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There Is A Trend Favoring Vancomycin Vs. Metronidazole In Treating Severe C. Difficile Infection, Dean D. Fouchia 2016 Wayne State University School of Medicine

There Is A Trend Favoring Vancomycin Vs. Metronidazole In Treating Severe C. Difficile Infection, Dean D. Fouchia

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Johnson S, Louie TJ, Gerding DN, et al. Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis. 2014;59(3):345-354. doi: 10.1093/cid/ciu313


N-Methylation Of A Bactericidal Compound As A Resistance Mechanism In Mycobacterium Tuberculosis, Kenan C. Murphy, Carl F. Nathan 2016 University of Massachusetts Medical School

N-Methylation Of A Bactericidal Compound As A Resistance Mechanism In Mycobacterium Tuberculosis, Kenan C. Murphy, Carl F. Nathan

Open Access Articles

The rising incidence of antimicrobial resistance (AMR) makes it imperative to understand the underlying mechanisms. Mycobacterium tuberculosis (Mtb) is the single leading cause of death from a bacterial pathogen and estimated to be the leading cause of death from AMR. A pyrido-benzimidazole, 14, was reported to have potent bactericidal activity against Mtb. Here, we isolated multiple Mtb clones resistant to 14. Each had mutations in the putative DNA-binding and dimerization domains of rv2887, a gene encoding a transcriptional repressor of the MarR family. The mutations in Rv2887 led to markedly increased expression of rv0560c. We characterized Rv0560c as an S-adenosyl-L-methionine-dependent ...


Genomic Insights Into The Ixodes Scapularis Tick Vector Of Lyme Disease, Monika Gulia-Nuss,, Daniel R. Caffrey, Neal S. Silverman, Adam R. Wespiser, Catherine A. Hill 2016 Purdue University

Genomic Insights Into The Ixodes Scapularis Tick Vector Of Lyme Disease, Monika Gulia-Nuss,, Daniel R. Caffrey, Neal S. Silverman, Adam R. Wespiser, Catherine A. Hill

Neal Silverman

Ticks transmit more pathogens to humans and animals than any other arthropod. We describe the 2.1 Gbp nuclear genome of the tick, Ixodes scapularis (Say), which vectors pathogens that cause Lyme disease, human granulocytic anaplasmosis, babesiosis and other diseases. The large genome reflects accumulation of repetitive DNA, new lineages of retro-transposons, and gene architecture patterns resembling ancient metazoans rather than pancrustaceans. Annotation of scaffolds representing approximately 57% of the genome, reveals 20,486 protein-coding genes and expansions of gene families associated with tick-host interactions. We report insights from genome analyses into parasitic processes unique to ticks, including host 'questing ...


Fecal Transplant Vs Vancomycin For Recurrent Clostridium Diffile, Lauren M. Taylor, Todd E. Edwards 2016 James Madison University

Fecal Transplant Vs Vancomycin For Recurrent Clostridium Diffile, Lauren M. Taylor, Todd E. Edwards

Physician Assistant Capstones

Objective: To compare fecal transplant and vancomycin in the treatment of recurrent clostridium difficile to determine which has the higher cure rate. Design: Systematic literature review. Methods: Pubmed, Google Scholar, and TRIP database using the search terms “recurrent clostridium difficile.” Filters were implemented in the Pubmed database including: randomized control trials, English, and published in the past 5 years. Records were screened for RCT with fecal transplant and full-text. Results: van Nood et al. revealed an initial cure rate of 81% for the infusion group, and a re-treated cure rate of 94%, compared to the vancomycin alone group of 31 ...


Linezolid Induced Delirium In The Absence Of Serotonin Syndrome: A Psychiatric Consultation/Liaison Case Report, Hani Nazha, MD, Nathan T. Harrington, MD 2016 WVU

Linezolid Induced Delirium In The Absence Of Serotonin Syndrome: A Psychiatric Consultation/Liaison Case Report, Hani Nazha, Md, Nathan T. Harrington, Md

Marshall Journal of Medicine

Delirium is one of the most common mental illnesses that can affect elderly patients and patients with advanced medical problems. Because these patients are frequently on multiple medications and/or are more sensitive to medications secondary to their age, interactions with current medications, or existing medical problems; medication toxicity is frequently the etiology behind their delirium. This is a case report of a patient admitted for cellulitis that developed delirium from Linezolid however did not develop any other signs or symptoms of Serotonin Syndrome; a known side effect of Linezolid. This distinctive case highlights the importance of a careful analysis ...


