Medicine and Health Sciences Commons^™

Evaluation Of Stratified Antibiograms For Use In Laboratory And Antimicrobial Stewardship, Linsey Donner

Theses & Dissertations

Antibiograms are critical for choosing empiric antimicrobial therapy. Cumulative antibiograms, which aggregate susceptibility data, can mask differences within specific patient subsets or clinical syndromes. This dissertation was done to determine if antibiotic susceptibilities showed substantial differences when comparing stratified antibiograms to cumulative antibiograms.

Antibiotic susceptibility data was retrospectively obtained from Nebraska Medicine January 1, 2017 – December 31, 2019 for Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecalis. The University of Nebraska Medical Center’s web antibiogram clinical decision support tool was used to export the data. Bacteria-antibiotic susceptibility rates of stratified antibiograms …

Examination Of The Association Between C - Reactive Protein(Crp) And Covid-19 Infection Severity And Length Of Hospitalization, Abdulahi Aremu Ayanwale

Open Access Theses & Dissertations

Chronic stress can lead to many systemic complications and low-grade systemic inflammation including increased levels of inflammatory cytokines, such as C-reactive protein (CRP). CRP is a marker of systemic inflammation and is associated with depression and perceived stress. Elevations can result in ineffective immune responses, thereby increasing the risk of complications and mortality from infections. Recent evidence suggests that uncontrolled inflammatory responses associated with COVID 19 are a major determinant of disease severity.  The COVID 19 is transmitted from one person to another through droplets from coughing, sneezing, talking, touching droplets on surfaces and contamination by hand-to-mouth routes. The mechanism …

Hand Hygiene And Covid Education At Women’S Shelter, Anastasiya Yerina, Cristal Garibay, Henok Tewolde, Muskan Priya, Jeannie Lee

Nursing Leadership in Community Engagement Projects

Introduction

In 2020, there were around 580,000 people experiencing homelessness in the US with about 39% of them in unsheltered locations (Montgomery et al., 2021). Many homeless women experience safety issues and have severely impacted physical and mental health, so finding shelter is crucial in efforts to improve their well being (Sarla, 2020). Women’s Shelter is a shelter for single homeless women in downtown Seattle that provides daily meals, laundry services, and overnight shelter. After assessing the women by visiting Angeline’s, the group found that hand hygiene was an issue among the women. Then, the group decided to focus on …

A Natural Preventative To Menstrual-Related Staphylococcus Aureus Toxic Shock Syndrome, Maieasha Rashid

Student Research

Menstrual-related Toxic Shock Syndrome (TSS), a bacterial disease contracted by thegrowth of Staphylococcus aureus (S. aureus), affects over 10,000 women annually in the UnitedStates. S. aureus enters and infects the bloodstream via small lacerations made in the vaginal walls while inserting menstrual products, such as tampons and feminine sponges. TSS is often misdiagnosed, however if detected early and treated with antibiotics harbors the risk of bacterial mutation and resistance in the body. The purpose of this study was to investigate whether a natural preventative terminates the risk of contracting TSS. This experiment tested two natural substances: (1) green tea, …

Prevalence Of Esbl-Producing Enterobacteriaceae Among Lebanese Patients With Urinary Tract Infections, Rasha Abdallah, Bassel Abdallah

BAU Journal - Health and Wellbeing

Being the most common infections worldwide, Urinary Tract Infections (UTIs) represent a major public health problem. Gram negative bacteria are the main pathogens causing UTIs where Extended spectrum β–lactamase (ESBL)-Producing Enterobacteriaceae, mainly the multi-drug resistant species, such as E. coli sequence type 131 and klebsiella.pneumoniae, account for serious health problems and high economic burden. In Lebanon, data about prevalence of antibiotic resistant pathogens during UTIs are still scarce. In this study we examined the prevalence of ESBL-producing pathogens among Lebanese patients mainly located at Bekaa governorate. This retrospective study included 7241 urine tests that were collected from all the …

Assessment Of Nurses’ Knowledge And Care Practices For Infection Prevention In Neutropenic Patients In Bekaa, Lebanon: A Descriptive Cross-Sectional Design, Mona Mortada, Salim Moussa

BAU Journal - Health and Wellbeing

Neutropenia is one of the serious complications to chemotherapy that increases the risk of infection and even mortality. Nurses’ knowledge about neutropenia and their care practices are essential in order to protect neutropenic patients from infection. Thus, this study aimed to assess nurses' knowledge and care practices for infection prevention in neutropenic patients in Bekaa, Lebanon. A cross-sectional descriptive research study had been conducted in five hospitals located in Bekaa district. 81 nurses had been recruited by convenience sampling. They completed the ‘Nurses’ Knowledge and Care Practices for Infection Control in Neutropenic Patients’ questionnaire. The majority were females 77.8% (n=63), …

