Digital Commons Network^™

Perspective Of Key Healthcare Professionals On Antimicrobial Resistance And Stewardship Programs: A Multicenter Cross-Sectional Study From Pakistan, Khezar Hayat, Meagen Rosenthal, Ali Hassan Gillani, Jie Chang, Wenjing Ji, Caijun Yang, Minghuan Jiang, Mingyue Zhao, Yu Fang

Faculty and Student Publications

Copyright © 2020 Hayat, Rosenthal, Gillani, Chang, Ji, Yang, Jiang, Zhao and Fang. Background: Antimicrobial resistance (AMR) is an increasing global threat, and hospital-based antimicrobial stewardship programs (ASPs) are one of the effective approaches to tackle AMR globally. This study was intended to determine the attitude of key healthcare professionals (HCPs), including physicians, nurses, and hospital pharmacists, towards AMR and hospital ASPs. Methods: A cross-sectional study design was used to collect data from HCPs employed in public teaching hospitals of Punjab, Pakistan, from January 2019 to March 2019. A cluster-stratified sampling method was applied. Descriptive statistics, Mann Whitney and Kruskal …

Can A "Super Bacteria" Be Stopped?, Marwa Turkistani

2020 Symposium Posters

Title: How Can "Super Bacteria" Be Stopped

One person dies in the United States every 15 minutes because of drug-resistant bacteria that have learned to overcome the most advanced antibiotics, according to a new report by the US Centers for Disease Control and Prevention. Genetic research shows that germs have become particularly adept at teaching each other how to get rid of antibiotics. And that occurs when bacteria, viruses, parasites, and other microbes continuously change and evolve to ensure their survival. Some of them are highly adapted to medical treatment so that the medications that are usually used to prevent …

What Makes Bats Special So That They Are Reservoirs For So Many Different Pathogens?, Deion Anderson, Eleanor Gorkovchenko, Nicole Hamada, Carolina Martinez, Lupe Martinez

2020 Symposium Posters

Bats, order Chiroptera, comprise more than 20 percent of all living mammal species with more than 1100 species. Bats are organisms that have high body temperatures and metabolic rates. Therefore, viral adaptation to febrile conditions in the bat host might explain the high reservoir competence that distinguishes these organisms from other mammalian hosts. The purpose of this study is to present a comparative meta-review of the available evidence in order to investigate and identify the reasons or characteristics as to what makes bats special reservoirs for so many different pathogens. Our investigation will not focus on a particular bat species, …

Gabapentin Abuse, Tuyet-Anh Nguyen

College of Pharmacy Student Research

No abstract provided.

Constituting Safety In Hunter’S Education: An Analysis Of Safety Messages In Texas Hunter’S Training Discourse, R. Tyler Spradley

International Crisis and Risk Communication Conference

Risk communication includes safety messages to reduce the likelihood of hazard and increase the likelihood of reliability. Hunter’s education in the state of Texas uses safety messages to reduce fatal or injurious incidents and to promote a positive image of hunting as a safe, leisure sport. Analysis of Texas’ hunters education training materials and messages related to safety reveals that safety messages construct an image of hunters as practicing safety first, conservationists, ethical, law abiding, and other-oriented. Given Texas safety record, much is to be learned about safety messaging that adopts a positive or ideal image that the trainee identifies.

Epidemiological And Clinical Characteristics Of International Travelers With Enteric Fever And Antibiotic Resistance Profiles Of Their Isolates: A Geosentinel Analysis, S. H. Hagmann, K. M. Angelo, R. Huits, K. Plewes, G. Eperon, M. P. Grobusch, A. Mccarthy, M. Libman, E. Caumes, D. H. Hamer, +15 Additional Authors

Journal Articles

Copyright © 2020 American Society for Microbiology. All Rights Reserved. Enteric fever, caused by Salmonella enterica serovar Typhi (S. Typhi) and S. enterica serovar Paratyphi (S. Paratyphi), is a common travel-related illness. Limited data are available on the antimicrobial resistance (AMR) patterns of these serovars among travelers. Records of travelers with a culture-confirmed diagnosis seen during or after travel from January 2007 to December 2018 were obtained from GeoSentinel. Traveler demographics and antimicrobial susceptibility data were analyzed. Isolates were classified as nonsusceptible if intermediate or resistant or as susceptible in accordance with the participating site’s national guidelines. A total of …

