Mucus

Mucus is a clear, slippery, gel-like substance that’s part of your immune system. It lines your mucous membranes and helps trap and destroy or clear out germs and harmful particles. Mucus gets thick and sticky and might be white, yellow or green when you have an infection. It’s also called phlegm, snot or sputum.

What is mucus?

Mucus is a slippery fluid that lines your respiratory, digestive, urinary and reproductive tracts. It acts like a shield to keep out harmful germs (pathogens) while also letting in things your body needs, like oxygen and nutrients. It also lubricates and moisturizes organs and structures in your body.

You might know mucus by one of its other names, like snot, phlegm or sputum. And you probably only think about it when you’re trying to get rid of it — like when there’s far too much mucus dripping from your nose or clogging your throat. But mucus is an important part of your immune system that’s constantly putting itself in harm’s way to keep you safe.

Function

What does mucus do?

Mucus has a lot of important jobs, including:

• Blocking germs and harmful particles from getting into your body’s tissues.
• Housing antibodies to disable and mark germs for destruction by immune cells.
• Trapping things that could harm you and moving them out of your body.
• Moisturizing your mucous membranes (mucosa) — the parts of your body that open to the outside world.
• Lubricating your mucous membranes. This helps different parts of your body perform different functions. For instance, it helps food move through your digestive tract and provides a way for sperm to get to an egg for fertilization in your reproductive tract (cervical mucus).

Anatomy

Where does mucus come from?

Goblet cells — specialized epithelial cells that are shaped a bit like a fancy drinking glass — and other cells in your mucosa create mucin, the main component of mucus. Mucus lines your:

• Sensory organs — your eyes, ears, mouth and nose.
• Respiratory system.
• Digestive system.
• Urinary system.
• Female reproductive system.
• Male reproductive system.

What’s in mucus?

The “ingredients” that make up mucus give it its consistency and help protect you from germs. They include:

• Water.
• Electrolytes.
• Enzymes.
• Antibodies (immunoglobulins).
• White blood cells.
• Mucin, a type of protein that gives mucus its gel-like consistency.

What does mucus look like?

Mucus is usually clear, thin and slippery. If you have a respiratory or sinus infection, the mucus coming out of your nose or throat may be thick, sticky and creamy white. Dead cells, germs, tobacco smoke and other substances in your mucus can change its color. Mucus colors include:

• White, cream-colored or light yellow. When your mucus gets dense and appears white or creamy, it usually means you’re fighting a cold or other viral infection. The color and thickness come from immune cells fighting the infection.
• Bright yellow or green. This also is usually a sign of infection. Based on your other symptoms and how long they’ve gone on, it could mean you have sinusitis, or a bacterial infection in your sinuses.
• Red or pink. Blood can make your mucus pink-tinged or streak it with red. You might have blood in your mucus if your nose is dried out or irritated. Small blood vessels in your nose can burst and leak blood.
• Brown. Air pollution or smoking can cause brown mucus. It also could be a sign of infection.
• Black. This can be something you inhaled, but it can also be a sign of a serious fungal infection.
• Mucus color alone won’t tell you if you have a specific kind of infection. See a healthcare provider if you have dark-colored mucus — or any other color that concerns you — especially if you have other symptoms, like facial pain or headaches.

What color mucus is healthy?

When you’re not sick, mucus is usually clear. Thick mucus that appears creamy, yellow or green could mean you have an infection. You might get a runny nose with large amounts of clear mucus if you have allergies.

Conditions and Disorders

What conditions affect mucus?

Anything that causes inflammation or activates your immune system can change the amount, color or consistency of mucus in different parts of your body. Hormones and genetic conditions can also affect it. Conditions that affect your mucus include:

• Infections. Being sick with sinusitis or respiratory infections is the most common cause of excess amounts of thick mucus in your nose or throat.
• Allergies or irritants. Allergies and other irritants in your respiratory tract can cause excess clear mucus.
• Lung diseases. Damage to your lungs and airways from bronchiectasis, COPD (chronic obstructive pulmonary disease) and other chronic lung diseases can cause mucus buildup.
• Cystic fibrosis. CF is a genetic disease that creates thick, sticky mucus that gets stuck in your pancreas and lungs.
• Digestive issues. Diverticulitis, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and anything that irritates your digestive tract can cause mucus in your poop (stool).
• Hormone issues. Menopause and conditions that cause low estrogen decrease the amount of mucus in your reproductive tract, which reduces fertility and causes vaginal dryness.
• Cancer. Certain types of cancer can arise from mucin, like mucinous carcinomas.

Care

How do I get rid of mucus?

