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      The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: from colonization to bloodstream infection

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          Most cited references 31

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          CDC definitions for nosocomial infections, 1988

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            Guidelines for the validation and application of typing methods for use in bacterial epidemiology.

            For bacterial typing to be useful, the development, validation and appropriate application of typing methods must follow unified criteria. Over a decade ago, ESGEM, the ESCMID (Europen Society for Clinical Microbiology and Infectious Diseases) Study Group on Epidemiological Markers, produced guidelines for optimal use and quality assessment of the then most frequently used typing procedures. We present here an update of these guidelines, taking into account the spectacular increase in the number and quality of typing methods made available over the past decade. Newer and older, phenotypic and genotypic methods for typing of all clinically relevant bacterial species are described according to their principles, advantages and disadvantages. Criteria for their evaluation and application and the interpretation of their results are proposed. Finally, the issues of reporting, standardisation, quality assessment and international networks are discussed. It must be emphasised that typing results can never stand alone and need to be interpreted in the context of all available epidemiological, clinical and demographical data relating to the infectious disease under investigation. A strategic effort on the part of all workers in the field is thus mandatory to combat emerging infectious diseases, as is financial support from national and international granting bodies and health authorities.
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              Mechanisms controlling pathogen colonization of the gut.

              The intestinal microbiota can protect efficiently against colonization by many enteric pathogens ('colonization resistance', CR). This phenomenon has been known for decades, but the mechanistic basis of CR is incompletely defined. At least three mechanisms seem to contribute, that is direct inhibition of pathogen growth by microbiota-derived substances, nutrient depletion by microbiota growth and microbiota-induced stimulation of innate and adaptive immune responses. In spite of CR, intestinal infections are well known to occur. In these cases, the multi-faceted interactions between the microbiota, the host and the pathogen are shifted in favor of the pathogen. We are discussing recent progress in deciphering the underlying molecular mechanisms in health and disease. Copyright © 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal of Medical Microbiology
                Microbiology Society
                0022-2615
                1473-5644
                January 28 2019
                Affiliations
                [1 ] 1​Department of Microbiology, G.Gennimatas General Hospital, Thessaloniki, Greece
                [2 ] 2​3rd Department of Pediatrics, Hippokration Hospital, Aristotle University, Thessaloniki, Greece
                [3 ] 3​ICU, G. Gennimatas General Hospital, Thessaloniki, Greece
                [4 ] 4​Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece
                [5 ] 5​1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Greece
                [6 ] 6​Department of Microbiology, National School of Public Health, Greece
                [7 ] 7​Department of Microbiology, Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece
                Article
                10.1099/jmm.0.000921
                © 2019

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