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Clinical Approach To Nonresponsive Pneumonia In Adults Diagnosed By A Primary Care Clinician: A Retrospective Study, Kiley B. Vander Wyst, Jessica J. F. Kram, Dennis J. Baumgardner 2016 Center for Urban Population Health; Aurora Health Care

Clinical Approach To Nonresponsive Pneumonia In Adults Diagnosed By A Primary Care Clinician: A Retrospective Study, Kiley B. Vander Wyst, Jessica J. F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose

Community-acquired pneumonia (CAP) is commonly diagnosed in the primary care setting. Management of nonresponsive pneumonia (NRP), i.e. failure to respond to CAP treatment, is not clearly understood. The purpose of this study was to describe the initial work-up and treatment of CAP in the ambulatory primary care setting and to determine relative proportion of, diagnostic approach to and treatment of NRP.

Methods

We retrospectively studied adult patients diagnosed with CAP within our large, integrated health care system from October 2006 through July 2013. Cases were defined as patients with CAP who worsened after 4 days, or did not ...


Intimin Likely Used To Cause Disease During Competition With Commensal Escherichia Coli, Dominique J. Richburg 2016 Liberty University

Intimin Likely Used To Cause Disease During Competition With Commensal Escherichia Coli, Dominique J. Richburg

Senior Honors Theses

The intimin gene in the Locus of Enterocyte Effacement (LEE) island of pathogenicity is the primary attachment mechanism in Citrobacter rodentium. Intimin is a bacterial adhesin (protein) that attaches to obtain a niche/nutrient and thrive within the intestine. Intimin was deleted within C. rodentium to study colonization and pathogenesis in the murine intestine. Additionally, C. rodentium is an attaching/effacing pathogen, and a useful murine model in understanding Enterohemorrhagic Escherichia coli (EHEC) infection in humans. E. coli and C. rodentium cause gastroenteritis in humans and mice, respectively. C. rodentium is a murine pathogen commonly used to model gastrointestinal disease ...


Paediatric Tuberculosis In Bhopal, Madhya Pradesh, India: Dots, Diagnosis, And Determinants, Emma Klein 2016 SIT Graduate Institute - Study Abroad

Paediatric Tuberculosis In Bhopal, Madhya Pradesh, India: Dots, Diagnosis, And Determinants, Emma Klein

Independent Study Project (ISP) Collection

Tuberculosis (TB) is one of the world’s largest public health challenges, and it has a disproportionate impact on India. In children, TB is a serious but understudied illness due to the complexity of case-notification and relative lack of public health importance. This study took place over the course of one month in Bhopal, Madhya Pradesh, India. In a mixed method study consisting of 53 quantitative patient interviews and qualitative interviews with healthcare providers, social determinants of TB in this setting were investigated as well as challenges faced at all stages of healthcare delivery. Malnutrition and housing were the most ...


Metagenomic Sequencing With Strain-Level Resolution Implicates Uropathogenic E. Coli In Necrotizing Enterocolitis And Mortality In Preterm Infants, Doyle V. Ward, Matthias Scholz, Moreno Zolfo, Diana H. Taft, Kurt R. Schibler, Adrian Tett, Nicola Segata, Ardythe L. Morrow 2016 University of Massachusetts Medical School

Metagenomic Sequencing With Strain-Level Resolution Implicates Uropathogenic E. Coli In Necrotizing Enterocolitis And Mortality In Preterm Infants, Doyle V. Ward, Matthias Scholz, Moreno Zolfo, Diana H. Taft, Kurt R. Schibler, Adrian Tett, Nicola Segata, Ardythe L. Morrow

Open Access Articles

Necrotizing enterocolitis (NEC) afflicts approximately 10% of extremely preterm infants with high fatality. Inappropriate bacterial colonization with Enterobacteriaceae is implicated, but no specific pathogen has been identified. We identify uropathogenic E. coli (UPEC) colonization as a significant risk factor for the development of NEC and subsequent mortality. We describe a large-scale deep shotgun metagenomic sequence analysis of the early intestinal microbiome of 144 preterm and 22 term infants. Using a pan-genomic approach to functionally subtype the E. coli, we identify genes associated with NEC and mortality that indicate colonization by UPEC. Metagenomic multilocus sequence typing analysis further defined NEC-associated strains ...