Most of the time, excess mucus is something you have to deal with when you’re sick, while your body tries to clear out germs and dead immune cells. Some treatments that can help with mucus include:

• Expectorants. Expectorants can thin out thick mucus and help you clear it out of your chest.
• Nasal rinses. These can help break up and clear mucus from your nose and sinuses. Make sure you follow precautions to use them safely.
• Decongestants. Decongestant medications or sprays can temporarily reduce the inflammation and mucus in your nose and throat.
• Antihistamines. These can prevent or calm down allergic reactions that cause too much mucus.
• Mucolytics. Mucolytics treat chronic lung diseases like cystic fibrosis.

Website: International Conference on Infectious Diseases

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Infection Control Guidance: Candida auris

Similar to other multidrug-resistant organisms (MDROs), C. auris spreads easily in healthcare settings and can cause outbreaks. C. auris can colonize patients for many months, persist on surfaces, and is not killed by some commonly used healthcare facility disinfectants. Hand hygiene, appropriate precautions, and environmental disinfection prevent and control outbreaks.

Summary of recommendations

The primary infection control measures for prevention of C. auris transmission in healthcare settings are:

• Hand hygiene.
• Setting-based precautions.
• Environmental disinfection with product effective against C. auris.
• Patient transfers that communicate patient's C. auris status.

In most instances, facilities equipped to care for patients with other multidrug-resistant organisms (MDROs) or Clostridioides difficile can also care for patients with C. auris.

Environmental disinfection

C. auris can persist on surfaces in healthcare settings. C. auris has been cultured from multiple locations in patient rooms. The fungus has been found on both high-touch surfaces, such as bedside tables and bedrails, and surfaces farther away from the patient, such as windowsills.

Surface Disinfectants

Several common hospital disinfectants are not effective against C. auris. Some products with C. albicans or fungicidal claims may not be effective against C. auris. Accumulating data indicate that products solely dependent on quaternary ammonia compounds (QACs) are NOT effective.

Products with EPA-registered claims for C. auris (List P)

CDC recommends using an Environmental Protection Agency (EPA)–registered hospital-grade disinfectant effective against C. auris. See EPA's List P for a current list of EPA-approved products for C. auris.

If the products on List P are not accessible or otherwise suitable, facilities may use an EPA-registered hospital-grade disinfectant effective against C. difficile spores (List K).

It is important to follow all manufacturer's directions for use, including applying the product for the correct contact time for all products.

“No-touch” devices

Research about disinfection effective against C. auris is ongoing. Data on "no-touch" devices, such as germicidal UV irradiation and vaporized hydrogen peroxide, are limited. The parameters required for effective disinfection are not yet well understood. These methods should only be used as a supplement to standard cleaning and disinfection methods.

Thorough routine and terminal discharge

Perform thorough routine (at least daily) and terminal cleaning and disinfection of patients' rooms and areas where patients receive care. Appropriately disinfect radiology, physical therapy, and other areas of the hospital patients may have visited.

Mobile and reusable equipment

Medical equipment that is shared between patients can spread C. auris. Clean and disinfect equipment after each use. Label disinfected equipment and separate it from dirty equipment.

• Examples include:Glucometers
• Temperature probes
• Blood pressure cuffs
• Ultrasound machines
• Nursing carts
• Ventilators
• Physical therapy equipment

CDC and health department outbreak investigations have found that healthcare personnel are not always aware of ftheir responsibilities for cleaning mobile and shared equipment.

Responsibilities for cleaning all mobile and reusable equipment should be well-established. Healthcare personnel should be aware of which equipment they are responsible to clean and trained in disinfection methods.

Hand hygiene

When caring for patients with C. auris, healthcare providers should follow standard hand hygiene practices. Alcohol-based hand sanitizer is preferred for C. auris when hands are not visibly soiled. If hands are visibly soiled, wash with soap and water. Wearing gloves is not a substitute for hand hygiene.

Transmission-Based and Enhanced Barrier Precautions

The Transmission-Based Precautions and Enhanced Barrier Precautions for C. auris are similar to those used for other multidrug-resistant organisms (MDROs). In most instances, facilities equipped to care for patients with other MDROs or Clostridioides difficile can also care for patients with C. auris.

In acute care and long-term acute care hospitals, healthcare providers should use Contact Precautions. In nursing homes and skilled nursing facilities, healthcare providers should use either Contact Precautions or Enhanced Barrier Precautions (EBP), based on the situation and local or state jurisdiction recommendations.

Refer to the CDC Guidance on Enhanced Barrier Precautions for more details about when Contact Precautions versus Enhanced Barrier Precautions would apply.
Considerations for patient room placement

Hospitals and nursing homes

Patients on Contact Precautions should be placed in a single-patient room whenever possible. In situations where limited single-rooms are available, prioritize placing patients with higher likelihood of transmission (such as those with uncontained secretions or excretions, diarrhea, and draining wounds).

