Characterization of a multi-component anthrax vaccine designed to target the initial stages of infection as well as toxaemia.

Current vaccine approaches to combat anthrax are effective; however, they target only a single protein [the protective antigen (PA) toxin component] that is produced after spore germination. PA production is subsequently increased during later vegetative cell proliferation. Accordingly, several aspects of the vaccine strategy could be improved. The inclusion of spore-specific antigens with PA could potentially induce protection to initial stages of the disease. Moreover, adding other epitopes to the current vaccine strategy will decrease the likelihood of encountering a strain of Bacillus anthracis (emerging or engineered) that is refractory to the vaccine. Adding recombinant spore-surface antigens (e.g. BclA, ExsFA/BxpB and p5303) to PA has been shown to augment protection afforded by the latter using a challenge model employing immunosuppressed mice challenged with spores derived from the attenuated Sterne strain of B. anthracis. This report demonstrated similar augmentation utilizing guinea pigs or mice challenged with spores of the fully virulent Ames strain or a non-toxigenic but encapsulated ΔAmes strain of B. anthracis, respectively. Additionally, it was shown that immune interference did not occur if optimal amounts of antigen were administered. By administering the toxin and spore-based immunogens simultaneously, a significant adjuvant effect was also observed in some cases. Thus, these data further support the inclusion of recombinant spore antigens in next-generation anthrax vaccine strategies.

Evaluation of community acquired pneumonia guidelines.

Community acquired pneumonia (CAP) is a serious illness, in which the etiology of disease cannot be determined in 50% of the patients. The American Thoracic Society (ATS) and the Infectious Disease Society of America (IDSA) have independently developed treatment guidelines for CAP. These guidelines, however, differ in their approaches. The differences can be attributed to their unique approaches. ATS favors the application of empiric methodology verse IDSA, which recommends a definitive clinical approach. Presently, a widely accepted, standardized guideline for the diagnosis and treatment of CAP is unavailable. This contributes to the large variation in admission rates, use of institutional resources, and quality of care given to CAP patients.