Peeling back the many layers of competitive exclusion.

Baby chicks administered a fecal transplant from adult chickens are resistant to Salmonella colonization by competitive exclusion. A two-pronged approach was used to investigate the mechanism of this process. First, Salmonella response to an exclusive (Salmonella competitive exclusion product, Aviguard®) or permissive microbial community (chicken cecal contents from colonized birds containing 7.85 Log10Salmonella genomes/gram) was assessed ex vivo using a S. typhimurium reporter strain with fluorescent YFP and CFP gene fusions to rrn and hilA operon, respectively. Second, cecal transcriptome analysis was used to assess the cecal communities' response to Salmonella in chickens with low (≤5.85 Log10 genomes/g) or high (≥6.00 Log10 genomes/g) Salmonella colonization. The ex vivo experiment revealed a reduction in Salmonella growth and hilA expression following co-culture with the exclusive community. The exclusive community also repressed Salmonella's SPI-1 virulence genes and LPS modification, while the anti-virulence/inflammatory gene avrA was upregulated. Salmonella transcriptome analysis revealed significant metabolic disparities in Salmonella grown with the two different communities. Propanediol utilization and vitamin B12 synthesis were central to Salmonella metabolism co-cultured with either community, and mutations in propanediol and vitamin B12 metabolism altered Salmonella growth in the exclusive community. There were significant differences in the cecal community's stress response to Salmonella colonization. Cecal community transcripts indicated that antimicrobials were central to the type of stress response detected in the low Salmonella abundance community, suggesting antagonism involved in Salmonella exclusion. This study indicates complex community interactions that modulate Salmonella metabolism and pathogenic behavior and reduce growth through antagonism may be key to exclusion.

Differentiating Vaccine-Related Fowl Cholera from Naturally Occurring Disease.

Vaccine-related fowl cholera must be considered when flock mortality increases after use of a live Pasteurella multocida vaccine product. All registered live vaccines serotype as Heddleston 3,4; however, in some regions this is also the most common serotype of outbreak isolates in broiler breeders and turkeys. Therefore, serotyping may not be useful for diagnosing vaccine-related fowl cholera. This project sought to apply a vaccine-specific test to differentiate vaccine-related disease from naturally occurring outbreaks. Results indicate that vaccine strains were commonly isolated from broiler breeders exhibiting signs of fowl cholera postvaccination, but some of these isolates exhibited only serotype 4 antigenicity. The isolates' lipopolysaccharides, the target antigen for serotyping, contained compositional changes that may explain the varying serotype results and virulence of the commercial preparations. These results suggest that vaccine-related disease may be common in broiler breeders, and live commercial vaccine preparations need to be assessed for serotype and titer prior to use in order to reduce vaccine-related fowl cholera.

Intensive, functional training leads to optimal outcomes in a young woman post brain stem hemorrhage due to cerebral cavernous malformation.

PURPOSE: Cerebral cavernous malformations (CCMs) can cause intracranial hemorrhages and account for 5-15% of all cerebral vascular malformations. The purpose of this retrospective case report is to describe the unusual motor recovery of a young woman following a large hemorrhage of a previously unknown brainstem CCM, otherwise not reported in the literature. Case Description: The patient was a 29-year-old female who presented with severe hemiparesis on the left 6 weeks after a first-ever hemorrhage. She had demonstrated minimal improvement in her motor recovery to date, was dependent on a walker for ambulation, and had no distal left upper extremity function. An intensive evidence-based plan of care over 6 weeks included progressive task-specific strengthening, treadmill training, and dynamic balance training. Outcomes: The patient achieved complete motor recovery, indicated by improvement from 23/66 to 64/66 in the Fugl-Meyer Upper Extremity Subscale score and from 12/30 to 30/30 in the Functional Gait Assessment. She returned to independent ambulation with functional gait speeds and kinematics. Discussion: This case report demonstrates an unusual clinical course of unexpected full recovery in a young woman after a large brainstem CCM after an intensive 6-week course of physical therapy. Other patients with a similar presentation after CCM may benefit from an intensive plan of care. Clinicians should be aware of the possibility of unusual recovery in this population as not to limit expectations for recovery.