Bacterial Infections and Mycoses Commons^™

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Impact Of A Urinary Tract Infection Treatment Pathway On Antimicrobial Prescribing Within A Community Hospital, Alyssa Donadio, Heidi Clarke, Erika Dittmar

All Publications

No abstract provided.

Risk Stratification Of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture., Paul L. Aronson, Marie E. Wang, Eugene D. Shapiro, Samir S. Shah, Adrienne G. Deporre, Russell J Mcculloh, Christopher M. Pruitt, Sanyukta Desai, Lise E. Nigrovic, Richard D. Marble, Rianna C. Leazer, Sahar N. Rooholamini, Laura F. Sartori, Fran Balamuth, Christopher Woll, Mark I. Neuman, Febrile Young Infant Research Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

Video Abstract: media-1vid110.1542/5840460609001PEDS-VA_2018-1879

OBJECTIVES: To evaluate the Rochester and modified Philadelphia criteria for the risk stratification of febrile infants with invasive bacterial infection (IBI) who do not appear ill without routine cerebrospinal fluid (CSF) testing.

METHODS: We performed a case-control study of febrile infants ≤60 days old presenting to 1 of 9 emergency departments from 2011 to 2016. For each infant with IBI (defined as a blood [bacteremia] and/or CSF [bacterial meningitis] culture with growth of a pathogen), controls without IBI were matched by site and date of visit. Infants were excluded if they appeared ill or had a …

Mycobacterium Tuberculosis Inhibitors: Action And Resistance, Pamela K. Garcia-Moreno

FIU Electronic Theses and Dissertations

Tuberculosis, an infectious disease caused by Mycobacterium tuberculosis, has been a global health problem for years. The emergence of drug resistance in this organism generates the necessity of exploring novel targets and developing new drugs. Topoisomerases are enzymes found in all kingdoms of life responsible for overcoming the topological barriers encountered during essential cellular processes. The genomes of mycobacteria encode only one type IA topoisomerase (MtopI), which has been validated as a novel TB drug target. The goal of this study is to obtain new information on the mechanism and resistance of endogenous and synthetic inhibitors of MtopI.

Rv1495 is …

Azithromycin For Early Pseudomonas Infection In Cystic Fibrosis. The Optimize Randomized Trial., Nicole Mayer-Hamblett, George Retsch-Bogart, Margaret Kloster, Frank Accurso, Margaret Rosenfeld, Gary Albers, Philip Black, Perry Brown, Annemarie Cairns, Stephanie D. Davis, Gavin R. Graff, Gwendolyn S. Kerby, David Orenstein, Rachael Buckingham, Bonnie W. Ramsey, Optimize Study Group

Manuscripts, Articles, Book Chapters and Other Papers

RATIONALE: New isolation of Pseudomonas aeruginosa (Pa) is generally treated with inhaled antipseudomonal antibiotics such as tobramycin inhalation solution (TIS). A therapeutic approach that complements traditional antimicrobial therapy by reducing the risk of pulmonary exacerbation and inflammation may ultimately prolong the time to Pa recurrence.

OBJECTIVES: To test the hypothesis that the addition of azithromycin to TIS in children with cystic fibrosis and early Pa decreases the risk of pulmonary exacerbation and prolongs the time to Pa recurrence.

METHODS: The OPTIMIZE (Optimizing Treatment for Early Pseudomonas aeruginosa Infection in Cystic Fibrosis) trial was a multicenter, double-blind, randomized, placebo-controlled, 18-month trial …

Design, Synthesis, And Evaluation Of Amphiphilic Cyclic And Linear Peptides Composed Of Hydrophobic And Positively-Charged Amino Acids As Antibacterial Agents, Neda Riahifard, Saghar Mozaffari, Taibah Aldakhil, Francisco Nunez, Qamar Alshammari, Saud Alshammari, Jason Yamaki, Keykavous Parang, Rakesh Kumar Tiwari

Pharmacy Faculty Articles and Research

Antimicrobial peptides (AMPs) contain amphipathic structures and are derived from natural resources. AMPs have been found to be effective in treating the infections caused by antibiotic-resistant bacteria (ARB), and thus, are potential lead compounds against ARB. AMPs’ physicochemical properties, such as cationic nature, amphiphilicity, and their size, will provide the opportunity to interact with membrane bilayers leading to damage and death of microorganisms. Herein, AMP analogs of [R₄W₄] were designed and synthesized by changing the hydrophobicity and cationic nature of the lead compound with other amino acids to provide insights into a structure-activity relationship against selected …

Nocardia Brasiliensis Infection After Hurricane Irma: Two Case Reports, Sarah Al-Obaydi Md, James Demaio, Nemer Dabage Md

Infectious Disease

Background: Although an increase in skin and soft tissue infections has been well documented after natural disasters, cases of Nocardia brasiliensis infection have not been included in prior reports. We present two cases of N. brasiliensis lymphadenitis that occurred in Manatee County, Florida after Hurricane Irma.

