SpR This study NVH-1311 NVH-1307 with pHT315_MW3gerA SpR and Em

SpR. This study NVH-1311 NVH-1307 with pHT315_MW3gerA. SpR and EmR. This study ATCC 14579 Bacillus cereus type strain [72, 73] B252 Bacillus subtilis

isolated from tap water [71] Plasmids     pMAD E. coli/B. licheniformis shuttle plasmid. ApR, EmR, ori Bacillus ts and pclpB-bgaB Fosbretabulin mw [75] pMAD_SpR pMAD-derivate supplemented with a SpR cassette in the SalI site. ApR, EmR, SpR, ori Bacillus ts and pclpB-bgaB [76] pMAD_SpRΔgerAA pMAD_SpR-derivate allowing substitution of parts of gerAA in MW3 with a SpR cassette. ApR, EmR, SpR, ori Bacillus ts and pclpB-bgaB This study pHT315 E. coli/B. licheniformis shuttle plasmid. ApR and EmR [52] pHT315_MW3gerA pHT315-derivate containing gerA fragment b amplified from MW3 DNA template. ApR and EmR This study a ApR; resistance to ampicillin, EmR; resistance to erythromycin, SpR; resistance to spectinomycin, ori Bacillus ts; temperature-sensitive Bacillus origin of replication, pclpB-bgaB; constitutively expressed termostable β-galactosidase SCH772984 mw (allowing blue/white screening of transformants on X-Gal plates). b gerA fragment contains a sequence

151 bp upstream of gerAA, gerAA, gerAB, gerAC and 177 bp downstream of gerAC. Preparation and transformation of B. licheniformis electrocompetent cells Electrocompetent B. licheniformis was prepared and transformed by a modified version of the protocol described by Mahillion et al.[74] as follows. A preculture in Brain Heart Infusion broth (BHI) (Oxoid, Cambridge, United Kingdom) was grown overnight at 37 °C, and 1 ml was used to inoculate 200 ml pre-warmed BHI in a 1 l Erlenmeyer. The culture was incubated 4 to 5 h at 37 °C and 150 rpm (HT-Infors AG CH-4103, Bottmingen, Switzerland) until A600 of 0.9-1.0 was reached (Shimadzu UV-VIS 160A, Shimadzu Europa GMBH). Cells were pelleted and washed twice with 200 ml RT autoclaved MilliQ water (MQ) by 15 min centrifugations at 3.300 and 10.400 × g. The pellet was resuspended in a 10 ml filter sterilised solution of freshly prepared polyethylene glycol (PEG) 6000 (Merck, Darmstadt, Germany), made by dissolving 40 g PEG6000 in 100 ml MQ. Following 15 min centrifugation at 4.080 × g,

cells were resuspended buy Enzalutamide in 0.5-1 ml of the PEG6000/MQ solution, aliquoted (100 µl) and stored at -80 °C. Transformation was conducted by adding 2 µl plasmid to 100 µl electro competent cells thawed on ice. Following ~1 min incubation on ice, electroporation was performed at 1.4 to 2.5 kV (Eppendorf Eporator, Eppendorf AG, Hamburg, Germany or MicroPulser™, Bio-Rad, Hercules, CA), using 0.2 cm gap width electroporation cuvettes (Bio-Rad Laboratories, Hercules, CA). Before plating on selective LB-agar plates, cells were recovered in LB or S. O. C. medium (Invitrogen) at 37 °C, 150 rpm, for 4 to 5 h. Construction of B. licheniformis MW3ΔgerAA::spc The shuttle vector used for construction of a spectinomycin resistant (SpR) insertion deletion in the gerAA was pMAD_SpR.

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Appendix 1 See Table 6 Table 6 The location and characteristics

Table 6 The location and characteristics of tree, bird and bat survey sites in the NSMNP on Luzon, the Philippines with a summary of survey effort Codea Locality Forest type Elevationb Co-ordinates Trees Birds Birds/bats Plot area (ha) Transect length (km) No of point counts Mist net days Mist net nights Trees A Dimolid LDF 90 N17°07′16″ E122°25′34″ 1    

