.
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              Current status of MALDI-TOF mass spectrometry in clinical microbiology

              Mass spectrometry (MS) is a type of analysis used to determine what molecules make up a sample, based on the mass spectrum that are created by the ions. Mass spectrometers are able to perform traditional target analyte identification and quantitation; however, they may also be used within a clinical setting for the rapid identification of bacteria. The causative agent in sepsis is changed over time, and clinical decisions affecting the management of infections are often based on the outcomes of bacterial identification. Therefore, it is essential that such identifications are performed quickly and interpreted correctly. Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometer is one of the most popular MS instruments used in biology, due to its rapid and precise identification of genus and species of an extensive range of Gram-negative and-positive bacteria. Microorganism identification by Mass spectrometry is based on identifying a characteristic spectrum of each species and then matched with a large database within the instrument. The present review gives a contemporary perspective on the challenges and opportunities for bacterial identification as well as a written report of how technological innovation has advanced MS. Future clinical applications will also be addressed, particularly the use of MALDI-TOF MS in the field of microbiology for the identification and the analysis of antibiotic resistance.
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                Author and article information

                Contributors
                Journal
                1886
                European Journal of Microbiology and Immunology
                Akadémiai Kiadó
                2062-8633
                05 June 2020
                Affiliations
                [1 ] deptDepartment of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy , univUniversity of Szeged , Eötvös utca 6., Szeged, 6720, Hungary
                [2 ] deptDepartment of Public Health, Faculty of Medicine , univUniversity of Szeged , Dóm tér 10., Szeged, 6720, Hungary
                [3 ] Institute for Translational Medicine, Medical School , univUniversity of Pécs , Szigeti út 12., Pécs, 7624, Hungary
                Author notes
                [* ]Corresponding author. Tel.: +36 62 341 330. E-mail: mariopharma92@ 123456gmail.com
                Author information
                https://orcid.org/0000-0003-1270-0365
                Article
                10.1556/1886.2020.00009
                fb9fc274-497f-4877-9958-2d795cd03ce0
                © 2020 The Authors

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated. (SID_1)

                History
                : 01 April 2020
                : 19 April 2020
                Page count
                References: 119, Pages: 12
                Funding
                Funded by: ESCMID
                Categories
                Review Paper
                Custom metadata
                1

                Medicine,Immunology,Public health,Microbiology & Virology,Infectious disease & Microbiology
                anaerobes,MALDI-TOF,bloodstream infections,bacteremia, Clostridium ,blood cultures, Bacteroides

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