Meningococcal Vaccination: Recommendations Of The Advisory Committee On Immunization Practices, United States, 2020, S. A. Mbaeyi, C. H. Bozio, J. Duffy, L. G. Rubin, S. Hariri, D. S. Stephens, J. R. Macneil

Journal Articles

© 2020. This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of meningococcal vaccines in the United States. As a comprehensive summary and update of previously published recommendations, it replaces all previously published reports and policy notes. This report also contains new recommendations for administration of booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease. These guidelines will be updated as needed on the basis of availability of new data or licensure of new meningococcal vaccines. ACIP recommends routine vaccination with a quadrivalent …

Clinical Practices For Measles-Mumps-Rubella Vaccination Among Us Pediatric International Travelers., E. P. Hyle, S. R. Rao, A. C. Bangs, P. Gastañaduy, A. P. Fiebelkorn, S. H. F. Hagmann, A. T. Walker, R. P. Walensky, E. T. Ryan, R. C. Larocque

Journal Articles

Importance: The US population is experiencing a resurgence of measles, with more than 1000 cases during the first 6 months of 2019. Imported measles cases among returning international travelers are the source of most US measles outbreaks, and these importations can be reduced with pretravel measles-mumps-rubella (MMR) vaccination of pediatric travelers. Although it is estimated that children account for less than 10% of US international travelers, pediatric travelers account for 47% of all known measles importations.

Objective: To examine clinical practice regarding MMR vaccination of pediatric international travelers and to identify reasons for nonvaccination of pediatric travelers identified as MMR …

School Nurses Bloom Where They Are Planted, Nicole Bryan

Integrated Studies

Abstract

School nurses are an integral part of our education system. They play a critical role in the overall wellbeing and health of school-aged children across the country. The provide daily care for a wide range of health needs and utilize a vast array of nursing skills, planning skills, and homemade gumption based on their medical knowledge and experience. School nurses follow federal, state and district statutes, as well as adopt core values and ethical codes of their profession. Evidence based research affirms the value of a school nurse to the education process, through results regarding improved attendance, immunization compliance, …

The Ivy Vine May 2020 - Vol. 3 No. 5, Alpha Kappa Alpha Sorority, Inc. Alpha Delta Omega Chapter, Nashville, Tn

Alpha Delta Omega Chapter 2020 Newsletters

No abstract provided.

Covid-19 Leading To Acute Encephalopathy In A Patient With Heart Transplant., K Jang, A Khatri, Dt Majure

Journal Articles

No abstract provided.

Intensive Care Unit Admissions For Pregnant And Nonpregnant Women With Coronavirus Disease 2019, M J. Blitz, A Grünebaum, A Tekbali, E Bornstein, B Rochelson, M Nimaroff, Fa Chervenak

Journal Articles

No abstract provided.

The Underrecognized Prothrombotic Vascular Disease Of Covid-19., Kp Cohoon, G Mahé, Ac Spyropoulos

Journal Articles

No abstract provided.

Iglv3-21∗01 Is An Inherited Risk Factor For Cll Through The Acquisition Of A Single-Point Mutation Enabling Autonomous Bcr Signaling, P. C. Maity, M. Bilal, M. T. Koning, M. Young, C. A. Van Bergen, V. Renna, A. Nicolò, A. N. Mazzarello, N. Chiorazzi, H. Jumaa, +28 Additional Authors