Variations In Covid-19 Airway Management And Preparedness Among Victorian Hospitals, Kaylee A. Jordan, Teresa M. Sindoni, Reny Segal, Keat Lee, Roni B. Krieser, Paul Mezzavia, Yinwei Chen, Irene Ng

Journal of Perioperative Nursing

The COVID-19 pandemic presents significant concerns surrounding the risk of transmission to health care workers involved in airway management of patients with suspected or known infection. Limited evidence has been available to guide the preparation of staff, intubation environments, team structure and personal protective equipment. Our study invited Victorian hospitals to complete a survey on their airway management practices and protocols, in order to assess the degree of variability in practice and preparedness. Twenty hospitals responded in September 2020, during Victoria’s second wave of COVID-19. Forty percent had dedicated COVID-19 intubation teams, all including consultant anaesthetists. Seventy-five percent had negatively …

Bias Of The Immune Response To Pneumocystis Murina Does Not Alter The Ability Of Neonatal Mice To Clear The Infection, Cathryn J. Kurkjian, Melissa L. Hollifield, David J. Feola, Beth A. Garvy

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Newborn mice are unable to clear Pneumocystis (PC) infection with the same efficiency as adults due, in part, to their inability to develop a robust immune response to infection until three weeks of age. It is known that infants tend develop a Th2 skewed response to antigen so we sought to determine whether a biased cytokine response altered the clearance of PC infection in neonatal mice. P. murina infection in neonatal mice resulted in increased IL-4 expression by CD4 T cells and myeloid cells, augmented IL-13 secretion within the airways and increased arginase activity in the airways, indicative of Th2-type …

Multiple Noncontiguous Spondylodiscitis Following Mastectomy Secondary To Breast Carcinoma: Case Report And Literature Review, Ghazwan Hasan, Ali Ali, Ameer Al-Jasim, Shahbaz Khan

Advanced Spine Journal

Background Data: Multiple noncontiguous spontaneous pyogenic spondylodiscitis is rare and has only been explained in the literature by case reports and case series. Purpose: We present a case report of multiple noncontiguous spontaneous spondylodiscitis caused by E. coli involving the cervical and lumbar spine following a mastectomy for breast cancer. We will explain the difficulties in diagnosis, treatment, and follow-up with the concomitant. Study Design: A case report and literature review. Case Report: A middle-aged patient with a history of breast carcinoma underwent surgery. Two weeks after mastectomy, the patient developed severe cervical and lumbar spine pain and a low-grade …

Prion Disease: A Challenging Diagnosis, Jeffrey F. Spindel, Anita M. Fletcher, William T. Smith, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

Introduction: Human prion diseases are a group of rare encephalopathies resulting in rapidly progressive dementia and ultimately death. While there are no effective treatments for any form of prion disease, prompt and efficient diagnosis is essential to prevent the spread of the self-propagating protein, which may occur through aerosols, and avoid unnecessary or invasive testing. Diagnosis relies largely on physical examination, with many nonspecific findings, and laboratory testing, which has wide ranges of reported accuracy and high false positive rates with diseases such as Alzheimer’s dementia.

Methods: Patients who underwent testing for prion disease were retrospectively identified from the electronic …

Infective Endocarditis Secondary To Mycoplasma Pneumoniae, Huzaifa Dawood, Saad Nasir, Reem M. Khair, Mustafa Dawood

Section of Internal Medicine

Mycoplasma pneumoniae (MP) is a gram-positive bacterium most commonly associated with community-acquired pneumonia in adults. It can also involve other systems of the body. Cardiovascular complications include pericarditis, myocarditis, congestive cardiac failure, and, rarely, infective endocarditis. We report a case of infective endocarditis secondary to MP infection in an adult. We treated our patient with doxycycline, which showed significant improvement.

Unicompartmental Knee Arthroplasty Is Associated With A Lower Rate Of Periprosthetic Joint Infection Compared To Total Knee Arthroplasty, Cody S. Lee, Edwin P. Su, Michael B. Cross, Alberto V. Carli, David C. Landy, Brian P. Chalmers

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Several studies have reported lower perioperative complications with unicompartmental knee arthroplasty (UKA) than with total knee arthroplasty (TKA). However, there is a paucity of data analyzing the incidence of periprosthetic joint infection (PJI) in similar patients undergoing UKA and TKA. As such, we sought to analyze the incidence of UKA and TKA PJI in a large matched population.

