Microbial pathogens involved in VAP are frequently multidrug resistant (MDR), which challenges the appropriateness of empirical antibiotic prescription [ 10].
In our series, patient outcome was associated with the microbial pathogens involved and the inflammatory state prior to ERC intervention.
Ideally, the diagnostic laboratory should be involved in active as well as in passive (or laboratory-based) surveillance, and in the subsequent molecular typing of microbial pathogens involved in an epidemic cluster [ 5- 7].
For instance, although a large proportion of genomic studies of microbial pathogens has involved pathogens of special importance in developing countries, involvement of researchers from developing countries in such projects has been quite limited, constraining timely development of bioinformatics capacity in developing countries [ 4, 5].
The MDR microbial pathogens imply a most important threat to human health.
The evolution of interactions between microbial pathogens and their hosts involves a continuous arms race, in which pathogens secrete effectors to deregulate host immunity (de Jonge et al., 2011).
To defend against external stimuli, plants have evolved inducible defense mechanisms against microbial pathogens and herbivores that involve the regulation of gene expression for the synthesis of specific proteins and secondary metabolites [ 1].
Significant shifts in the microbiota associated with progressive sexual maturation as measured by Tanner staging suggest that puberty-dependent shifts in the skin and nares microbiomes may have significant implications regarding prevention and treatment of pediatric disorders involving microbial pathogens and colonization.
"While the steps involved in recognizing microbial pathogens and inducing the immune response have been extensively studied, the pathways involved in host recovery after an infection are not well understood," said Alejandro Aballay, Ph.D., an associate professor of molecular genetics and microbiology at Duke University School of Medicine.
Previously, several groups suggested that infection by microbial pathogens induces hypermethylation of candidate genes involved in oncogenesis [ 35, 36, 24].
A troubling number of health care-acquired infection outbreaks and transmission events, some involving highly resistant microbial pathogens and resulting in serious patient outcomes, have been traced to reusable, high-level disinfected duodenoscopes in the United States.