Journal Articles

© 2020 National Academy of Sciences. All rights reserved. The prognosis of chronic lymphocytic leukemia (CLL) depends on different markers, including cytogenetic aberrations, oncogenic mutations, and mutational status of the immunoglobulin (Ig) heavy-chain variable (IGHV) gene. The number of IGHV mutations distinguishes mutated (M) CLL with a markedly superior prognosis from unmutated (UM) CLL cases. In addition, B cell antigen receptor (BCR) stereotypes as defined by IGHV usage and complementaritydetermining regions (CDRs) classify ∼30% of CLL cases into prognostically important subsets. Subset 2 expresses a BCR with the combination of IGHV3-21-derived heavy chains (HCs) with IGLV3- 21-derived light chains (LCs), …

Integrated Urine Proteomics And Renal Single-Cell Genomics Identify An Interferon-Γ Response Gradient In Lupus Nephritis., A. Fava, J. P. Buyon, C. Mohan, T. Zhang, H. M. Belmont, P. Izmirly, A. Arazi, A. Davidson, B. Diamond, M. Petri, +12 Additional Authors

Journal Articles

Lupus nephritis, one of the most serious manifestations of systemic lupus erythematosus (SLE), has both a heterogeneous clinical and pathological presentation. For example, proliferative nephritis identifies a more aggressive disease class that requires immunosuppression. However, the current classification system relies on the static appearance of histopathological morphology which does not capture differences in the inflammatory response. Therefore, a biomarker grounded in the disease biology is needed to understand the molecular heterogeneity of lupus nephritis and identify immunologic mechanism and pathways. Here, we analyzed the patterns of 1000 urine protein biomarkers in 30 patients with active lupus nephritis. We found that …

Aid Overlapping And Polη Hotspots Are Key Features Of Evolutionary Variation Within The Human Antibody Heavy Chain (Ighv) Genes, C. Tang, D. Bagnara, N. Chiorazzi, M. D. Scharff, T. Maccarthy

Journal Articles

© Copyright © 2020 Tang, Bagnara, Chiorazzi, Scharff and MacCarthy. Somatic hypermutation (SHM) of the immunoglobulin variable (IgV) loci is a key process in antibody affinity maturation. The enzyme activation-induced deaminase (AID), initiates SHM by creating C → U mismatches on single-stranded DNA (ssDNA). AID has preferential hotspot motif targets in the context of WRC/GYW (W = A/T, R = A/G, Y = C/T) and particularly at WGCW overlapping hotspots where hotspots appear opposite each other on both strands. Subsequent recruitment of the low-fidelity DNA repair enzyme, Polymerase eta (Polη), during mismatch repair, creates additional mutations at WA/TW sites. Although …

Febrile Infant: Covid-19 In Addition To The Usual Suspects, E Robbins, Z Ilahi, P Roth

Journal Articles

No abstract provided.

Major Thrombotic Event Despite Anticoagulation In A Patient With Covid-19., B. Ataallah, A. Sharma, S. Tamanna, J. Ng, G. Haggerty

Journal Articles

The outbreak of coronavirus disease 2019 (known as COVID-19), which started in Wuhan, China in December 2019, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been associated with both venous and arterial thromboembolism likely secondary to significant cytokine activation and inflammation. Reports on the incidence of thrombotic complications, however, are not well documented. Our case will examine a young man diagnosed with COVID-19 who developed an acute, severe bilateral saddle pulmonary embolism while on prophylactic dose anticoagulation after being admitted to the hospital and treated for two weeks with significant improvement.

Nebulized In-Line Endotracheal Dornase Alfa And Albuterol Administered To Mechanically Ventilated Covid-19 Patients: A Case Series, A. G. Weber, A. S. Chau, M. Egeblad, B. J. Barnes, T. Janowitz

Journal Articles

© 2020 The Author(s). Background: Mechanically ventilated patients with COVID-19 have a mortality of 24-53%, in part due to distal mucopurulent secretions interfering with ventilation. DNA from neutrophil extracellular traps (NETs) contribute to the viscosity of mucopurulent secretions and NETs are found in the serum of COVID-19 patients. Dornase alfa is recombinant human DNase 1 and is used to digest DNA in mucoid sputum. Here, we report a single-center case series where dornase alfa was co-administered with albuterol through an in-line nebulizer system. Methods: Demographic and clinical data were collected from the electronic medical records of five mechanically ventilated patients …