Material and Methods: The Mariner data set of the PearlDiver database was queried for all patients undergoing UKA or TKA during 2010-2017. Included patients were required to have at least 2 years of database inclusion after surgery. Patients were then matched …

Diagnosing Total Joint Arthroplasty-Associated Periprosthetic Joint Infections In Immunocompromised Patient Populations, Philip Zakko, Erin A. Baker, Christian M. Huber, Corinn Gehrke, Brett J. Friedman, Michael A. Flierl

Conference Presentation Abstracts

The 2018 ICM/MSIS classification system was used to assess PJI diagnosis in immunocompromised vs. non-immunocompromised patient populations to determine applicability of the scoring criteria.

Methods Of Educating Nursing Students On Proper Handwashing To Enhance Infection Control During The Covid Pandemic, Yulanda King

Doctor of Nursing Practice Projects

Background: Medical professionals have commonly been urged to use soap and water to sanitize their hands to prevent contamination and disease transmission. However, thorough handwashing requires a couple of minutes to clean hands thoroughly. Considering that health professionals must sanitize their hands' multiply times during a day, handwashing consumes a significant amount of time away from bedside care. Time spent away from patients may also result in a substantial decrease in the quality of healthcare services provided by the medical institution.

Purpose: This project evaluates the current policy and procedure for appropriate use of handwashing versus hand sanitizer in the …

Coccidioidomycosis (Valley Fever) Awareness, Kelly Dzialowski

Nursing Student Class Projects (Formerly MSN)

The overall purpose of this poster is to describe the fungal infection, Coccidioidomycosis, and bring awareness to this infection. The poster describes the history of the infection, pathophysiology, risk factors, and clinical presentation. Diagnosis, treatment, and complications of coccidioidomycosis are also addressed. The poster discusses the implications for nursing practice, information about the search for a vaccine, and comparisons of coccidioidomycosis and Covid-19. Finally, the conclusion discusses the key points within the poster and the importance of prompt and accurate diagnosis.

The Prospect Of Nanoparticle Systems For Modulating Immune Cell Polarization During Central Nervous System Infection, Lee E. Korshoj, Wen Shi, Bin Duan, Tammy Kielian

Journal Articles: Pathology and Microbiology

The blood-brain barrier (BBB) selectively restricts the entry of molecules from peripheral circulation into the central nervous system (CNS) parenchyma. Despite this protective barrier, bacteria and other pathogens can still invade the CNS, often as a consequence of immune deficiencies or complications following neurosurgical procedures. These infections are difficult to treat since many bacteria, such as Staphylococcus aureus, encode a repertoire of virulence factors, can acquire antibiotic resistance, and form biofilm. Additionally, pathogens can leverage virulence factor production to polarize host immune cells towards an anti-inflammatory phenotype, leading to chronic infection. The difficulty of pathogen clearance is magnified by …

Evidence That Maackia Amurensis Seed Lectin (Masl) Exerts Pleiotropic Actions On Oral Squamous Cells With Potential To Inhibit Sars-Cov-2 Infection And Covid-19 Disease Progression, Stephanie A. Sheehan, Kelly L. Hamilton, Edward P. Retzbach, Premalatha Balachandran

Faculty and Student Publications

COVID-19 was declared an international public health emergency in January, and a pandemic in March of 2020. There are over 125 million confirmed COVID-19 cases that have caused over 27 million deaths worldwide as of March 2021. COVID-19 is caused by the SARS-CoV-2 virus. SARS-CoV-2 presents a surface “spike” protein that binds to the ACE2 receptor to infect host cells. In addition to the respiratory tract, SARS-Cov-2 can also infect cells of the oral mucosa, which also express the ACE2 receptor. The spike and ACE2 proteins are highly glycosylated with sialic acid modifications that direct viral-host interactions and infection. Maackia …

Role Of Interferon Gamma Release Assay In The Diagnosis And Management Of Mycobacterium Tuberculosis-Associated Uveitis: A Review, Samra Rahman, Muhammad Irfan, Rehman Siddiqui

Section of Pulmonary & Critical Care

Tuberculosis (TB)-associated uveitis is a common cause of infectious uveitis in the developing world. Diagnosis of TB uveitis remains a challenge. The role of interferon gamma release assays (IGRAs) is uncertain. Herein we summarise the available literature on the utility of IGRAs in the diagnosis and management of TB uveitis. We searched PubMed database from 1 August 2010 to 31 July 2020 using the following keywords alone and in combination: 'interferon-gamma release assay', 'QuantiFERON', 'T-SPOT.TB', 'TB uveitis', 'serpiginous like choroiditis', 'tuberculoma', 'TB vasculitis', 'TB panuveitis' and 'ocular tuberculosis'. Data from 58 relevant studies were collated. The review is focused on …