Gram-Negative Bacteria And Sepsis, Christine D. Ridge 2016 Otterbein University

Gram-Negative Bacteria And Sepsis, Christine D. Ridge

Master of Science in Nursing (MSN) Student Scholarship

Today’s medical world encompasses an environment in which gram-negative bacteria that once were defeated with common antibiotics, have now become resistant. Gram-negative bacteria like Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter, and Acinetobacter are pathogens that are an emerging threat causing sepsis due to multidrug-resistance (Pop-Vicas & Opal, 2014, p.189). The multidrug-resistance mechanisms of gram-negative bacteria coupled with a patient population commonly seen in hospital settings, that consist of immunocompromised adults due to advancing age, comorbidities (e.g. AIDS, history of transplants, diabetes, and chemotherapy), and immunotherapies, create an environment for advanced infection or sepsis to take place.

Complications of multidrug-resistant ...


Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu 2016 Chapman University

Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu

Pharmacy Faculty Articles and Research

Socially responsible technologies are designed while taking into consideration the socioeconomic, geopolitical and environmental limitations of regions in which they will be implemented. In the medical context, this involves making therapeutic platforms more accessible and affordable to patients in poor regions of the world wherein a given disease is endemic. This often necessitates going against the reigning trend of making therapeutic nanoparticles ever more structurally complex and expensive. However, studies aimed at simplifying materials and formulations while maintaining the functionality and therapeutic response of their more complex counterparts seldom provoke a significant interest in the scientific community. In this review ...


The Effect Of Oral Antibiotics On The Development Of Community Acquired Clostridium Difficile Colitis In Medicare Beneficiaries, Charles M. Psoinos, Courtney E. Collins, M. Didem Ayturk, Julie Flahive, Frederick A. Anderson Jr., Heena Santry 2016 University of Massachusetts Medical School

The Effect Of Oral Antibiotics On The Development Of Community Acquired Clostridium Difficile Colitis In Medicare Beneficiaries, Charles M. Psoinos, Courtney E. Collins, M. Didem Ayturk, Julie Flahive, Frederick A. Anderson Jr., Heena Santry

UMass Center for Clinical and Translational Science Research Retreat

Clostridium difficile infection (CDI) is increasingly prevalent among community dwelling Americans. Older Americans are particularly vulnerable to community-acquired Clostridium difficile (CACD), in part to increasing use of antibiotics. We studied the association between outpatient antibiotics and CACD among Medicare beneficiaries.

Case-control study utilizing a 5% sample of Medicare beneficiaries (2009-2011). Patients with CACD severe enough to warrant hospitalization were identified by a primary diagnosis code for CDI and no exposure to a healthcare environment within 90-days of admission. 1,514 CACD cases were matched to ten controls each on birth year and sex. Potential controls with exposure to healthcare environment ...


Pre-Exposure Prophylaxis With Ospa-Specific Human Monoclonal Antibodies Protects Mice Against Tick Transmission Of Lyme Disease Spirochetes, Yang Wang, Aurélie Kern, Naomi Boatright, Zachary Schiller, Andrew Sadowski, Monir Ejemel, Colby A. Souders, Keith A. Reimann, Linden Hu, William D. Thomas 2016 University of Massachusetts Medical School

Pre-Exposure Prophylaxis With Ospa-Specific Human Monoclonal Antibodies Protects Mice Against Tick Transmission Of Lyme Disease Spirochetes, Yang Wang, Aurélie Kern, Naomi Boatright, Zachary Schiller, Andrew Sadowski, Monir Ejemel, Colby A. Souders, Keith A. Reimann, Linden Hu, William D. Thomas

UMass Center for Clinical and Translational Science Research Retreat

Background. Tick transmission of Borrelia spirochetes to humans results in significant morbidity from Lyme disease worldwide. Serum concentrations of antibodies against outer surface protein A (OspA) were shown to correlate with protection from infection with Borrelia burgdorferi, the primary cause of Lyme disease in the United States.

Methods. Mice transgenic for human immunoglobulin genes were immunized with OspA protein of B. burgdorferi to generate human monoclonal antibodies (HuMabs) against OspA. HuMabs were generated and tested in in vitro borreliacidal assays and animal protection assays.

Results. Nearly 100 unique OspA specific HuMabs were generated and four HuMabs (221-7, 857-2, 319-44, and ...