Facilities can group C. auris patients together in a dedicated unit or part of a unit. This decreases movement of healthcare personnel and equipment to non-affected areas. Facilities could also consider dedicating healthcare personnel (e.g., nurses, nursing assistants) who provide regular care to these patients during a shift.

In nursing homes, facilities with the capacity may consider placing patients with C. auris in single-patient rooms. Healthcare providers can find recommendations about patient placement in nursing homes using Enhanced Barrier Precautions (EBP) in CDC's FAQs about Enhanced Barrier Precautions in Nursing Homes.

When single rooms are not available, facilities may choose to cohort patients with C. auris together in the same room. It is preferable to cohort patients with the same MDROs together. However, facilities may assign rooms based on single (or a limited number of) high-concern MDROs (e.g., C. auris or carbapenemase-producing Enterobacterales) without regard to co-colonizing organisms.

Reducing transmission in cohort settings

Facilities must implement strategies to help minimize transmission between roommates when patients are placed in shared rooms. The following strategies apply for all shared rooms, regardless of patient colonization or infection status:

• Maintain separation of at least 3 feet between beds.
• Use privacy curtains to limit direct contact.
• Clean and disinfect as if each bed area were a different room.
• Clean and disinfect any shared or reusable equipment.
• Change mopheads, cleaning cloths, and other cleaning equipment between bed areas.
• Clean and disinfect environmental surfaces on a more frequent schedule.
• Have healthcare personnel change personal protective equipment (if worn), including gloves.
• Perform hand hygiene before and after interaction with each roommate.

Website: International Conference on Infectious Diseases

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What To Know About Amino Acids

Amino acids are the building blocks of protein. Proteins and the amino acids they are made from are necessary to make or repair protein tissues, which include muscles, bones, cartilage, skin, and blood.1 There are 20 amino acids, including nine essential amino acids that your body cannot produce itself.

Your body digests or breaks up protein into amino acids when you eat protein-rich foods, like beans, tofu, dairy products, eggs, seafood, or whole grains. Your body absorbs amino acids from your digestive tract into your bloodstream.

Types of Essential Amino Acids

Plant and animal proteins are made up of about 20 common amino acids. Amino acids are "essential," which means you must consume them from foods. These are also referred to as "indispensable amino acids." Your body cannot survive without them.

Lopez MJ, Mohiuddin SS. Biochemistry, essential amino acids. In: StatPearls. StatPearls Publishing; 2024.

Essential amino acids include:

• Histidine: Helps make histamine, which is a neurotransmitter that aids in immune function, digestion, and sleep
• Isoleucine: Aids in the production of hemoglobin (an essential part of red blood cells that carries oxygen throughout your body)
• Leucine: Helps the body make proteins that aid in muscle growth and repair and regulates blood glucose (sugar) levels
• Lysine: Assists your body in the absorption of calcium and formation of collagen, both of which are important for muscle and bone health
• Methionine: Can be converted into molecules that contain sulfur that protect your tissues, repair DNA, and support cell function
• Phenylalanine: Is the precursor for dopamine and norepinephrine, which have antidepressant effects
• Threonine: Breaks down fat build-up in your liver and can reduce indigestion and gut problems
• Tryptophan: Helps your body make melatonin (regulates the sleep-wake cycle) and serotonin (regulates appetite, mood, pain, and sleep)
• Valine: Promotes muscle growth and repair and is thee precursor for the synthesis of penicillin

Nonessential

You do not need to consume nonessential amino acids, also known as "dispensable," from food. Your body can make these amino acids using only the nine essential amino acids.

Nonessential amino acids include:

• Alanine
• Arginine
• Asparagine
• Aspartic acid
• Cysteine
• Glutamic acid
• Glutamine
• Glycine
• Proline
• Serine
• Tyrosine

Conditionally Essential

Certain amino acids are conditionally essential. It depends on your overall health. Certain disease states can cause an amino acid to become conditionally essential.

A healthy adult may be able to make the nonessential amino acid tyrosine from phenylalanine, which is an essential amino acid. A young child may not have developed the enzyme needed to do this, which would make tyrosine an essential amino acid for them.

There are seven nonessential amino acids that sometimes become conditionally essential, such as:

• Arginine
• Cysteine
• Glutamine
• Glycine
• Proline
• Serine
• Tyrosine

Amino Acid Structure

Amino acids contain the elements carbon, hydrogen, oxygen, and nitrogen. A carbon atom is located at the center of an amino acid.

The carbon atom forms a bond with a hydrogen atom, an amino group, a carboxylic acid group, and an R group. An R group is a unique side chain that differentiates between each amino acid. Amino acids can connect to form a protein, which creates a 3D shape.