    B Apaya LDF 300 N17°00′57″ E122°09′34″ 1         C Diguides UBF 200 N17°15′34″ E122°24′11″ 1         D Divinisa UBF 90 N16°56′23″ E122°25′59″ 1         E Subplot 1 MF 1,700 N17°24′45″ E122°01′53″ 0.04         F Subplot 2 MF 1,500 N17°24′57″ E122°01′30″ 0.25         G Subplot 3 MF 1,450 N17°25′50″ E122°00′35″ BIRB 796 concentration 0.25         H Dimasalansan MGF 0 N17°18′27″ E122°23′10″ 1         Birds/bats 1 Apaya LDF 250–350 N17°01′46″ E122°11′34″   4.1   5 5 2 Ambabok LDF 200–260 N17°01′28″ E122°10′46″   3.2 4 9 9 3 Pagsungayan LDF 300–350 N16°59′ E122°11′       4 4 4 Dicaruyan LDF 100 N17°20′06″ E122°13′33″     5 4 3 5 Honeymoon LDF 0–40 N17°20′43″ E122°23′28″   1.45   3 3 6 Villa Robles learn more LDF 100–200 N17°02′15″ E122°23′22″   2.5   4 3 (1) Apaya2 LDF 250–350 N17°01′46″ E122°11′34″     10 2 3 (2) Ambabok2 LDF 200–260 N17°01′28″

E122°10′46″     15 2 3 7 Magsinarawc LDF 50 N16°56′28″ E122°27′13″         2 8 Dicadicanc LDF 575 N16°38′08″ E122°15′08″         3 9 Diguides UBF 20–250 N17°12′33″ E122°25′14″   3.0   4 3 10 Pangden UBF 50 N16°49′57″ E122°25′05″   2.0 1 4 3 11 Dyadyadin UBF 500–550 N16°47′54″ E122°23′32″   3.7   3 2 12 Nanguyaman UBF 500–600 N16°38′16″ E122°18′44″   4.0   4 3 (12) Naguyaman2c tuclazepam UBF 500–600 N16°38′16″ E122°18′44″         3 13 Puerta MF 1,600–1,750 N17°24′ E122°02′       6 6 (13) Puerta2 MF 1,600–1,750 N17°24′ E122°02′       8 8 14 Dipalayag MF 950–1,160 N16°56′55″ E122°17′04″   1.5   4 4 15 Pangal MF 500–900 N16°50′34″ E122°14′36″   2.5 2 6 6 16 Dimasalansan MGF 0 N17°17′15″ E122°23′44″     11 5 4 LDF lowland

dipterocarp forest, UBF ultrabasic forest, MF montane forest and MGF mangrove forest aCodes refer to localities in Fig. 1, codes within brackets indicate replicated surveys; b meters above sea-level; c bats only References 2008 IUCN red list of threatened species (2008) IUCN, Gland. Downloaded 3 Mar 2008 Andal ES, Shoji A, Yumul GP Jr (2005) Complete mantle section of a slow-spreading ridge-derived ophiolite: an example from the Isabela ophiolite in the Philippines. Island Arc 14(3):272–294CrossRef Ashton PS (2003) Floristic zonation of tree communities on wet tropical mountains revisited. Perspectives in Plant Ecology. Evol Syst 6(1–2):87–104 Balmford A, Long A (1995) Across country analyses of biodiversity congruence and current conservation effort in the tropics.

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Int Immunopharmacol. 2003;3:987–99.PubMedCrossRef 24. Einecke G, Mai I, Fritsche L, Slowinski T, Waiser J, Neumayer HH, et al. The value of C2 monitoring in stable renal allograft MCC-950 recipients on maintenance immunosuppression. Nephrol Dial Transplant. 2004;19:215–22.PubMedCrossRef 25. Levy G, Thervet E, Lake J, Uchida K. Patient management by Neoral C(2) monitoring: an international consensus statement. Transplantation. 2002;73(9 Suppl):S12–8.PubMedCrossRef 26. Praditpornsilpa K, Avihingsanon Y, Nivatvong S, Kansanabuch T, Eiam-Ong S, Tiranathanagul K, et al. Outcome of microemulsion

cyclosporine C2 concentration monitoring in kidney transplantation. Clin Transplant. 2005;19:335–9.PubMedCrossRef 27. Wang SM, Lai MK, Chueh SC, Tai HC, Chung SD. Optimal C2 concentration of cyclosporin corrected with good efficacy and safety in Asian kidney transplant recipients. Transplant Proc. 2008;40:2243–4.PubMedCrossRef 28. Crabtree GR, Olson EN. NFAT signaling: choreographing the social lives of cells. Cell. 2002;109(Suppl):S67–79.PubMedCrossRef 29. Faul C, Donnelly M, Merscher-Gomez S, Chang YH, Franz S, Delfgaauw J, et al. The actin cytoskeleton of kidney podocytes is a direct HDAC assay target of the antiproteinuric effect of cyclosporine A. Nat Med. 2008;14:931–8.PubMedCrossRef 30. Fujii Y, Khoshnoodi J, Takenaka H, Hosoyamada M, Nakajo A, Bessho F,