Methods: Case 1-A 75 year old immune competent male may have injured his arm while retrieving a golf ball approximately four weeks after Hurricane Irma. Ten days later he presented to the hospital with an abscess on his left forearm and a lymphadenitis extending nearly to the axilla. Despite treatment with vancomycin, the lymph …

Interfering With Dna Decondensation As A Strategy Against Mycobacteria, Enzo M. Scutigliani, Edwin R. Scholl, Anita E. Grootemaat, Sadhana Khanal, Jakub A. Kochan, Przemek M. Krawczyk, Eric A. Reits, Atefeh Garzan, Huy X. Ngo, Keith D. Green, Sylvie Garneau-Tsodikova, Jan M. Ruijter, Henk A. Van Veen, Nicole N. Van Der Wel

Pharmaceutical Sciences Faculty Publications

Tuberculosis is once again a major global threat, leading to more than 1 million deaths each year. Treatment options for tuberculosis patients are limited, expensive and characterized by severe side effects, especially in the case of multidrug-resistant forms. Uncovering novel vulnerabilities of the pathogen is crucial to generate new therapeutic strategies. Using high resolution microscopy techniques, we discovered one such vulnerability of Mycobacterium tuberculosis. We demonstrate that the DNA of M. tuberculosis can condense under stressful conditions such as starvation and antibiotic treatment. The DNA condensation is reversible and specific for viable bacteria. Based on these observations, we hypothesized …

Evaluation Of The Diagnostic Accuracy Of Computer-Aided Detection Of Tuberculosis On Chest Radiography Among Private Sector Patients In Pakistan, Syed Mohammad Asad Zaidi, Shifa Salman Habib, Bram Van Ginneke, Rashida Abbas Ferrand, Jacob Creswell, Saira Khowaja, Aamir Khan

Community Health Sciences

The introduction of digital CXR with automated computer-aided interpretation, has given impetus to the role of CXR in TB screening, particularly in low resource, high-burden settings. The aim of this study was to evaluate the diagnostic accuracy of CAD4TB as a screening tool, implemented in the private sector in Karachi, Pakistan. This study analyzed retrospective data from CAD4TB and Xpert MTB/RIF testing carried out at two private TB treatment and diagnostic centers in Karachi. Sensitivity, specificity, potential Xperts saved, were computed and the receiver operator characteristic curves were constructed for four different models of CAD4TB. A total of 6,845 individuals …

Antimicrobial Efficacy And Safety Of A Novel Gas Plasma-Activated Catheter Lock Solution, Sudhir Bhatt, Poonam Mehta, Chen Chen, Dayle A. Daines, Leonard A. Mermel, Hai-Lan Chen, Michael G. Kong

Bioelectrics Publications

Antimicrobial lock solutions are important for prevention of microbial colonization and infection of long-term central venous catheters. We investigated the efficacy and safety of a novel antibiotic-free lock solution formed from gas plasma-activated disinfectant (PAD). Using a luminal biofilm model, viable cells of methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans in mature biofilms were reduced by 6 to 8 orders of magnitude with a PAD lock for 60 min. Subsequent 24-h incubation of PAD-treated samples resulted in no detectable regrowth of viable bacteria or fungi. As a comparison, the use of a minocycline-EDTA-ethanol lock solution for 60 …

Infections Not Fought: Antibiotic Resistance In Underserved Communities, Derek Lillestolen

Senior Honors Theses

In 1928, the profound effects of penicillin were discovered and antibiotic treatments became extremely popular. Broad-spectrum antibiotics, like tetracyclines, have been since branded as cure-all prescriptions and used profusely in the Western World and abroad. Due to ignorance of specific biochemical mechanisms and the misuse of antibiotics these drugs inadvertently allowed the rise in prevalence of antibiotic resistant strains of certain bacteria as the century progressed. Now, the specific genetic causes and mechanisms of antibiotic resistance are being understood, but the fight against antimicrobial resistance is far from over. In the United States, thousands of fatalities are caused annually by …

