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Infectious Diseases: Many Gains, Much To Do

A large chunk of bacterial life individually lacks the genetic wherewithal to live, yet, they do; many are found in the mouth, not just transiently. “We think that in their dependencies, they are supporting the growth of other microbes that are a clinical concern,” said Dr. Relman.
The microbial reality is that microbes seldom live alone. Rather, they live as members of a community—and this includes our gut. An analysis of genes recovered from 755 metagenomic samples from 100 healthy volunteers revealed that dozens of gene clusters that encode unknown products had proved present in over half of the people. In environments like this, the bacterial communities survive and thrive because of communication between the bacteria in the form of small molecules that shuttle between cells. Within the community, bacteria can produce compounds that they themselves do not use, but which benefit other members of the community and thus maintain the overall “health” of the community. This can have clinical implications. An example is the production of indole by antibiotic-resistant Escherichia coli, which allows more vulnerable bacteria in the population to survive the antibiotic stress.
Bacteria can offer lessons for clinical practice. Disturbance of a microbial ecosystem can have negative effects, as integration of environmental and host features can influence health management and disease classification. The maintenance of bacterial communities points the way to the therapeutic use of microbial compounds and “informed manipulation” of the microbiota.

Thomas Frieden, Deborah Brix, David Relman: none
Special Opening Plenary Session: Infectious Diseases: Looking Back, Moving Forward
  • Antibiotic Resistance & Where We Are Today: Thomas Frieden, MD, MPH, director, CDC
  • 20 Years of Antiretroviral Therapy: Deborah L. Birx, MD, ambassador-at-large, State Department
  • Microbes, Infectious Disease, and the Future of Medicine: David Relman, MD, Stanford University School of Medicine 

Brian Hoyle, PhD, is a medical and science writer and editor from Halifax, Nova Scotia, Canada. He has been a full-time freelance writer/editor for over 15 years. Prior to that, he was a research microbiologist and lab manager of a provincial government water testing lab. He can be reached at
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