Infection And Diet-Induced Gut Dysbiosis: Impact On Sleep Quality In Danio Rerio, Benjamin Williams

Honors College

A known bidirectional relationship between intestinal microflora and the central nervous system, coined the gut-brain-axis, has stimulated work on the association between gut dysbiosis and inflammation, and sleep quality. Previous studies in the Hayes Lab have reported that a high fat (HF) diet was correlated with immobile phases, a marker of low motility during sleep found in some neurological disease and sleep duration[1]. Long sleep duration (>1 S.D. above norms for age) is associated with poor sleep quality or sleep fragmentation in participants who are overweight or obese according to body mass index values[2]. The current work utilizes a …

Streptococcus Anginosus Lung Infection And Empyema: A Case Report And Review Of The Literature, Nishita Tripathi, Kuldeep Ghosh, Anupama Raghuram

The University of Louisville Journal of Respiratory Infections

Streptococcus milleri group (SMG) also referred to as the Streptococcus anginosus group. These are Gram-positive, variable hemolysis, catalase negative, microaerophilic, non-motile facultative anaerobes which have been known to cause abscesses in humans. We report a case of empyema caused by Streptococcus anginosus in a patient with an unresolved pneumonia for over a month. In early October 2018, the patient presented to an emergency room with the complaints of shortness of air, productive cough, chills, subjective fever and weight loss for 4 weeks. A chest X-ray revealed a left lower lobe pneumonia. He was treated with 250 mg of azithromycin for …

Respiratory Pathogens In Patients With Acute Exacerbation Of Non-Cystic Fibrosis Bronchiectasis From A Developing Country, Shayan Shahid, Kausar Jabeen, Nousheen Iqbal, Joveria Farooqi, Muhammad Irfan

Medical College Documents

Bronchiectasis unrelated to cystic fibrosis (non-CF bronchiectasis) has become a major respiratory disease in developing nations. The dilated mucus filled airways promote bacterial overgrowth followed by chronic infection, bronchial inflammation, lung injury and re-infection Accurate pathogen identification and antimicrobial susceptibility allowing appropriate treatment, in turn, may break this vicious cycle. To study the spectrum and antimicrobial spectrum of pathogen yielded from respiratory specimens in adult patients with acute exacerbation of non-cystic fibrosis (CF) bronchiectasis. This cross-sectional study was performed at the pulmonology clinics of the Aga Khan University, Karachi, Pakistan from 2016-2019. Respiratory specimens were collected from adult patients with …

Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye

Journal of Patient-Centered Research and Reviews

While transfusion of blood and blood products is instinctively linked to the provision of emergent care, blood and blood products are also routinely used for the treatment of subacute and chronic conditions. Despite the efforts of the World Health Organization and others, developing countries are faced with a three-part problem when it comes to access to and delivery of transfusions: insufficient supply, excessive demand, and inadequate quality of available supply. Developing countries rely heavily on replacement and remunerated donors rather than voluntary nonremunerated donors due to concerns regarding donation- and transfusion-transmitted infection as well as local and cultural beliefs. While …

Management Of Primary Spondylodiscitis: Clinical Outcome Of A Series Of Twenty-Seven Patients, Mohamed Nagy, Mahmoud Wahdan, Ahmed Saleh

Advanced Spine Journal

Background Data: Spondylodiscitis is a major clinical condition with significant health and economic burden. There is a controversy regarding the use of conservative therapy with systemic antibiotics alone versus combined with surgery to manage primary spondylodiscitis. Study Design: Retrospective clinical case study. Purpose: To assess the clinical outcome of treatment of the patients with primary spondylodiscitis. Patients and Methods: This study was conducted on 27 patients with primary spondylodiscitis. There were 17 males and 10 females. The mean age was 49.96 ± 9.83 years. All the patients presented with local pain over the involved vertebral level. The clinical outcomes were …

Efficacy And Safety Of Vancomycin Loading Doses In Critically Ill Patients With Methicillin-Resistant Staphylococcus Aureus Infection, Alexander H. Flannery, Katie L. Wallace, Christian N. Rhudy, Allison S. Olmsted, Rachel C. Minrath, Stuart M. Pope, Aaron M. Cook, David S. Burgess, Peter E. Morris

Pharmacy Practice and Science Faculty Publications

Background: While vancomycin loading doses may facilitate earlier pharmacokinetic–pharmacodynamic target attainment, the impact of loading doses on clinical outcomes remains understudied. Critically ill patients are at highest risk of morbidity and mortality from methicillin resistant Staphylococcus aureus (MRSA) infection and hypothesized to most likely benefit from a loading dose. We sought to determine the association between receipt of a vancomycin loading dose and clinical outcomes in a cohort of critically ill adults.