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

Open Access Articles

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 ...


Targeting An Essential Gtpase Obg For The Development Of Broad-Spectrum Antibiotics, Josephine A. Bonventre, Ryszard A. Zielke, Konstantin V. Korotkov, Aleksandra E. Sikora 2016 Oregon State University

Targeting An Essential Gtpase Obg For The Development Of Broad-Spectrum Antibiotics, Josephine A. Bonventre, Ryszard A. Zielke, Konstantin V. Korotkov, Aleksandra E. Sikora

Molecular and Cellular Biochemistry Faculty Publication

A promising new drug target for the development of novel broad-spectrum antibiotics is the highly conserved small GTPase Obg (YhbZ, CgtA), a protein essential for the survival of all bacteria including Neisseria gonorrhoeae (GC). GC is the agent of gonorrhea, a prevalent sexually transmitted disease resulting in serious consequences on reproductive and neonatal health. A preventive anti-gonorrhea vaccine does not exist, and options for effective antibiotic treatments are increasingly limited. To address the dire need for alternative antimicrobial strategies, we have designed and optimized a 384-well GTPase assay to identify inhibitors of Obg using as a model Obg protein from ...


Diabetes Is Associated With Worse Clinical Presentation In Tuberculosis Patients From Brazil: A Retrospective Cohort Study, Leonardo Gil-Santana, Jilson L. Almeida-Junior, Carolina A.M. Oliveira, Lucas S. Hickson, Carla Daltro, Simone Castro, Hardy Kornfeld, Eduardo M. Netto, Bruno B. Andrade 2016 Fundação Oswaldo Cruz

Diabetes Is Associated With Worse Clinical Presentation In Tuberculosis Patients From Brazil: A Retrospective Cohort Study, Leonardo Gil-Santana, Jilson L. Almeida-Junior, Carolina A.M. Oliveira, Lucas S. Hickson, Carla Daltro, Simone Castro, Hardy Kornfeld, Eduardo M. Netto, Bruno B. Andrade

Open Access Articles

BACKGROUND: The rising prevalence of diabetes mellitus (DM) worldwide, especially in developing countries, and the persistence of tuberculosis (TB) as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil.

METHODS: We performed a retrospective analysis of a TB patient cohort (treatment naive) of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define ...


Difference In Knowledge Of Mrsa Regarding Sophomore And Senior Baccalaureate Nursing Students, Payton T. Lloyd, Daniel B. Whited, Lori N. Crimaldi 2016 The University of Akron

Difference In Knowledge Of Mrsa Regarding Sophomore And Senior Baccalaureate Nursing Students, Payton T. Lloyd, Daniel B. Whited, Lori N. Crimaldi

Honors Research Projects

Abstract

Background

The risk of infection by antibiotic resistant organisms is a common problem in hospital settings. Methicillin-resistant Staphylococcus Aureus (MRSA) is the most common type of resistant bacteria that can have serious consequences or even lead to death. Nurses' knowledge of how to prevent and treat this problem is essential for patient safety. The purpose of this study is to determine the differences in level of knowledge of MRSA in sophomore and senior level baccalaureate nursing students.

Methods

This descriptive, comparative study will examine differences in knowledge of MRSA between sophomore and senior baccalaureate nursing students and determine if ...


Burkholderia Pseudomallei Enters The Brain And Spinal Cord Via The Trigeminal Nerve, Heidi Walkden, James St John, Lynn Nazareth, Jenny Ekberg 2016 Bond University

Burkholderia Pseudomallei Enters The Brain And Spinal Cord Via The Trigeminal Nerve, Heidi Walkden, James St John, Lynn Nazareth, Jenny Ekberg

Posters

Background

The trigeminal nerve is the largest cranial nerve responsible for sensation in the face and motor functions such as chewing. It constitutes a direct route from the nasal cavity into the brain (Fig. 1). Despite this, only a handful of microorganisms are thought to infect the brain via this route.

