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Not applicable.

The data and materials supporting the conclusions of this article are included within the article and its additional files.

adenomatous polyposis coli

antibiotic resistance gene-ANNOTation

colorectal cancer

the database for annotation, visualization and integrated discovery

database of essential genes

epithelial-mesenchymal transition

gene ontology

host-pathogen interaction database

host-pathogen protein-protein interactions

inflammatory bowel disease

kyoto encyclopedia of genes and genomes

lymphoid enhancer factor

lipopolysaccharide

outer membrane proteins

resistance-nodulation-cell division

The Cancer Genome Atlas

toll-like receptors

virulence factors database

Dr. R. Krishna and Amit Kumar gratefully acknowledge Council of Scientific and Industrial Research (CSIR), India for providing financial support to carry out this research work.

Funding

The Council Of Scientific And Industrial Research (CSIR), New Delhi, India (37(1610)/13/EMR-II).

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (
) applies to the data made available in this article, unless otherwise stated.

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List of essential genes in from DEG. Table S2. virulence factors list from VFDB search and literature. Table S3. List of resistance causing proteins from ARG-ANNOT tool. (XLSX 66kb)
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Non-human homologous proteins present in . Table S5. Metabolic pathways of non-human homologous proteins according to KEGG. Table S6. Pathogen-specific metabolic pathways of screened proteins in . Table S7. Subcellular localization of druggable proteins. (XLSX 45kb)
Additional file 3: Table S8. Homology based HP-PPIs predicted from HPIDB. Table S9. Pathway enrichment analysis of host genes from DAVID functional annotation tool. Table S10. Gene ontology report of host genes. Table S11. Disease enrichment analysis of host genes participated in HP-PPIs. Table S12. Total functional annotation cluster analysis of host genes. (XLSX 99kb)

The authors declare that they have no competing interests.

To monitor changes in the transcriptional profile of M. catarrhalis BBH18 early after adherence to upper airway epithelial cells, we compared expression of the adherent (cell-attached) and non-adherent (planktonic) fractions after 1h adherence to Detroit 562 cells. In addition, we examined expression of bacteria that were only incubated in the infection medium (control fraction). Rather surprisingly, very few expression differences (~3-fold increased expression of lbpB and MCR_0218) were observed between control and non-adherent bacteria, indicating that in the absence of direct contact, host cells had a limited impact on M. catarrhalis , and that the non-adherent fraction is likely to represent basal expression levels under our assay conditions. Therefore, we focused our analysis on the differences between the cell-attached and non-adherent fractions.

In total, we found increased expression of 34 genes and reduced expression of 16 genes in adherent relative to non-adherent bacteria ( Table S2 ). Next to (conserved) hypothetical genes (19, 55.8%), predominant classes found among the genes with increased expression in the cell-attached fraction were metabolic genes (7, 20.6%) and genes encoding “transport and binding” proteins (5, 14.7%) ( Figure 3A ). For example, increased expression was found for the putative acyl-CoA dehydrogenase gene fadE (MCR_0042) involved in beta-oxidation of fatty acids [ Very Cheap Price Bulk Designs Rock Tshirt Brown Masnada Pre Order For Sale Shop Offer Sale Online hPSiWlUf
], and for ABC transporter genes for molybdate ( modABC- cluster). An increased need for molybdenum could arise due to higher redox activity in sulfur, nitrogen en carbon metabolism for which molybdenum is required [ SKIRTS Long skirts Ichi Clearance Sast Sale The Cheapest Quality 70fzfr1e2y
]. In line with this, gene expression of nitrate reductase ( narJ ), encoding a molybdenum cofactor-dependent enzyme [ Star Intarsia Merino Wool Jumpsuit Navy Perfect Moment Low Price Cheap Online Buy Cheap Low Shipping Low Cost Cheap Online Clearance Online Amazon EnyYiYEv17
], was also increased, potentially to fulfill the energy need required for adaptation during epithelial cell adherence. In addition, several sulfate metabolism genes displayed increased expression in cell-attached bacteria, namely ABC transporter genes that mediate uptake of sulfur ( cysP and cysU ) and genes that participate in biosynthesis of reduced sulfur metabolites ( cysH and cysI ). Interestingly, deletion of cysH from Mycobacterium tuberculosis resulted in attenuated virulence in mice and reduced resistance against oxidative stress [ 37 ]. The majority of lower expressed genes in cell-attached bacteria were (conserved) hypotheticals (9, 56.3%), but reduced expression was also found for genes encoding a putative lipoprotein (MCR_1168), glutaredoxin-like protein (MCR_0600), and 50S ribosomal protein L33 ( rpmG ).