Immune Features That Afford Protection From Clinical Disease Versus Sterilizing Immunity To Bordetella Pertussis Infection In A Nonhuman Primate Model Of Whooping Cough, Keith A. Reimann, Aaron J. Belli, Sarah Fulco, Jason M. Warfel, Rijian Wang, Lisa Cavacini, James F. Papin, Steven F. Merkel, Tod J. Merkel, Mark S. Klempner 2016 University of Massachusetts Medical School

Immune Features That Afford Protection From Clinical Disease Versus Sterilizing Immunity To Bordetella Pertussis Infection In A Nonhuman Primate Model Of Whooping Cough, Keith A. Reimann, Aaron J. Belli, Sarah Fulco, Jason M. Warfel, Rijian Wang, Lisa Cavacini, James F. Papin, Steven F. Merkel, Tod J. Merkel, Mark S. Klempner

UMass Center for Clinical and Translational Science Research Retreat

The respiratory bacterial infection caused by Bordetella pertussis (whooping cough) is the only vaccine-preventable disease whose incidence has been increasing over the last 3 decades. To better understand the resurgence of this infection, a baboon animal model of pertussis infection has been developed. Naïve baboons that recover from experimental pertussis infection are resistant both to clinical disease and to airway colonization when re-challenged. In contrast, animals vaccinated with acellular pertussis vaccine and experimentally challenged do not develop disease, but airways remain colonized for 4-6 weeks. We explored the possibility that the IgG antibody response to pertussis infection is qualitatively different ...


Identification Of Fully Human Monoclonal Antibodies Against The Adhesin Domain Of Colonizing Factor Antigen I Of Escherichia Coli, Maja Sedic, Danielle Wisheart, Monir Ejemel, Matteo Stoppato, Serena Giuntini, Eileen Barry, William D. Thomas, Mark S. Klempner, Yan Wang 2016 University of Massachusetts Medical School

Identification Of Fully Human Monoclonal Antibodies Against The Adhesin Domain Of Colonizing Factor Antigen I Of Escherichia Coli, Maja Sedic, Danielle Wisheart, Monir Ejemel, Matteo Stoppato, Serena Giuntini, Eileen Barry, William D. Thomas, Mark S. Klempner, Yan Wang

UMass Center for Clinical and Translational Science Research Retreat

Enterotoxigenic Escherichia coli (ETEC) causes significant diarrheal illness in infants in the developing world and travelers to endemic countries including military personnel. Infection of the host involves bacterial colonization of the small intestinal epithelium and toxin secretion leading to watery diarrhea. CFA/I is the most common colonizing factor antigens expressed on the surface of ETEC isolates. The CFA/I adhesin, CfaE, appears to be required for ETEC binding to human intestinal cells for colonization. Human antibodies against the binding domain of CfaE have potential to block colonization of ETEC and serve as a potent immunoprophylactic therapeutic for ETEC-related diarrhea ...


Structural And Molecular Analysis Of A Protective Epitope Of Lyme Disease Antigen Ospa And Antibody Interactions, Shivender Shandilya, Nese Kurt Yilmaz, Ejemel Monir, Andrew Sadowski, William D. Thomas, Mark S. Klempner, Celia A. Schiffer, Yan Wang 2016 University of Massachusetts Medical School

Structural And Molecular Analysis Of A Protective Epitope Of Lyme Disease Antigen Ospa And Antibody Interactions, Shivender Shandilya, Nese Kurt Yilmaz, Ejemel Monir, Andrew Sadowski, William D. Thomas, Mark S. Klempner, Celia A. Schiffer, Yan Wang

UMass Center for Clinical and Translational Science Research Retreat

The murine monoclonal antibody LA-2 recognizes a clinically protective epitope on outer surface protein (OspA) of Borrelia burgdorferi, the causative agent of Lyme disease in North America. Human antibody equivalence to LA-2 is the best serologic correlate of protective antibody responses following OspA vaccination. Understanding the structural and functional basis of the LA-2 protective epitope is important for developing OspA-based vaccines and discovering prophylactic antibodies against Lyme disease.

Here, we present a detailed structure-based analysis of the LA-2/OspA interaction interface and identification of residues mediating antibody recognition. Mutations were introduced into both OspA and LA-2 based on computational predictions ...


Disease-Causing Fungi In Homes And Yards In The Midwestern United States, Dennis J. Baumgardner 2016 Aurora UW Medical Group, Aurora Health Care

Disease-Causing Fungi In Homes And Yards In The Midwestern United States, Dennis J. Baumgardner

Dennis J. Baumgardner. MD

A number of fungal pathogens that may result in a variety of human diseases are found in residential homes and yards. The growth of these microscopic fungi is often favored by particular characteristics of the dwelling and nearby outdoor environment. Evolved virulence factors or increased ability of specific fungi to grow in diverse, and sometimes harsh, microenvironments presented by the domestic environment may promote growth and pathogenesis. Infection may occur by inhalation or direct inoculation and include endemic fungi in addition to opportunistic or emerging species. Systemic or locally aggressive fungal infections are particularly likely and may be life-threatening in ...


Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke 2016 Aurora Health Care

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Dennis J. Baumgardner. MD

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305 ...


