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This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death. "In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, Ph.D., principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future. "Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," he said. "Hospitals and other health care providers must act now to protect patients from this growing menace." Laxminarayan and his colleagues analyzed 69 million discharge records from hospitals in 40 states and identified two conditions caused by health care-associated infections: sepsis, a potentially lethal systemic response to infection and pneumonia, an infection of the lungs and respiratory tract. The researchers looked at infections that developed after hospitalization. They zeroed in on infections that are often preventable, like a serious bloodstream infection that occurs because of a lapse in sterile technique during surgery, and discovered that the cost of such infections can be quite high: For example, people who developed sepsis after surgery stayed in the hospital 11 days longer and the infections cost an extra $33,000 to treat per person. Even worse, the team found that nearly 20 percent of people who developed sepsis after surgery died as a result of the infection. "That's the tragedy of such cases," said Anup Malani, a study co-author, investigator at Extending the Cure, and professor at the University of Chicago. "In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control—and they can die." The team also looked at pneumonia, an infection that can set in if a disease-causing microbe gets into the lungs—in some cases when a dirty ventilator tube is used. They found that people who developed pneumonia after surgery, which is also thought to be preventable, stayed in the hospital an extra 14 days. Such cases cost an extra $46,000 per person to treat. In 11 percent of the cases, the patient died as a result of the pneumonia infection.

George Whitesides has developed a prototype for paper "chip" technology that could be used in the developing world to cheaply diagnose deadly diseases such as HIV, malaria, tuberculosis, hepatitis and gastroenteritis. The first products will be available in about a year, he said. His efforts, which find their inspiration from the simple designs of comic books and computer chips, are surprisingly low-tech and cheap. Patients put a drop of blood on one side of the slip of paper, and on the other appears a colorful pattern in the shape of a tree, which tells medical professionals whether the person is infected with certain diseases. Water-repellent comic-book ink saturates several layers of paper, he said. The ink funnels a patient's blood into tree-like channels, where several layers of treated paper react with the blood to create diagnostic colors. It's not entirely unlike a home pregnancy test, Whitesides said, but the chips are much smaller and cheaper, and they test for multiple diseases at once. They also show how severely a person is infected rather than producing only a positive-negative reading.

The team observed viruses as they evolved over hundreds of generations to infect bacteria. They found that when the bacteria could evolve defences, the viruses evolved at a quicker rate and generated greater diversity, compared to situations where the bacteria were unable to adapt to the viral infection. The study shows, for the first time, that the American evolutionary biologist Leigh Van Valen was correct in his 'Red Queen Hypothesis'. The theory, first put forward in the 1970s, was named after a passage in Lewis Carroll's Through the Looking Glass in which the Red Queen tells Alice, 'It takes all the running you can do to keep in the same place'. This suggested that species were in a constant race for survival and have to continue to evolve new ways of defending themselves throughout time. Dr Steve Paterson, from the University's School of Biosciences, explains: "Historically, it was assumed that most evolution was driven by a need to adapt to the environment or habitat. The Red Queen Hypothesis challenged this by pointing out that actually most natural selection will arise from co-evolutionary interactions with other species, not from interactions with the environment. "This suggested that evolutionary change was created by 'tit-for-tat' adaptations by species in constant combat. This theory is widely accepted in the science community, but this is the first time we have been able to show evidence of it in an experiment with living things." Dr Michael Brockhurst said: "We used fast-evolving viruses so that we could observe hundreds of generations of evolution. We found that for every viral strategy of attack, the bacteria would adapt to defend itself, which triggered an endless cycle of co-evolutionary change. We compared this with evolution against a fixed target, by disabling the bacteria's ability to adapt to the virus. "These experiments showed us that co-evolutionary interactions between species result in more genetically diverse populations, compared to instances where the host was not able to adapt to the parasite. The virus was also able to evolve twice as quickly when the bacteria were allowed to evolve alongside it."

"As far as we can tell, this is the first time this type of behavior has been reported in cells that are part of a larger organism," says Peter T. Cummings, John R. Hall Professor of Chemical Engineering, who directed the study that is described in the March 10 issue of the Public Library of Science journal PLoS ONE. The discovery was the unanticipated result of a study the Cummings group conducted to test the hypothesis that the freedom with which different cancer cells move - a concept called motility - could be correlated with their aggressiveness: That is, the faster a given type of cancer cell can move through the body the more aggressive it is. "Our results refute that hypothesis—the correlation between motility and aggressiveness that we found among three different types of cancer cells was very weak," Cummings says. "In the process, however, we began noticing that the cell movements were unexpectedly complicated." Then the researchers' interest was piqued by a paper that appeared in the February 2008 issue of the journal Nature titled, "Scaling laws of marine predator search behaviour." The paper contained an analysis of the movements of a variety of radio-tagged marine predators, including sharks, sea turtles and penguins. The authors found that the predators used a foraging strategy very close to a specialized random walk pattern, called a Lévy walk, an optimal method for searching complex landscapes. At the end of the paper's abstract they wrote, "...Lévy-like behaviour seems to be widespread among diverse organisms, from microbes to humans, as a 'rule' that evolved in response to patchy resource distributions." This gave Cummings and his colleagues a new perspective on the cell movements that they were observing in the microscope. They adopted the basic assumption that when mammalian cells migrate they face problems, such as efficiently finding randomly distributed targets like nutrients and growth factors, that are analogous to those faced by single-celled organisms foraging for food. With this perspective in mind, Alka Potdar, now a post-doctoral fellow at Case Western Reserve University and the Cleveland Clinic, cultured cells from three human mammary epithelial cell lines on two-dimensional plastic plates and tracked the cell motions for two-hour periods in a "random migration" environment free of any directional chemical signals. Epithelial cells are found throughout the body lining organs and covering external surfaces. They move relatively slowly, at about a micron per minute which corresponds to two thousandths of an inch per hour. When Potdar carefully analyzed these cell movements, she found that they all followed the same pattern. However, it was not the Lévy walk that they expected, but a closely related search pattern called a bimodal correlated random walk (BCRW). This is a two-phase movement: a run phase in which the cell travels primarily in one direction and a re-orientation phase in which it stays in place and reorganizes itself internally to move in a new direction. In subsequent studies, currently in press, the researchers have found that several other cell types (social amoeba, neutrophils, fibrosarcoma) also follow the same pattern in random migration conditions. They have also found that the cells continue to follow this same basic pattern when a directional chemical signal is added, but the length of their runs are varied and the range of directions they follow are narrowed giving them a net movement in the direction indicated by the signal.