Outcomes Of Patients With End-Stage Kidney Disease Hospitalized With Covid-19., J. H. Ng, J. S. Hirsch, R. Wanchoo, M. Sachdeva, V. Sakhiya, S. Hong, K. D. Jhaveri, S. Fishbane, Northwell Covid-19 Research Consortium, Northwell Nephrology Covid-19 Research Consortium

Journal Articles

Given the high risk of infection-related mortality, patients with end-stage kidney disease (ESKD) may be at increased risk with COVID-19. To assess this, we compared outcomes of patients with and without ESKD, hospitalized with COVID-19. This was a retrospective study of patients admitted with COVID-19 from 13 New York. hospitals from March 1, 2020, to April 27, 2020, and followed through May 27, 2020. We measured primary outcome (in-hospital death), and secondary outcomes (mechanical ventilation and length of stay), Of 10,482 patients with COVID-19, 419 had ESKD. Patients with ESKD were older, had a greater percentage self-identified as Black, and …

Pulmonary Embolism And Increased Levels Of D-Dimer In Patients With Coronavirus Disease, D. O. Griffin, A. Jensen, M. Khan, J. Chin, K. Chin, J. Saad, R. Parnell, C. Awwad, D. Patel

Journal Articles

No abstract provided.

Rapid Emergence Of Sars-Cov-2 In The Greater New York Metropolitan Area: Geolocation, Demographics, Positivity Rates, And Hospitalization For 46,793 Persons Tested By Northwell Health., S. B. Reichberg, P. P. Mitra, A. Haghamad, G. Ramrattan, J. M. Crawford, G. J. Berry, K. W. Davidson, A. Drach, S. Duong, S. Juretschko, N. I. Maria, Y. Yang, Y. C. Ziemba, Northwell Covid-19 Research Consortium

Journal Articles

BACKGROUND:In March 2020, the greater New York metropolitan area became an epicenter for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The initial evolution of case incidence has not been well characterized. METHODS:Northwell Health Laboratories tested 46,793 persons for SARS-CoV-2 from March 4 through April 10. The primary outcome measure was a positive reverse-transcription-polymerase-chain-reaction (RT-PCR) test for SARS-CoV-2. The secondary outcomes included patient age, sex, and race if stated; dates the specimen was obtained and the test result; clinical practice site sources; geo-location of patient residence; and hospitalization. RESULTS:From March 8 through April 10, a total of 26,735 of 46,793 …

Are Children With Sars-Cov-2 Infection At High Risk For Thrombosis? Viscoelastic Testing And Coagulation Profiles In A Case Series Of Pediatric Patients, M. Al-Ghafry, B. Aygun, A. Appiah-Kubi, A. Vlachos, G. Ostovar, C. Capone, T. Sweberg, N. Palumbo, P. Goenka, L. L. Wolfe, J. M. Lipton, S. S. Acharya

Journal Articles

© 2020 Wiley Periodicals LLC The coagulopathy of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well documented in adults, with increases in D-dimer and prothrombin time found to be strong predictors of mortality, and anticoagulation shown to decrease this mortality. Viscoelastic parameters such as elevations in maximum clot firmness (MCF) on rotational thromboelastometry (ROTEM) have correlated with a hypercoagulable state in adults with SARS-CoV-2. We report our experience in children infected with SARS-CoV-2, with noted elevations in D-dimer and MCF on ROTEM (indicating hypercoagulability). Exploration of viscoelastic testing to provide additional laboratory-based evidence for pediatric-specific risk assessment …

Comparative Survival Analysis Of Immunomodulatory Therapy For Coronavirus Disease 2019 Cytokine Storm., S. Narain, D. G. Stefanov, A. S. Chau, A. G. Weber, G. Marder, B. Kaplan, P. Malhotra, O. Bloom, A. Liu, M. M. Lesser, N. Hajizadeh, Northwell Covid-19 Research Consortium

