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In summary, accumulating evidence points to metabolism as a key determinant of meningococcal colonization and invasion, with important differences between hypervirulent and carrier strains ( Table 2 )
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This catabolic state leads to anabolic resistance, tipping the balance between protein synthesis and degradation towards net catabolism in critically ill patients (67,68)
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FDA approval was part of new pilot program The FDA reviewed data from the STEP UP trial when considering this approval