Bioprospecting Deep-Sea Actinobacteria For Novel Anti-Infective Natural Products, Dongbo Xu, Linna Han, Chunhui Li, Qi Cao, Duolong Zhu, Nolan H. Barrett, Dedra Harmody, Jing Chen, Haining Zhu, Peter J. Mccarthy, Xingmin Sun, Guojun Wang

Molecular and Cellular Biochemistry Faculty Publications

The global prevalence of drug resistance has created an urgent need for the discovery of novel anti-infective drugs. The major source of antibiotics in current clinical practice is terrestrial actinobacteria; the less-exploited deep-sea actinobacteria may serve as an unprecedented source of novel natural products. In this study, we evaluated 50 actinobacteria strains derived from diverse deep water sponges and environmental niches for their anti-microbial activities against a panel of pathogens including Candida albicans, Clostridium difficile, Staphylococcus aureus, and methicillin-resistant S. aureus (MRSA), and Pseudomonas aeruginosa. More than half of the tested strains (27) were identified as …

Microbial Co-Infection Alters Macrophage Polarization, Phagosomal Escape, And Microbial Killing, Nikita H. Trivedi, Jieh-Juen Yu, Chiung-Yu Hung, Richard P. Doelger, Christopher S. Navara, Lisa Y. Armitige, Janakiram Seshu, Anthony P. Sinai, James P. Chambers, M. Neal Guentzel, Bernard P. Arulanandam

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Macrophages are important innate immune cells that respond to microbial insults. In response to multi-bacterial infection, the macrophage activation state may change upon exposure to nascent mediators, which results in different bacterial killing mechanism(s). In this study, we utilized two respiratory bacterial pathogens, Mycobacterium bovis (Bacillus Calmette Guẻrin, BCG) and Francisella tularensis live vaccine strain (LVS) with different phagocyte evasion mechanisms, as model microbes to assess the influence of initial bacterial infection on the macrophage response to secondary infection. Non-activated (M0) macrophages or activated M2-polarized cells (J774 cells transfected with the mouse IL-4 gene) were first infected with BCG for …

Rapid Identification And Typing Of Mycobacterium Avium Complex Using Matrix Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (Maldi-Tof) Library And Biomarker Based Approaches., Claudia Antonika, John Dustin Loy, Raul Barletta, Michael Collins

UCARE Research Products

Bacteria associated with the Mycobacterium avium complex (MAC) cause significant problems in animal agriculture and cause large economic losses and morbidity of livestock. Two clinically important subspecies of M. avium are M.avium ssp paratuberculosis (MAP) and M. avium ssp hominissuis (MAH). MAP is the etiologic agent of Johne’s disease, a chronic and fatal enteritis in ruminants, that has been linked to Crohn’s disease in humans.1 MAH has zoonotic potential as it is one of the leading causes of secondary infections in AIDS patients. Identification of M. avium in clinical samples is challenging as they have overlapping host ranges and clinical …

Loop-Mediated Isothermal Amplification Methods For Diagnosis Of Bacterial Meningitis, Mitsuko Seki, Paul E. Kilgore, Eun Jin Kim, Makoto Ohnishi, Satoshi Hayakawa, Dong Wook Kim

Department of Pharmacy Practice

The rapid, accurate, and efficient identification of an infectious disease is critical to ensure timely clinical treatment and prevention in public health settings. In 2015, meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis was responsible for 379,200 (range: 322,700–444,700) deaths. Clinical features alone cannot determine whether bacterial meningitis is present; an analysis of cerebrospinal fluid (CSF) is essential. Loop-mediated isothermal amplification (LAMP) is a nucleic acid amplification method offering an alternative to polymerase chain reaction (PCR). LAMP-based assays for detection of three leading bacteria in CSF for diagnosis of meningitis have been established. The typing assays …

Gas Plasma Pre-Treatment Increases Antibiotic Sensitivity And Persister Eradication In Methicillin-Resistant Staphylococcus Aureus, Li Guo, Ruobing Xu, Yiming Zhao, Dingxin Liu, Zhijie Liu, Xiaohua Wang, Hailan Chen, Michael G. Kong