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“A 68-year-old female treated by peritoneal dialysis (PD) for 4 years was hospitalized for cough and dyspnea without chest pain. Chest X-ray revealed massive right pleural effusion. High glucose content in pleural fluid in comparison with blood glucose level was suggestive of transdiaphragmatic leakage.

acetivorans and

acetivorans and Pexidartinib clinical trial absent in the sequenced genomes of acetotrophic Methanosarcina species capable of metabolizing H2/CO2 [22, 39]. Conclusions Although the majority of Methanosarcina species are unable to metabolize H2, electron transport has only been investigated in the few species for which H2 is an obligatory intermediate. M. acetivorans is proposed to utilize a fundamentally different electron transport pathway based on bio-informatic, proteomic and genetic approaches. However, the proposal

has not been tested biochemically. The results indicate roles for ferredoxin, cytochrome c and MP in support of the proposed electron transport pathway. Further, this is the first

report for involvement of a cytochrome c in acetotrophic methanogens. The results suggest that diverse acetotrophic Methanosarcina species have evolved diverse membrane-bound electron transport pathways leading from ferredoxin and culminating with MP donating electrons to HdrDE for reduction of CoM-S-S-CoB. Methods Materials CoM-S-S-CoB was a kind gift of Dr. Jan Keltjens. 2-hydroxyphenazine was custom synthesized FK228 supplier by Sigma-Aldrich (St. Louis, MO). All other chemicals were purchased from Sigma-Aldrich or VWR International (West Chester, PA). All chromatography columns, resins and pre-packed columns were purchased from GE Healthcare (Waukesha, WI). Preparation of cell extract and membranes M. acetivorans [40] was cultured with acetate as described previously [41] and the cell paste was frozen at -80°C.

All solutions were O2-free and manipulations were performed anaerobically in an anaerobic chamber (Coy Manufacturing, Ann Arbor, MI) containing 95% N2 and 5% H2. Frozen cells were thawed, re-suspended (1 g wet weight/ml buffer) in 50 mM MOPS buffer (pH 6.8) containing 10% (v/v) ethylene glycol and passed twice through a French pressure cell at 6.9 × 103 kPa. The lysate was centrifuged at 7,200 × g for 15 min to pellet cell debris Idoxuridine and unbroken cells. Membranes were purified from the cell extract using a discontinuous sucrose gradient comprised of 2 ml 70% sucrose, 4 ml 30% sucrose and 1.5 ml 20% sucrose contained in 50 mM MOPS buffer (pH 6.8). A 2 ml volume of cell extract was overlaid on the gradient and centrifuged at 200,000 × g for 2 h in a Beckman type 50 Ti rotor. The brown band containing membranes at the 30% and 70% sucrose interface was collected and stored at -80°C until use. Purification of the αε component (CdhAE) of the CO dehydrogenase/acetyl-CoA synthase complex All purification steps and biochemical assays were performed anaerobically in the anaerobic chamber. Crude cell extract of acetate-grown M. acetivorans was centrifuged at 200,000 × g for 2 h to pellet the membrane fraction.

The cells were filtered

The cells were filtered SC75741 clinical trial through 80 μm mesh (Becton Dickinson Co., USA) to obtain a single cell suspension before analysis and sorting. Analysis and sorting were performed on a FACSVantage II (Becton Dickinson Co., USA). The Hoechst 33342 dye was excited at 355 nm and its fluorescence was dual-wavelength analyzed with emission for Hoechst blue at 445 nm, and Hoechst red at 650 nm. RNA isolation and miRNA microarray Total RNA from two groups of SP cells was isolated using TRIZOL reagent (Invitrogen) according to the instructions of the supplier and was further purified using an RNeasy mini kit (Qiagen, Valencia, CA USA). The miRCURY Hy3/Hy5

