Since pneumococcal conjugate vaccination has caused a shift in the predominant OM pathogens, nontypeable H. influenzae (NTHI) is becoming the most commonly-isolated organism of OM [ 13].
Wide use of PCV-7 led to a relative shift in the proportion of pathogens causing persistent AOM was observed (decrease in S. pneumoniae and an increasing predominance of NTHi) [ 10].
It is noteworthy that a considerable shift in the spectrum of pathogens isolated from blood cultures of febrile neutropenic cancer patients in the USA has emerged since 1995, with Gram-positive cocci increasing from 62%to76%6% of isolates [ 21], Gram-negative bacilli declining from 21.5%to14%4% and fungi declining from 15 to 8%.
A shift in the existing paradigm of pathogen-focused policies and programs would contribute to a healthier future for everyone.
In the cases of ongoing IAI causing sepsis antibiotic therapy had to be adapted several times due to a shift in the spectrum of isolated pathogens.
These measures significantly reduced the incidence of salmonellosis [ 15, 16] and most likely contributed to a shift in the relative contribution of pathogens that are currently causing AGE.
A shift in the predominance of CRI pathogens, from Gram-positive to Gram-negative bacteria, is widely reported, which suggests that central line insertion bundles are more effective in reducing Gram-positive CRI than Gram-negative CRI [ 18, 22, 30- 32].
In our CDH cohort, we observed a microbiological shift in VAP pathogen.
A heptavalent pneumococcal conjugate vaccine (PCV7) was introduced in 2000, and since its acceptance for widespread use there has been a shift in the incidence of otitis media pathogens.
Recent studies have shed a new light on the potential for using probiotics for the prevention of oral diseases, i.e. a shift in the microbial population towards a pathogen-associated population, which is central to the development of the major oral diseases (caries and periodontal disease).
From a physiological point of view, the similar lipid patterns observed in vitro and in vivo (early and late infection, respectively) suggest a pathogen-driven host metabolic shift in the Cho pathway.