Journal Articles

BACKGROUND:Cytokine storm is a marker of coronavirus disease 2019 (COVID-19) illness severity and increased mortality. Immunomodulatory treatments have been repurposed to improve mortality outcomes. RESEARCH QUESTION:Do immunomodulatory therapies improve survival in patients with COVID-19 cytokine storm (CCS)? STUDY DESIGN AND METHODS:We conducted a retrospective analysis of electronic health records across the Northwell Health system. COVID-19 patients hospitalized between March 1, 2020, and April 24, 2020, were included. CCS was defined by inflammatory markers: ferritin, > 700 ng/mL; C-reactive protein (CRP), > 30 mg/dL; or lactate dehydrogenase (LDH), > 300 U/L. Patients were subdivided into six groups: no immunomodulatory treatment (standard of care) and …

Covid-19 And Cancer Patients., R Patel, J Park, A Shah, Mw Saif

Journal Articles

No abstract provided.

An Unusual Case Of Moraxella Osleonsis Bacteremia In An Immunocompetent Patient With Sars-Cov-2 Infection., B. C. Veerabathini, K. Manthani, S. Gandhi

Journal Articles

Moraxella osleonsis (M.osleonsis ) is an organism that rarely presents with bacteremia in immunocompetent patients. We report a case of an immunocompetent 59-year-old male with a recent SARS-CoV-2 infection that developed M. osleonsis bacteremia. We believe that SARS-CoV-2 infection may have played a role in developing M. osleonsis bacteremia in this patient and may be one of the first reported cases of such bacteremia in a COVID-19 patient.

Central Nervous System Complications Associated With Sars-Cov-2 Infection: Integrative Concepts Of Pathophysiology And Case Reports, S. Najjar, A. Najjar, D. J. Chong, B. K. Pramanik, C. Kirsch, R. Kuzniecky, S. Pacia, S. Azhar

Journal Articles

No abstract provided.

Covid-19 As A Possible Cause Of Functional Exhaustion Of Cd4 And Cd8 T-Cells And Persistent Cause Of Methicillin-Sensitive Staphylococcus Aureus Bacteremia., I. Choudhury, H. Han, K. Manthani, S. Gandhi, R. Dabhi

Journal Articles

We report a case of a 73-year-old male with a history of diabetes mellitus, osteomyelitis, methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia who recently completed an extended intravenous course of cefazolin eight days back, and presented with MSSA bacteremia complicated by epidural abscess, endocarditis, and aortic root abscess. Meanwhile, the patient was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription-polymerase chain reaction (RT-PCR). Even with aggressive antibiotic treatment, the patient remained bacteremic and developed endocarditis with a worsening aortic root abscess. We suspect coronavirus disease 2019 (COVID-19) as a cause for the infectious paradox and will discuss …

Covid-19 Clinical Research., J. Chi, D. Chitty, M. Lee, N. Hakim, S. Lakhani, L. Rajdev, X. Zhu, M. W. Saif

Journal Articles

Introduction:While the global COVID-19 pandemic has challenged the entire humanity and health systems, it also triggered researchers to urgently perform clinical trials to assess the safety and efficacy of many agents and modalities to combat COVID-19. As of April 22, over 650 clinical studies have been registered both in USA and internationally. Results from these studies are also coming at a brisk pace in this unprecedented emergency. Areas covered:We searched the NCI website and Medline and summarize various national and international clinical trials and summarize few of the pivotal ones in this paper, including those specific to oncology population. Two …

Development Of A New Multiplex Real-Time Rt-Pcr Assay For Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) Detection., W. Zhen, G. J. Berry

Journal Articles

This research describes the development of a new multiplex real-time RT-PCR test for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with primers designed to amplify a 108 bp target on the spike surface glycoprotein (S gene) and a hydrolysis TaqMan probe designed to specifically detect SARS-CoV-2. The limit of detection (LOD) and clinical performance of this new assay were evaluated. A LOD study with inactivated virus exhibited performance equal to the modified CDC assay, with a final LOD of 1301 ± 13 genome equivalents/mL for the Northwell Health Laboratories laboratory-developed test (NWHL LDT) versus 1249 ± 14 genome …