Bioelectrics Publications

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of serious nosocomial infections, and recurrent MRSA infections primarily result from the survival of persister cells after antibiotic treatment. Gas plasma, a novel source of ROS (reactive oxygen species) and RNS (reactive nitrogen species) generation, not only inactivates pathogenic microbes but also restore the sensitivity of MRSA to antibiotics. This study further found that sublethal treatment of MRSA with both plasma and plasma-activated saline increased the antibiotic sensitivity and promoted the eradication of persister cells by tetracycline, gentamycin, clindamycin, chloramphenicol, ciprofloxacin, rifampicin, and vancomycin. The short-lived ROS and RNS generated by plasma …

Factors Associated With Month 2 Smear Non-Conversion Among Category 1 Tuberculosis Patients In Karachi, Pakistan, Kimberly A. D'Souza, Syed M A. Zaidi, Maria Jaswal, Shahid Butt, Saira Khowaja, Shifa Salman Habib, Amyn A. Malik

Community Health Sciences

Predictors of smear non-conversion at baseline can help identify cases at risk for failure of tuberculosis treatment. Retrospective data for smear-positive Category 1 patients in Karachi, Pakistan, was analyzed. Predictors of sputum conversion were determined using multiple logistic regression with sputum conversion as outcome variable and patient demographics, baseline weight, baseline sputum smear grade, case-finding approach as explanatory variables. Age ≥35 years, baseline sputum grade of 3+ were significantly associated with predicting sputum smear positivity at month 2 of treatment. Monitoring compliance to TB treatment should be considered amongst older patients and those with a high sputum grade at baseline.

“When One Shingle Sends Up Smoke”: The Summit Beacon Advises Akron About The Epidemic Cholera, 1849, Elizabeth Hall

Nineteenth-Century Ohio Literature

Elizabeth Hall explains the American cholera epidemic of 1849, with special attention to how cholera afflicted Akron, a booming canal town in Northeast Ohio. The article presents the full text of 1849 Akron newspaper articles on cholera and explains how their mix of good and bad information was published right before scientific breakthroughs in cholera research.

The Neurodevelopmental Perspective Of Surgical Necrotizing Enterocolitis: The Role Of The Gut-Brain Axis., Chariton Moschopoulos, Panagiotis Kratimenos, Ioannis Koutroulis, Bhairav V Shah, Anja Mowes, Vineet Bhandari

Pediatrics Faculty Publications

This state-of-the-art review article aims to highlight the most recent evidence about the therapeutic options of surgical necrotizing enterocolitis, focusing on the molecular basis of the gut-brain axis in relevance to the neurodevelopmental outcomes of primary peritoneal drainage and primary laparotomy. Current evidence favors primary laparotomy over primary peritoneal drainage as regards neurodevelopment in the surgical treatment of necrotizing enterocolitis. The added exposure to inhalational anesthesia in infants undergoing primary laparotomy is an additional confounding variable but requires further study. The concept of the gut-brain axis suggests that bowel injury initiates systemic inflammation potentially affecting the developing central nervous system. …

Lebanon: Cholera Outbreak, Muhammad Naqvi

Global Public Health

Lebanon is a country that has always been tangled with the ever looming threat of a growing health crisis. With a failing government and massive influx of refugees, mostly the victim of their war torn economy, it seemed inevitable that sanitation procedures would run short. Now the Lebanese people and government face the challenge of the spread of Cholera, a water-borne disease, within the countries vicinity as a result of mass pollution from the formation of informal settlements as well as the country being a hotbed for political instability. These have resulted in limited success in controlling the outbreak engulfing …

The Gambia : Tuberculosis, Amen Belayneh

Global Public Health

Tuberculosis in the Gambia

This brief consists of some general information about Gambia, demographic information, the effects of tuberculosis in the country including the challenges brought forth by the disease, and some personal suggestions on the matter. From the general information on Gambia, we learn the location, political structure as well as major internal and external challenges faced by the country. Tuberculosis is one of the country’s major internal challenges in addition to its environmental and economic issues. Under the demographic information we get a broader idea of the Gambia people by looking at population demographic such as birth and …

Niger: Meningitis, Rodrigo Medeiros

Global Public Health

Niger is a semi-presidential republic located in western Africa. The majority of the population lives in the most extreme southern part of the country since 80% of Niger’s territory is occupied by the Sahara desert. The desert has been spreading in recent years forcing people to leave their subsistence farms. The majority of the population lives with less than 1 dollar per day. The first meningitis outbreak lasted from 2002 until 2012, but the 2015 outbreak was the one that caused more damage to the countries located in the meningitis belt of sub-Saharan Africa. The meningitis belt is the place …

