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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.

During evolution, living species have adapted to environmental constraints according to the mechanism of natural selection; when a mutation that aids the survival (and reproduction) of an individual appears in the genome, it then spreads throughout the rest of the species until, after several hundreds or even thousands of generations, it is carried by all individuals. But does this selection, which occurs on a specific gene in the genome of a species, also occur on the same gene in neighboring species? On which set of genes has natural selection acted specifically in each species? Researchers in the Dynamique et Organisation des Génomes team at the Institut de Biologie of the Ecole Normale Supérieure (CNRS/ENS/INSERM) have studied the genome of humans and three other primate species (chimpanzee, orangutan and macaque) using bioinformatics tools. Their work consisted in comparing the entire genomes of each species in order to identify the genes having undergone selection during the past 200,000 years. The result was that a few hundred genes have recently undergone selection in each of these species. These include around 100 genes detected in man that are shared by two or three other species, which is twice as many as might be anticipated as a random phenomenon. Thus a not inconsiderable proportion of the genes involved in human adaptation are also present in the chimpanzee, orangutan or macaque, and sometimes in several species at the same time. Natural selection acts not only by distancing different species from each other when new traits appear. But by acting on the same gene, it can also give rise to the same trait in species that have already diverged, but still have a relatively similar genome. This study thus provides a clearer understanding of the group of genes that are specifically implicated in human evolution (during the past 200,000 years), as it allows the identification of those genes which did not undergo selection in another primate line. An example that has been confirmed by this study is the well-known case of the lactase gene that can metabolize lactose during adulthood (a clear advantage with the development of agriculture and animal husbandry). The researchers have also identified a group of genes involved in some neurological functions and in the development of muscles and skeleton.

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."