The tropical disease melioidosis caused by Burkholderia pseudomallei is endemic to the northern Australia and south-east Asia. The main route of transmission is via inhalation of droplets and soil. The Australian variant can result in brain infection, but the mechanism of infection is unknown.

Here, we investigated whether B ...


In Vitro Activity Of Polymyxin B And Meropenem Alone And In Combination Against Carbapenem-Resistant Enterobacteriaceae, Brandon T. Kulengowski 2016 University of Kentucky

In Vitro Activity Of Polymyxin B And Meropenem Alone And In Combination Against Carbapenem-Resistant Enterobacteriaceae, Brandon T. Kulengowski

Theses and Dissertations--Pharmacy

Background: Infections caused by carbapenem-resistant Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae are among the most urgent threats of the infectious disease realm. The incidence of these infections has only been increasing over the years and due to very limited treatment options, mortality is estimated at about 50%.

Methods: To evaluate the in vitro activity of meropenem and polymyxin B against carbapenem-resistant Enterobacteriaceae, antimicrobial susceptibility testing and time-kill studies were performed on K. pneumoniae clinical isolates representing a wide range of meropenem resistance (MICs 4 – 128 mg/L).

Results: Regrowth was observed at clinically relevant concentrations of meropenem alone ...


Aeromonas Hydrophila In Amphibians: Harmless Bystander Or Opportunistic Pathogen, Zachary P. Rivas 2016 University of Central Florida

Aeromonas Hydrophila In Amphibians: Harmless Bystander Or Opportunistic Pathogen, Zachary P. Rivas

Honors in the Major Theses

For several decades amphibian populations have been declining. Historically, the bacterium A. hydrophila (Ah) was hypothesized to be the causal factor in amphibian disease and population declines. However, with the discovery of a chytrid fungus, Batrachochytrium dendrobatidis (Bd) in 1998, which was identified on the skin of amphibians during documented mortality events, Ah research became of minor interest as focus shifted to Bd. Recent studies into the immunocompromising abilities of Bd, however, have opened new questions about its relationship with Ah and their combined effects on a host.

In this study, I explore the relationship between infection with these two ...


Inhibition Of Bacterial Growth And Prevention Of Bacterial Adhesion With Localized Nitric Oxide Delivery, Julia Osborne 2016 Michigan Technological University

Inhibition Of Bacterial Growth And Prevention Of Bacterial Adhesion With Localized Nitric Oxide Delivery, Julia Osborne

Dissertations, Master's Theses and Master's Reports

Bacterial infections continue to be a problem at the site of an indwelling medical device, and over the years, various bacterial strains have become more resistant to current antibiotic treatments. Bacterial infection at an indwelling medical device can be dangerous and affect the performance of the medical device which can ultimately lead to the failure of the device due to bacterial resistance to treatment.

Nitric Oxide (NO) has been shown to possess antibacterial properties to prevent and inhibit bacterial growth. NO releasing coatings on indwelling medical devices could provide a reduction in bacterial infections that occur at the device site ...


Pseudomonas Aeruginosa Outer Membrane Vesicles Triggered By Human Mucosal Fluid And Lysozyme Can Prime Host Tissue Surfaces For Bacterial Adhesion, Matteo M. E. Metruccio, David J. Evans, Manal M. Gabriel, Jagath L. Kadurugamuwa, Suzanne M. J. Fleiszig 2016 Touro University California

Pseudomonas Aeruginosa Outer Membrane Vesicles Triggered By Human Mucosal Fluid And Lysozyme Can Prime Host Tissue Surfaces For Bacterial Adhesion, Matteo M. E. Metruccio, David J. Evans, Manal M. Gabriel, Jagath L. Kadurugamuwa, Suzanne M. J. Fleiszig