labeling kit (Exiqon) was used to label purified miRNA with Hy3TM fluorescent dye. Labeled samples were hybridized Selleckchem Emricasan on the miRCURY LNA (locked nucleic acid) Array (v.11.0, Exiqon, Denmark). Each sample was run in quadruplicate. Labeling efficiency was evaluated by analyzing signals from control spike-in capture probes. LNA-modified capture probes corresponding to human, mouse, and rat mature sense miRNA sequences based on Sanger’s miRBASE version 13.0 were spotted onto the slides. The hybridization was carried out according to the manufacturer’s instructions; a 635 nm laser was used to scan the slide using the Agilent G2505B. Data

were analyzed using Genepix Pro 6.0. Statistical analysis Signal intensities for each spot were calculated by subtracting local background (based on the median intensity of the area surrounding each spot) from total intensities. An average value of the three spot replicates of each miRNA

was generated after data transformation (to convert any negative value to 0.01). Normalization was performed using a per-chip 50th percentile method that normalizes each chip on its median, allowing comparison among chips. In two class comparisons (embryonic hepatocytes SP vs. HCC SP), differentially expressed miRNAs were identified using the adjusted t-test procedure within the Significance Analysis of Microarrays (SAM). The SAM Excel plug-in used here calculated Florfenicol a score for each gene on the basis of the observed change in its expression relative to the standard deviation of all measurements. Because this was a multiple test, permutations were performed to calculate the false discovery rate (FDR) or q value. miRNAs with fold-changes greater than 2 or less than 0.5 were considered for further analysis. Hierarchical clustering was generated for both up-regulated and down-regulated genes and conditions using standard correlation as a measure of similarity. Real-time polymerase chain reaction (real-time RT-PCR) analysis To compare the expression of AFP and CK-7 between SP and non-SP and validate the differential expression of miRNAs in SP fractions, we applied real-time RT-PCR analysis to sorted cells. Specially, stem-loop primers were used for reverse transcription reaction of miRNAs [14].

7 fmol; c) relative abundance tests were performed on 1 fmol E c

7 fmol; c) relative abundance tests were performed on 1 fmol E. coli PCR amplicon, mixed with human genomic DNA extracted

from whole blood, at decreasing concentrations, from 4%, down to 0.02%; d) LDR experiments on the eight faecal samples were performed on 50 fmol of PCR product. Data analysis All arrays were scanned with ScanArray 5000 scanner (Perkin Elmer Life Sciences, Boston, MA, USA), at 10 μm resolution. In the experiments, the fluorescent images were obtained with different acquisition parameters on both laser power and photo-multiplier gain, in order to avoid saturation. IF were quantitated by ScanArray Express 3.0 software, using the “”Adaptive circle”" option, letting diameters vary from 60 to 300 μm. TGF-beta inhibitor No normalization procedures on the IFs JAK cancer have been performed. To assess whether a probe pair was significantly above the background (i.e. was “”present”" or not), we performed a one-sided t-test (α = 0.01). The criteria was relaxed to α = 0.05 for sensitivity tests. The null distribution was set as the population of “”Blank”" spots (e.g. with no oligonucleotide spotted, n = 6). Two times the standard deviation of pixel intensities of the same spots

was added to obtain a conservative estimate. For each zip-code, we considered the population of the IFs of all the replicates (n = 4) and tested it for being significantly above the null-distribution (H0: μtest = μnull; H1: μtest>μnull). In case one replicate in the test population was below 2.5 times the distribution mean, this was considered an outlier and was discarded from the analyses. We calculated the ratio between the signal intensities of the next specific probes on the blank intensity (SNRs) and the ratio between all the other probes and

the blank intensity (SNRns). Clustering Hierarchical clustering of HTF-Microbi.Array profiles was carried out using the statistical software R http://​www.​r-project.​org. The Euclidean distance among sample profiles was calculated and Ward’s method was used for agglomeration. Acknowledgements This work was funded by the Micro(bi)array project of the University of Bologna, Italy. Our thanks to Maria Vurchio for help with administrative issues and to Giada Caredda for the support in the experimental phase. Electronic supplementary material Additional file 1: HTF-Microbi.Array target groups. Phylogenetically related groups target of the HTF-Microbi.Array. (XLS 74 KB) Additional file 2: HTF-Microbi.Array probe list. Table of the 30 designed probe pairs. Sequences (5′ -> 3′) for both DS and CP are reported, as well as major thermodynamic parameters (melting temperature, length, number of degenerated bases). (DOC 78 KB) Additional file 3: Specificity tests of the HTF-Microbi.Array.