Figure 3. Gene expression of BBH18 during adherence to Detroit 562 cells.

A) Functional class distribution of genes differentially expressed in cell-attached relative to non-adherent (planktonic) M. catarrhalis (n = 4), depicted as number of genes per functional class category. B) Distribution of gene expression levels of known adhesins and structural components associated with adherence in cell-attached M. catarrhalis . Average log 2 microarrays signal intensities (SI) per gene were grouped into bins (1-log interval per bin), and the total number of genes within a bin is shown here.

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At a Glance

The classical symptoms and signs of meningitis are:

There are many infectious causes of meningitis, including:

What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?

The diagnosis of meningitis is centered on the examination and evaluation of cerebral spinal fluid (CSF), blood cultures, and radiology.

The initial approach to confirmation of meningitis first requires examination of the patient and classification of the patient either as without papilledema or focal neurological deficits or as having papilledema or focal neurological deficits. Lumbar puncture in patients with papilledema or focal neurological deficits has been associated with herniation and, thus, would not be the first step.

In patients without papilledema or focal neurological deficits:

In patients with papilledema or neurological deficits:

Are There Any Factors That Might Affect the Lab Results? In particular, does your patient take any medications - OTC drugs or Herbals - that might affect the lab results?

There are a number of factors that can affect CSF analysis, most preanalytical in nature.

What Lab Results Are Absolutely Confirmatory?

This can be a complex question for any microbiological analysis, as the presence of a microorganism (or viral nucleic acid) in a clinical sample is not 100% confirmatory, but rather the presence of that organism (or viral nucleic acid) must be determined to be the clinically relevant pathogen based on the clinical scenario.

It has been stated that the following profile predicts bacterial meningitis with up to 99% certainty:

What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?

A discussion of meningitis is not complete without a short reminder of the most common causative pathogens. The most common bacterial pathogens have changed over the years primarily because of immunization with the B vaccine. This vaccine has dramatically reduced the incidence of meningitis. In fact, meningitis is now considered more of a disease of adults than children. The most common pathogens identified in all patients are and .

The most common viral pathogens are enterovirus, HSV, HIV, and the arboviruses. However, the latter are more important causes of encephalitis (see module on encephalitis for more information).

headache (typically severe)

meningismus (stiff neck)

altered mental status (typically temporally follows headache)

Enlarge Print

CDC = Centers for Disease Control and Prevention; USPSTF = U.S. Preventive Services Task Force .

A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort.xml .

CDC = Centers for Disease Control and Prevention; USPSTF = U.S. Preventive Services Task Force .

A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort.xml .

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Genitourinary infection affects primarily young adults and persons with multiple sex partners. Cheap 2018 New Free Shipping Outlet Store White cotton pleated skirt Fabiana Filippi Find Great Cheap Online RxSaC
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Young women 15 to 19 years of age carry the highest incidence of disease, followed by women 20 to 24 years of age. Although chlamydia is common in all races, blacks, American Indians/Alaska Natives, and Hispanic women are disproportionately affected. Other groups at higher risk include adolescents and men who have sex with men. 8

According to the CDC, chlamydia infection rates in men are also increasing, and at a faster rate than in women. Between 2005 and 2009, the reported infection rate for men rose from 159.4 to 219.3 cases per 100,000 males, a 37.6 percent increase. 7 During the same period, the rate of infection among women increased 29.3 percent. 7

Prevalence rates among men vary depending on the subgroups screened. One study reported a prevalence of 3.7 percent in men 18 to 26 years of age. PSWL Cotton Dress White Proenza Schouler Factory Price Free Shipping Limited Edition Cheap Countdown Package Buy Cheap High Quality JWCUq
Other studies report an overall prevalence among asymptomatic men in the United States of between 6 and 7 percent, and as much as 18 to 20 percent in men attending inner-city primary care clinics. 10 In select groups, such as men who have sex with men, rates of rectal infections were found to be high. 11 Risk factors for men and women include lack of condom use, lower socioeconomic status, living in an urban area, and having multiple sex partners.

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