Micronesia: Tuberculosis, Mulualem Hailom

Global Public Health

This brief contains the general information of the Federal state of Micronesia, major problems of the country, and in particular Tuberculosis disease and Multidrug-Resistant Tuberculosis. Under the general information of Micronesia, the location, the political structure, the demographic information, and the internal and also external challenges are listed. This brief also has detailed information about the two simultaneous outbreaks of Multidrug-Resistant Tuberculosis of Micronesia. Tuberculosis is one of death contributing factor in Micronesia. Tuberculosis can be cured if the therapy is properly taken but if the therapy isn’t taken properly, the TB disease can grow into Multidrug –Resistance tuberculosis, which …

Cholera: Uganda, Emilie Verran

Global Issues in Public Health

The bacterium Vibrio cholerae, when ingested, infects the intestines and causes a communicable diarrhea disease called cholera. Outbreaks of cholera occur in areas with poor sanitation and sewage treatments where fecal material of an infected person contaminates the water. These areas include Southeast Asia, Haiti, and sub-Saharan Africa, including Uganda. From 2011-2016, an analysis of Ugandan cholera data showed ‘hot spots’ of cholera cases in fishing communities with incidence rates as high as 120-998 cases per 100,000 people. An analysis of these same districts from 2011-2015 showed an average Case-Fatality Ratio of 2.4%, with the worst district as high …

Epithelial Cell Lysates Induce Exos Expression And Secretion By Pseudomonas Aeruginosa, Victoria Hritonenko, Matteo Metruccio, David J. Evans, Suzanne Fleiszig

Faculty Publications & Research of the TUC College of Pharmacy

No abstract provided.

Risk Factors For Short- And Long-Term Outcomes In Children With Stec-Hus/D, Judith Sebestyen Vansickle, Tarak Srivastava, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Background. Hemolytic uremic syndrome (HUS) is one of the common causes for acute kidney injury in childhood. Objective. The goals of our study were to identify risk factors for short-term complications and long-term outcomes of chronic kidney disease (CKD) in Shiga toxin-producing Escherichia coli (STEC)-HUS and other diarrhea positive (D+) HUS. Methods. Retrospective chart review was obtained of 58 pediatric patients treated for STEC-HUS and other D+ HUS between February 2002 and January 2011. Results. Thirty-three patients (56.9%) required dialysis. Dialysis was more likely initiated if a patient was a female (P < .012), oliguric (urine output < 0.5 mL/kg/h, P < .0005), or hemoglobin (HGB) level >10 g/dL …

The Impact Of Exos On Pseudomonas Aeruginosa Internalization By Epithelial Cells Is Independent Of Fleq And Correlates With Bistability Of Type Three Secretion System Gene Expression, Abby R. Kroken, Camille K. Chen, David J. Evans, Timothy L. Yahr, Suzanne M. J. Fleiszig

Faculty Publications & Research of the TUC College of Pharmacy

Pseudomonas aeruginosa is internalized into multiple types of epithelial cell in vitro and in vivo and yet is often regarded as an exclusively extracellular pathogen. Paradoxically, ExoS, a type three secretion system (T3SS) effector, has antiphagocytic activities but is required for intracellular survival of P. aeruginosaand its occupation of bleb niches in epithelial cells. Here, we addressed mechanisms for this dichotomy using invasive (ExoS-expressing) P. aeruginosaand corresponding effector-null isogenic T3SS mutants, effector-null mutants of cytotoxic P. aeruginosa with and without ExoS transformation, antibiotic exclusion assays, and imaging using a T3SS-GFP reporter. Except for effector-null PA103, all strains were internalized while …

An Adult With A Remnant Urachus Anomaly Diagnosed In The Emergency Department., Alan Lucerna, James Lee, James Espinosa, Risha Hertz, Victor Scali

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The urachus is a midline tubular structure that stretches from the apex of the bladder and connects to the umbilicus. Urachal remnants result from incomplete regression of the fetal urachus in infancy. We report the case of a 21-year-old male who presented to the emergency department with purulent drainage from his umbilicus in association with a chronic intermittent "pulling sensation" in the umbilicus and suprapubic areas. An infected urachal remnant was diagnosed and was treated with an oral antibiotic and ultimately with outpatient excision of the remnant. Such cases are rare but have the potential to progress to sepsis. In …