College of Pharmacy (TUC) Publications and Research

Pseudomonas aeruginosa is a leading cause of human morbidity and mortality that often targets epithelial surfaces. Host immunocompromise, or the presence of indwelling medical devices, including contact lenses, can predispose to infection. While medical devices are known to accumulate bacterial biofilms, it is not well understood why resistant epithelial surfaces become susceptible to P. aeruginosa. Many bacteria, including P. aeruginosa, release outer membrane vesicles (OMVs) in response to stress that can fuse with host cells to alter their function. Here, we tested the hypothesis that mucosal fluid can trigger OMV release to compromise an epithelial barrier. This was tested using ...


Isavuconazole In The Treatment Of Invasive Aspergillosis And Mucormycosis Infections, Monica A. Donnelley, Elizabeth S. Zhu, George R. Thompson III 2016 Touro University California

Isavuconazole In The Treatment Of Invasive Aspergillosis And Mucormycosis Infections, Monica A. Donnelley, Elizabeth S. Zhu, George R. Thompson Iii

College of Pharmacy (TUC) Publications and Research

We have a limited arsenal with which to treat invasive fungal infections caused by Aspergillus and Mucorales. The morbidity and mortality for both pathogens remains high. A triazole antifungal, isavuconazole, was recently granted approval by the US Food and Drug Administration and the European Medicines Agency for the treatment of invasive aspergillosis and mucormycosis. A randomized double-blind comparison trial for the treatment of invasive aspergillosis found isavuconazole noninferior to voriconazole. A separate, open-label study evaluating the efficacy of isavuconazole in the treatment of mucormycosis found comparable response rates to amphotericin B and posaconazole treated historical controls. The prodrug isavuconazonium sulfate ...


Discovering New Antibiotics: Bacterial Extracts Separated By Thin-Layer Chromatography Inhibit The Growth Of Staphylococcus, Heidi Hughes 2016 Ouachita Baptist University

Discovering New Antibiotics: Bacterial Extracts Separated By Thin-Layer Chromatography Inhibit The Growth Of Staphylococcus, Heidi Hughes

Honors Theses

Many bacteria have become resistant to commonly used antibiotics because of antibiotic use in people and animals. Therefore, new antibiotics are needed that will inhibit these resistant bacteria. Bacteria found in soil are a likely source for new antibiotics because of the limited available nutrients found in the soil. We isolated soil bacteria and screened them for antibiotic production against Staphylococcus epidermidids. Methanol extracts were made from entire agar plates of the soil bacteria that inhibited S. epidermidis. These extracts were spotted on a lawn of Staphylococcus aureus; growth inhibition was measured to comfirm that the extracts contained the antimicrobial ...


Hydrocortisone, Vitamin C And Thiamine For The Treatment Of Severe Sepsis And Septic Shock: A Retrospective Before-After Study, Paul E. Marik, Vikramjit Khangoora, Racquel Rivera, Michael H. Hooper, John Catravas 2016 Eastern Virginia Medical School

Hydrocortisone, Vitamin C And Thiamine For The Treatment Of Severe Sepsis And Septic Shock: A Retrospective Before-After Study, Paul E. Marik, Vikramjit Khangoora, Racquel Rivera, Michael H. Hooper, John Catravas

Bioelectrics Publications

BACKGROUND: The global burden of sepsis is estimated as 15 to 19 million cases annually with a mortality rate approaching 60% in low income countries.

METHODS: In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a 7-month period (treatment group) compared to a control group treated in our ICU during the preceding 7 months. The primary outcome was hospital survival. A propensity score was generated to adjust the primary outcome.

FINDINGS: There were 47 patients in both treatment and control groups with no ...