Phylogenetic support Tribe Arrhenieae appears as a strongly suppo

Phylogenetic support Tribe Arrhenieae appears as a strongly supported monophyletic clade in our four-gene backbone (97 % MLBS; 1.0 BPP), Supermatrix (99 % MLBS) and ITS-LSU (97 % MLBS) analyses,

HDAC inhibitor and moderately supported in our LSU analysis (67 % MLBS). Similarly, Lawrey et al. (2009) show strong support for a monophyletic Arrhenieae using a combined ITS-LSU data set (96 % MPBS and 100 % MLBS). Only our ITS analysis shows tribe Arrhenieae as a paraphyletic grade. Genera included Arrhenia, Acantholichen, Cora, Corella, Cyphellostereum, Dictyonema and Eonema. Comments The monophyly of the new tribe Arrhenieae, established by Lawrey et al. (2009), is confirmed here. It includes the non-lichenized genera Arrhenia s.l. (paraphyletic) and Eonema and the genera lichenized with cyanobacteria — Acantholichen, Cora, Corella, Cyphellostereum, and Dictyonema (Dal-Forno et al. 2013). In the analyses by Dal-Forno et al. (2013), Corella appears as a sister clade to Acantholichen with strong support in their combined ITS-LSU-RPB2 analysis (91 % MLBS; 0.98 BPP). Acantholichen P.M. Jørg., Bryologist 101: 444 (1998). Type species: Acantholichen pannarioides P.M. Jørg., Bryologist 101: 444 (1998). Basidiomata absent; lichenized, thallus small, squamulose-sordiate, appearing on the margins of the foliose lichen; acanthohyphidia present;

internal structure homomerous, composed of jigsaw cells; clamp connections Selleckchem HSP990 absent. Phylogenetic support Acantholichen is represented only by the type of this monotypic genus in Galeterone our Supermatrix

analysis (57 % MLBS), where it appears as sister to Corella. Similarly, the combined ITS-LSU- RPB2 analyses by Dal-Forno et al. (2013), show Acantholichen as sister to Corella (91 % MLBS, 1.0 B.P. with 88 % MLBS and 1.0 BPP support for the branch that subtends both). Species included Type species: Acantholichen pannarioides. The genus is currently monotypic, but two undescribed species have been found in Brazil and the Galapagos Islands. Comments Acantholichen was originally classified as an ascolichen because basidiomata are absent, and the spiny structures indicated placement in the Pannariaceae. Jørgensen (1998) reinterpreted the spiny structures as basidiomycete dendrohyphidia. Cora Fr., Syst. orb. veg. (Lundae) 1: 300 (1825). Type species: Cora pavonia (Sw.) Fr., Syst. orb. veg. (Lundae) 1: 300 (1825), ≡ Thelephora pavonia Sw., Fl. Ind. Occid. 3: 1930 (1806). Basidiomes stereoid-corticioid; hymenium smooth; lichenized with cyanobacteria, thallus thelephoroid or foliose-lobate, gray and white; jigsaw shaped sheath cells present; clamp connections present. Phylogenetic support Only a few representatives of Cora were included in our analyses – as Dictyonema minus isotype, Cora glabrata R06 & C. glabrata s.l. AFTOL. The ITS-LSU analysis of Lawrey et al. (2009) places D.

The genes required for TCP synthesis and the genes encoding the v

The genes required for TCP synthesis and the genes encoding the virulence transcriptional activators ToxT and TcpP are located on a 40-kb Vibrio pathogenicity island (VPI) [4]. Coordinate expression of V. cholerae virulence genes results from the activity of a cascading system of regulatory factors [5] (Fig. 1). Figure 1 The ToxR regulon. AphA and

AphB are known to activate tcpPH expression. TcpPH and ToxRS activate the expression of ToxT, which in turn activates the expression of the central virulence factors, cholera toxin (CT) and the toxin-coregulated pilus (TCP). ToxRS also upregulates OmpU and downregulates OmpT, which are outer membrane porins. The primary direct transcriptional activator of V. cholerae virulence genes, including ctxAB and tcpA, is ToxT, a member of the