Benefits

Amino acids are the building blocks of proteins, which are essential for muscle, bone, and skin health. Each amino acid has different benefits, but they generally perform functions like:

• Aid in the synthesis of hormones and neurotransmitters
• Break down food
• Grow and repair muscles
• Help support digestive and immune function
• Provide energy
• Strengthen skin, hair, and nail health

How To Get Enough Amino Acids

It's best to consume a variety of foods, which will supply a wide array of amino acids. You can also take amino acids in supplement form. It's important to talk to a healthcare provider before starting a new supplement.

You do not need to consume animal-based foods to meet all of your amino acid needs, including the nine essential amino acids.144 A varied diet also helps you take in a broad range of other nutrients, like vitamins, minerals, and fiber.

You do not need to worry about a strategy called food combining if you eat a plant-based diet. Food combining means pairing a plant food that's low in one amino acid with another that's high, like eating beans and rice together.3 You can obtain all of the amino acids in adequate amounts, even on a fully plant-based diet, if you eat a wide variety of foods overall.

What Foods Have Amino Acids?

Amino acids come from food, including plant-based and animal-based foods. Some foods provide more total protein—and therefore, more amino acids—than others per serving.

You can find amino acids in foods like:

• Beans, lentils, and peas
• Dairy products
• Eggs
• Fruits
• Nuts and seeds
• Seafood, poultry, and meat
• Soy products, like tofu and tempeh
• Vegetables
• Whole grains

It's a common belief that most plant foods are missing certain amino acids. The truth is that all plant foods contain all 20 amino acids. The amounts of some amino acids are simply low in certain sources, not absent.

Website: International Conference on Infectious Diseases

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Innovative TB risk scoring tool enhances patient care and workflow

Caitlin Dugdale, MD, MSc, and Kimon Zachary, MD, physicians in the Division of Infectious Diseases at Massachusetts General Hospital (MGH) and assistant professors of Medicine at Harvard Medical School, are co-lead authors of a new study in Infection Control and Hospital Epidemiology, TB or Not TB? Development and Validation of a Clinical Decision Support System for the Evaluation of Suspected Tuberculosis.

Erica Shenoy, MD, PhD, Chief of Infection Control at Mass General Brigham and an Associate Professor of Medicine at Harvard Medical School, is senior author of the study.

Summary:

Patients with suspected tuberculosis (TB) require special precautions in healthcare facilities, and cases of TB have been rising in the US over the past several years. These precautions include isolating persons with suspected TB in patient rooms with specialized air handling known as airborne infection isolation rooms.

To improve our ability to assess patients for potential TB infections, we developed a TB risk scoring tool by reviewing past patient data. This tool was then integrated into the electronic health record with the label "TB or Not TB."

The tool helps clinicians assess, once their TB workup is complete and apparently negative, whether infection control precautions can be discontinued, ensuring accurate decisions for TB isolation, alleviating workload and improving patient experience.

The tool has been validated and is now in use at all MGB sites.

Background:

Infection Prevention and Control (IPC) programs are tasked with implementing the appropriate isolation of patients with suspected or confirmed communicable diseases to reduce the risk of healthcare-associated infections to patients and mitigate occupational risks to healthcare personnel.

However, patient isolation can negatively impact clinical workflows, access to care, and hospital capacity, highlighting the critical importance of safe and efficient deisolation protocols. System-based solutions for isolation and deisolation, including clinical decision support tools, are increasingly needed to:

• Support patient and healthcare personnel safety
• Reduce cognitive and administrative burden on clinicians
• Enhance clinician well-being

A team of infection prevention experts, infectious disease physicians and researchers at Massachusetts General Hospital (MGH) developed a risk scoring tool by reviewing the records of past patients who had been diagnosed with TB and those who had been deemed at risk but turned out not to have TB. They created a validated model to assess the likelihood of TB infection before discontinuing isolation precautions.

Then this same team joined with developers in clinical informatics and digital health to program the scoring model into the electronic health record in the form of a tool called "TB or Not TB."

If a patient is identified as needing evaluation for TB, they are labeled as "TB-Risk," prompting the correct isolation in the specialized hospital room and use of personal protective equipment. Once the healthcare provider believes, given the patient's symptoms, test results and/or risk factors, that TB is no longer a possibility, they can use the TB or Not TB tool to determine if it is safe to discontinue isolation precautions.

What are the clinical implications and next steps?

This tool will positively impact patient care and clinician workflows. In a rigorous analysis of TB evaluations across the MGB system over six years, the tool correctly identified all instances in which TB infection was present and ensured that all those patients would remain safely isolated during their work up.

At the same time, the tool was able to identify about a quarter of cases where TB was highly unlikely. This allows tool those patients to come out of isolation safely and efficiently, which may increase bed capacity, alleviate workload, reduce the time spent on infection control consultations, and improve the patient experience.

Website: International Conference on Infectious Diseases

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