Community Acquired Pneumonia Project, Patricia Heaney 2016 Eastern Kentucky University

Community Acquired Pneumonia Project, Patricia Heaney

Doctor of Nursing Practice Capstone Projects

There is an increasing number of microorganisms that are becoming resistant to antimicrobial medications. This growing number of resistant organism poses a serious health threat, not only in this nation, but throughout the world. The Center for Disease Control and Prevention (CDC) estimates that there are greater than 2 million people who acquire serious infections that are resistant to one or more antimicrobial agents that were made to treat those organisms (CDC, 2013). Streptococcus pneumonia (S. pneumoniae or pneumococcus) is one such organism that has been identified by the CDC (2013) as becoming increasingly resistant to drugs that were once ...


Application Of The Split Gfp System To Listeria Monocytogenes To Visualize The Virulence Factor Inlc, Dilara Batan 2016 University of Colorado, Boulder

Application Of The Split Gfp System To Listeria Monocytogenes To Visualize The Virulence Factor Inlc, Dilara Batan

Undergraduate Honors Theses

Listeria monocytogenes (Lm) is an opportunistic pathogen that is able to survive in a range of environments and cell types, and therefore serves as an important model system for host-pathogen studies. Lm can enter mammalian cells and survive within these host cells by secreting a number of virulence proteins during these steps. In the literature, there are inconsistencies in the localizations of one of these effector proteins, InlC. In order to better understand the localizations of the Lm effector protein InlC in the live cell during infections, a split GFP approach is taken to fluorescently label the protein. This system ...


Differences In Rhodococcus Equi Infections Based On Immune Status And Antibiotic Susceptibility Of Clinical Isolates In A Case Series Of 12 Patients And Cases In The Literature, Praveen Gundelly, Yasuhiro Suzuki, Julie A. Ribes, Alice C. Thornton 2016 University of Kentucky

Differences In Rhodococcus Equi Infections Based On Immune Status And Antibiotic Susceptibility Of Clinical Isolates In A Case Series Of 12 Patients And Cases In The Literature, Praveen Gundelly, Yasuhiro Suzuki, Julie A. Ribes, Alice C. Thornton

Internal Medicine Faculty Publications

Rhodococcus equi is an unusual zoonotic pathogen that can cause life-threatening diseases in susceptible hosts. Twelve patients with R. equi infection in Kentucky were compared to 137 cases reported in the literature. Although lungs were the primary sites of infection in immunocompromised patients, extrapulmonary involvement only was more common in immunocompetent patients (P > 0.0001). Mortality in R. equi-infected HIV patients was lower in the HAART era (8%) than in pre-HAART era (56%) (P > 0.0001), suggesting that HAART improves prognosis in these patients. Most (85–100%) of clinical isolates were susceptible to vancomycin, clarithromycin, rifampin, aminoglycosides, ciprofloxacin, and ...


Protection Against Experimental Cryptococcosis Following Vaccination With Glucan Particles Containing Cryptococcus Alkaline Extracts, Charles A. Specht, Chrono K. Lee, Haibin Huang, Donald J. Tipper, Zu T. Shen, Jennifer K. Lodge, John D. Leszyk, Gary R. Ostroff, Stuart M. Levitz 2015 University of Massachusetts Medical School

Protection Against Experimental Cryptococcosis Following Vaccination With Glucan Particles Containing Cryptococcus Alkaline Extracts, Charles A. Specht, Chrono K. Lee, Haibin Huang, Donald J. Tipper, Zu T. Shen, Jennifer K. Lodge, John D. Leszyk, Gary R. Ostroff, Stuart M. Levitz

Infectious Diseases and Immunology Publications and Presentations

A vaccine capable of protecting at-risk persons against infections due to Cryptococcus neoformans and Cryptococcus gattii could reduce the substantial global burden of human cryptococcosis. Vaccine development has been hampered though, by lack of knowledge as to which antigens are immunoprotective and the need for an effective vaccine delivery system. We made alkaline extracts from mutant cryptococcal strains that lacked capsule or chitosan. The extracts were then packaged into glucan particles (GPs), which are purified Saccharomyces cerevisiae cell walls composed primarily of β-1,3-glucans. Subcutaneous vaccination with the GP-based vaccines provided significant protection against subsequent pulmonary infection with highly virulent ...


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