City of Hope, one of the largest cancer research and treatment organizations in the United States, treated the oldest person to be cured of a blood cancer and then achieve remission for HIV after receiving a blood stem cell transplant from a donor with a rare genetic mutation. Research published in the New England Journal of Medicine today demonstrates that older adults with blood cancers who receive reduced intensity chemotherapy before a stem cell transplant with donor cells that are resistant to HIV may be cured of HIV infection.

Paul Edmonds, 68, of Desert Springs, California, is the fifth person in the world to achieve remission for acute myelogenous leukemia and HIV after receiving stem cells with a rare genetic mutation, homozygous CCR5 Delta 32. That mutation makes people who have it resistant to acquiring HIV. Edmonds is also the person who had HIV the longest—for over 31 years—among these five patients.

Known as the “City of Hope patient” among these five patients, Edmonds received a transplant at City of Hope on Feb. 6, 2019, and is now considered to be cured of leukemia. Edmonds stopped taking antiretroviral therapies for HIV nearly three years ago and will be considered cured of HIV after he has stopped taking antiretrovirals for five years.

Plasminogen deficiency, a rare disorder characterized by impaired fibrinolysis, frequently results in ligneous conjunctivitis. In this report, we report a case of a Saudi girl manifesting both conjunctivitis and hydrocephalus. Her initial symptoms at 1 month of age were recurring eye redness, which was inaccurately diagnosed as simple conjunctivitis. Surgical intervention for her ocular lesions revealed underlying membrane deposition. She later exhibited signs of increased intracranial pressure, resulting in a hydrocephalus diagnosis and subsequent surgery. Genetic analysis confirmed the presence of plasminogen deficiency. Clinical evaluations highlighted ligneous conjunctivitis, variations in visual acuity, and facial acne. Laboratory assessments demonstrated diminished plasminogen levels.

After years of trials, Iowa State genetic scientists can build a DNA structure that can express its own genetic instructions, which could lead to medical advances.

Patients with recurrent Escherichia coli bacteremia can harbor strains with mutations that promote multidrug antibiotic resistance:

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Certain patients with gram-negative bacterial bloodstream infections (GNB-BSIs) are well-known to experience recurrent bacteremia after receiving antimicrobial therapy — but is this phenomenon due to microbial factors? Researchers have analyzed isolates from patients with relapsed GNB-BSIs in which the initial and subsequent strains were nearly identical genetically.

Paired bacteremic isolates of E. coli, Klebsiella species, Serratia marcescens, and Pseudomonas aeruginosa were identified for a detailed analysis of the E. coli strains. Time-kill studies found that 4 of the 11 recurrent isolates had a higher number of bacterial colony-forming units persisting through 24 hours of exposure to meropenem. The recurrent strain with the greatest number of persisting cells had a loss-of-function mutation in the ptsI gene (involved in the phosphoenolpyruvate phosphotransferase system and shown in vitro to be important to the effects of bactericidal antibiotics). Challenging mice with the initial and ptsI mutant recurrent strains in a bacteremia model showed that both variants were equally virulent, but the recurrent strain was 10-fold less susceptible to treatment with ertapenem.

This work affirms the clinical importance of persister bacterial strains in relapsing infections while also confirming the role of bacterial metabolic pathways in the development of antibiotic resistance. The results also raise the question of whether more-prolonged antibiotic therapy might be appropriate in individuals who develop recurrent E. coli bacteremia without an obvious host-related explanation.