AraC family of proteins [6]. The expression of ToxT is under the control of a complex regulatory pathway. The ToxR protein was identified as the first positive Doxorubicin regulator of V. cholerae virulence genes [7]. ToxR activity requires the presence of another protein, ToxS, which is also localized to the inner membrane, but is thought to reside predominantly in the periplasm, where ToxR and ToxS are hypothesized to interact. ToxS serves as a mediator of ToxR function, perhaps by influencing its stability and/or capacity to dimerize [6]. To regulate expression of toxT, ToxR acts in conjunction with a second transcriptional activator, TcpP, which is also membrane-localized with a cytoplasmic DNA-binding and other periplasmic domains [8]. TcpP, like ToxR, requires the presence of a membrane-bound GPCR Compound Library research buy effector protein, TcpH, which interacts with TcpP [9]. Two activators encoded by unlinked genes, AphA and AphB, regulate the transcription of tcpPH. AphA is a dimer with an N-terminal winged-helix DNA binding domain that is structurally similar to those of MarR family transcriptional regulators [10]. AphA cannot activate transcription of tcpP alone, but requires interaction with the LysR-type Nutlin-3 cell line regulator AphB that binds downstream of the AphA binding site [11]. The ToxR and ToxS regulatory proteins have long been

considered to be at the root of the V. cholerae virulence regulon, called the ToxR regulon. The membrane localization of ToxR suggests that it may directly sense and respond to environmental signals such as temperature, osmolarity, and pH [12]. In addition to regulating the expression toxT, ToxR activates the transcription of ompU and represses the transcription of ompT, outer membrane porins important for V. cholerae virulence [13, 14]. Microarray analysis indicates that ToxR regulates additional genes, including a large number of genes involved in cellular transport, energy metabolism, motility, and iron uptake [15]. It has been reported that levels of ToxR protein appear to remain constant under various in vitro conditions [16, 17] and are modulated by the heat shock response [18].

Increase of this resistance pattern has led to a progressive expa

Increase of this resistance pattern has led to a progressive expansion of carbapenems use, because this class of antibiotics was traditionally considered ROCK inhibitor the last resort for managing ESBL producers Enterobacteriaceae. The inevitably increased carbapenem consumption has been associated to increasing carbapenemase production among Enterobacteriaceae. The recent rapid spread of serine carbapenemase in Klebsiella pneumoniae (KPC) is now an additional major threat for antimicrobial therapy in hospitals worldwide, and stresses the concept that the use of carbapenems must be mandatorily optimized in terms of indication and exposure [42].

Also Acinetobacter spp have worldwide shown similar alarming rates of increasing resistance to antibiotics. Today, Carbapenem-resistant A. baumannii-producing oxacillinases retaining susceptibility to only colistin and tigecycline is an ominous reality in hospitals worldwide and compounding this

problem is the paucity of new antibiotics under development to address it [43]. In hospital acquired IAIs also P. aeruginosa plays an important – although less critical than in other settings – role. The high intrinsic antibiotic resistance of this pathogen, together with its extraordinary capacity for acquiring additional resistances through chromosomal mutations, should be always taken into consideration. Among multidrug resistant Gram PLX4032 cell line positive bacteria, Enterococci remain a challenge despite the availability of large number of antimicrobial agents theoretically active against this species. The clinical management of enterococcal infection remains ID-8 challenging, mainly because no single agent could be anticipated to exert strong bactericidal activity against them. Clinical

patient’s severity This choice of the antimicrobial regimen poses serious problems for the management of critically ill patients. In patients with severe sepsis or septic shock an early correct empirical antimicrobial therapy has a significant impact on the outcome, independently by the site of infection [44]. This data confirm the results of Riché and coll. who demonstrated, in a prospective observational study involving 180 consecutive patients with secondary generalized peritonitis, a significantly higher mortality rate in septic shock (35 versus 8% for patients without shock) [45]. Recent international guidelines for the management of severe sepsis and septic shock (Surviving Sepsis Campaign) [6] recommend intravenous antibiotics within the first hour after severe sepsis and septic shock are recognized, use of broad-spectrum agents with good penetration into the presumed site of infection, and reassessment of the antimicrobial regimen daily to optimize efficacy, prevent resistance, avoid toxicity and minimize costs [6].