Antonie van Leeuwenhoek. International Journal of General and Molecular Microbiology
Exposure to harsh surfactants, ruthless proteases and pH values as low as 1, are extreme conditions that are endured by the microbes colonizing the largest microbial ecosystem that is closest to our heart: our microbes inside. Since birth, these intestinal microbes dominate our body and outnumber our own cells by one or more orders of magnitude. Hence, the collective genome of these microbes, also know as the microbiome, contributes considerably to the coding capacity of our system. However,
... ike our own genome, the microbiome is not, or not only, vertically inherited and moreover, this personalized organ can be modified by diet, life style and antimicrobials. Hence, there is great interest in relating the intestinal microbiome to health and disease. This requires a quantitative description of the main microbial community members, their genomes and functions. Moreover, as the intestinal microbes have developed intimate relations with the host, their dynamics and interactions should be analyzed. This contribution aims to summarize the recent state of the art in this area with specific attention for describing the microbial diversity in time and space, studying the microbe by functional metagenomics, and understanding the interaction of intestinal bacteria with the host. Hospital 7 , Oss Until 2007, Q fever was a rare disease in The Netherlands, 10-15 cases per year spreaded all over the country. In the spring of 2007 a large Q fever outbreak occurred in northeast Brabant. The epicenter was the village of Herpen. Unfortunately, 2007 was only a 'warming up' for 2008, in which in total more than 998 cases were found. The center of the infection moved a little to the east in North-Brabant, around Zeeland/Veghel. In summary, in 2007In summary, in ? 2008 ? 998 = 1,176 patients with acute Q-fever were diagnosed. Soon after the beginning of the outbreak in 2007, a multidisciplinary Qfever team developed a provisionally protocol 1 for diagnosis and treatment of acute and chronic Q fever 1 . Reviewing the literature many questions came arise. Test-methods were not clearly described and or differed from the tests used in The Netherlands. Also interpretation of tests varied. Additionally, there were conflicting data about the treatment of specific patient groups and there were questions about the efficacy of the newer antibiotic for the treatment of Q-fever, etc. Therefore, we decided to evaluate the above-mentioned protocol. All patients with acute Q fever in 2007, living in the region Nijmegen-Herpen-Oss, were followed for 1 year. At baseline (moment of diagnosis of acute Q fever) patient characteristics, symptoms, physical examination, laboratory test and echocardiogram were performed. Additionally, 3, 6 and 12 month after the diagnosis of Q fever, patients were seen Objectives: IFA has been a reliable method to detect antibodies against C. burnetii, the causative agent of Q-fever. However, this method is laborious and cannot be efficiently up scaled, which is disadvantageous in large outbreaks and in epidemiology. In contrast, ELISA's are easy to perform and can be automated. We compared the Serion C. burnetii Phase II IgG ELISA-kit with the Focus C. burnetii-IgG IFA. Methods: 487 sera from 487 inhabitants of the village of Herpen were tested for presence of IgG-antibodies. This village was the epicentre of an outbreak of Q-fever in Northern Brabant in 2007. A titer of [ = 1:64 was considered positive both for the IgG as for the IgM IFA. In the IgG ELISA, a value of [ = 20 IU/ml was positive. Results: The presence of antibodies by IFA was detected in 136 sera. 77 of these were positive with ELISA (sensitivity: 57%). Of 351 IFA negative sera, 341 were negative with ELISA (specificity: 97%). The presence of IgM antibodies by IFA was detected in 85 sera. Of these 70 were positive with ELISA (sensitivity: 82%). All IFA negative sera were also negative with the ELISA. The positive-and negative predictive value were 100 and 97%, respectively. Additionally 66 sera from 56 patients with infections like legionellosis, mycoplasmosis and leptospirosis were tested. 9 were positive with IgG IFA and 4 in IgM IFA. With ELISA IgG 13 were positive and 4 with IgM. Conclusion: The limited sensitivity of the C. burnetii ELISA limits its suitability for seroprevalence studies.