Blastomyces: Why Be Dimorphic?, Dennis J. Baumgardner 2016 Aurora UW Medical Group, Aurora Health Care

Blastomyces: Why Be Dimorphic?, Dennis J. Baumgardner

Dennis J. Baumgardner. MD

In introducing the infectious disease focus for this edition of the Journal of Patient-Centered Research and Reviews, the author describes the unsolved mysteries surrounding the dimorphic fungus Blastomyces and the related pathogenesis of pulmonary blastomycosis.


Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke 2016 Aurora Research Institute, Aurora Health Care

Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke

Dennis J. Baumgardner. MD

Purpose

Blastomycosis is an endemic fungal infection. In rural northern Wisconsin, blastomycosis cases are associated with certain environmental features including close proximity to waterways. Other studies have associated blastomycosis with particular soil chemicals. However, blastomycosis also occurs in urban and suburban regions. We explored the geodemographic associations of blastomycosis cases in the more urban/suburban landscape of eastern Wisconsin.

Methods

We conducted a retrospective study of 193 laboratory-identified blastomycosis cases in a single eastern Wisconsin health system, 2007–2015. Controls were 250 randomly selected cases of community-diagnosed pneumonia from a similar time period. Geographic features of home addresses were explored ...


The Effects Of Implementing Best Practice On Clostridium Difficile Infection Treatment, Melissa A. Craig 2016 Valparaiso University

The Effects Of Implementing Best Practice On Clostridium Difficile Infection Treatment, Melissa A. Craig

Evidence-Based Practice Project Reports

For many years the number of Clostridium difficile infections (CDI) has steadily risen. This common cause of antibiotic-associated diarrhea can have variable clinical presentations ranging from mild diarrhea to severe cases complicated by the development of pseudomembranous colitis, electrolyte abnormalities, dehydration, sepsis, and even death. The resistant nature of the spores produced by the bacteria and the emergence of hypervirulent strains have made treatment challenging. Previous studies have demonstrated clinician non-adherence to CDI clinical treatment guidelines may result in poor patient outcomes. This evidence-based practice project was implemented at a 311 bed academic medical center in the Midwest. The project ...


Exploring The Mechanisms Of Action Of Antifungal Peptides Using Saccharomyces Cerevisiae., Michelle L. Mason 2016 University of Arkansas, Fayetteville

Exploring The Mechanisms Of Action Of Antifungal Peptides Using Saccharomyces Cerevisiae., Michelle L. Mason

Biological Sciences Undergraduate Honors Theses

Candida albicans is a normal inhabitant of the skin and mucosal membranes of humans, however, in individuals with depressed immune systems or disrupted cutaneous flora, Candida can overgrow and cause serious infection. Candida infection is the fourth leading cause of nosocomial infection in the United States. These infections are often associated with longer hospital stays and higher mortality. Current drug therapies for this infection are largely ineffective due to the increased drug resistance of Candida species, and for some therapeutics, high levels of drug toxicity to humans. Histatin 5 is a naturally occurring salivary peptide that has strong antifungal properties ...


The Effect Of Increased Exposure Of Uvc Light On Human Skin Microbiota, T'Kylia S. Moss 2016 The University of Southern Mississippi

The Effect Of Increased Exposure Of Uvc Light On Human Skin Microbiota, T'Kylia S. Moss

Honors Theses

Many methods have been employed to prevent infections from opportunistic pathogens in immunocompromised individuals. Among these are the use of ultraviolet light (UV). In this study, UVC light, was found to have a deleterious effect on specific skin flora. Organisms tested included Acinetobacter baumanii, Candida albicans, Candida kefyr, Corynebacterium renale, Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes. Nutrient agar was used to cultivate most organisms. Blood agar was used for the cultivation of Streptococcus pyogenes and Enterococcus faecalis. Bacterial suspensions were made and utilized to plate each organism onto a set of 7 nutrient agar or ...


The Effect Of Interspecies Signaling On Stenotrophomonas Maltophilia Growth., Zachary Ethan Dickinson 2016 University of Louisville

The Effect Of Interspecies Signaling On Stenotrophomonas Maltophilia Growth., Zachary Ethan Dickinson

College of Arts & Sciences Senior Honors Theses

Cystic fibrosis (CF) is a genetic disorder that effects over 70,000 people worldwide, and is particularly prevalent in those of Caucasian descent. CF increases susceptibility to chronic infections of the lungs and GI tract, often leading to decreased quality of life and early death to afflicted individuals. No cure is available, and so treatment is limited to treating the frequent infections that afflict CF patients. Several species of bacteria are commonly implicated in these infections, including Stenotrophomonas maltophilia. Infections of this species is of particular interest as it has been shown to be highly antibiotic resistant. This is a ...


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