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MID and UspA1/A2 of the human respiratory pathogen Moraxella catarrhalis, and interactions with the human host as basis for vaccine development

100%

Riesbeck K. , Tan T. T. , Forsgren A.

nr 3

445-456

Moraxella catarrhalis IgD-binding protein MID is a 200 kDa autotransporter protein that exists as a oligomer and is governed at the transcriptional level. The majority of M. catarrhalis clinical isolates expresses MID. Two functional domains have been attributed to MID; MID764-913 functions as an adhesin and promotes the bacteria to attach to epithelial cells, whereas the IgD-binding domain is located within MID962-1200. In parallel, MID is stimulatory for B lymphocytes through the IgD B cell receptor. M. catarrhalis ubiquitous surface proteins A1 and A2 (UspA1/A2) are multifunctional outer membrane proteins that can bind complement and extracellular matrix proteins such as vitronectin and fibronectin. An interaction between the complement fluid phase regulator of the classical pathway, C4b binding protein (C4BP), and UspA1/A2 has also been observed. Moreover, UspA1/A2 has a unique feature to interfere with the innate immune system of complement by binding C3. Taken together, a growing body of knowledge on M. catarrhalis outer membrane proteins MID and UspA1/A2 and their precise interactions with the human host make them promising vaccine candidates in a future multicomponent vaccin.

Prescriptions of broad-spectrum antibiotics to outpatients do not match increased prevalence and antibiotic resistance of respiratory pathogens in Bavaria

72%

Borgmann S. , Jakobiak T. , Gruber H. , Schroder H. , Sagel U.

nr 2

105-110

In this study we present an analysis of prescription numbers of various antibiotic classes to Bavarian (Southern Gennany) outpatients between 2000 and 2006 compared to fluctuating resistance patterns in representative respiratory pathogens. Prescriptions of "narrow-spectrum" antibiotics (e.g. penicillins, macrolides) decreased by 39% while prescriptions of "broad-spectrum" antibiotics increased by 38%. The most prominent increase was for quinolones and cephalosporines class II. Prescriptions of these antibiotics exhibited prominent seasonal alterations suggesting that these drugs had been used for treatment of respiratory infections. In contrast, the numbers of S. pneumoniae and H. influenzae detected in respiratory specimen decreased. Almost constant resistance rates of S. pneumoniae for first line antibiotics do not justify an increased use of cephalosporins class II and quinolones. Compared to Europe and Gennany in general, consumption of antibiotics is low in Bavaria. Even at this low level we propose an education of physicians treating outpatients in a way to avoid an excessive use of antimicrobials.