Methods: Four hundred and forty-nine critically ill patients with MRSA cultures isolated from blood or respiratory specimens were eligible for the study. Cohorts were established by receipt of …

Photonic Designs To Reduce Morbidity And Mortality For Icu Patients On Ventilators, Jacob C. Lomonaco, Noah R. Baker, C. David Melville, Catherine A. Olivo, Matthew D. Carson, Eric J. Seibel

School of Medicine Faculty Publications

Ventilator-associated pneumonia (VAP) is pneumonia that occurs >48hrs after initiation of mechanical ventilation and is a significant cause of morbidity and mortality in patients that are hospitalized in intensive care units (ICU). The risk of developing VAP increases during use, and a diagnosis of VAP has been associated with a substantial cost. There are up to hundreds of thousands of cases in the US per year, costing the healthcare system billions annually. Patients who suffer from VAP frequently require longer ICU stays, higher exposure to antibiotics, and more hospital care at the risk of increased mortality. The SARS-CoV-2 pandemic has …

Covid-19 And Adult Acute Lymphoblastic Leukemia: Presentation And Management, Ayesha Butt, Natasha Bahadur Ali

Medical College Documents

No abstract provided.

Infection And Risk Of Parkinson's Disease, Richard Jay Smeyne, Alastair J Noyce, Matthew D. Byrne, Rodolfo Savica, Connie Marras

Department of Neuroscience Faculty Papers

Parkinson's disease (PD) is thought to be caused by a combination of genetic and environmental factors. Bacterial or viral infection has been proposed as a potential risk factor, and there is supporting although not entirely consistent epidemiologic and basic science evidence to support its role. Encephalitis caused by influenza has included parkinsonian features. Epidemiological evidence is most compelling for an association between PD and hepatitis C virus. Infection with Helicobacter pylori may be associated not only with PD risk but also response to levodopa. Rapidly evolving knowledge regarding the role of the microbiome also suggests a role of resident bacteria …

Heterocycles In The Treatment Of Neglected Tropical Diseases, Kush K. Maheshwari, Debasish Bandyopadhyay

Chemistry Faculty Publications and Presentations

Background: Neglected Tropical Diseases (NTDs) affect a huge population of the world and the majority of the victims belong to the poor community of the developing countries. Until now, the World Health Organization (WHO) has identified 20 tropical diseases as NTDs that must be addressed with high priority. However, many heterocyclic scaffolds have demonstrated potent therapeutic activity against several NTDs.

Objective: There are three major objectives: (1) To discuss the causes, symptoms, and current status of all the 20 NTDs; (2) To explore the available heterocyclic drugs, as well as their mechanisms of action (if known), that are being used …

Modes Of Transmission Of Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-Cov-2) And Factors Influencing On The Airborne Transmission: A Review, Mahdieh Delikhoon, Marcelo I. Guzman, Ramin Nabizadeh, Abbas Norouzian Baghani

Chemistry Faculty Publications

The multiple modes of SARS-CoV-2 transmission including airborne, droplet, contact, and fecal–oral transmissions that cause coronavirus disease 2019 (COVID-19) contribute to a public threat to the lives of people worldwide. Herein, different databases are reviewed to evaluate modes of transmission of SARS-CoV-2 and study the effects of negative pressure ventilation, air conditioning system, and related protection approaches of this virus. Droplet transmission was commonly reported to occur in particles with diameter >5 µm that can quickly settle gravitationally on surfaces (1–2 m). Instead, fine and ultrafine particles (airborne transmission) can stay suspended for an extended period of time (≥2 h) …

Stay-At-Home Order And Spatial Disparities In Covid-19 Pandemic In New York City, Youqin Huang, Rui Li

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

Much of the world has adopted unprecedented lockdown policies as the key method to address the spread of COVID-19; yet their effect on pandemic outcomes remain largely unknown. This research determines how mobility restriction policies and public transit system shape intra-city health disparities in this pandemic, using New York City as a case study. With a spatial method and multiple sources of data, this research demonstrates the effectiveness of the stay-at-home order. On average, people spent about 20% more time at home in 2020 than in the same period in 2019. Census tracts with people spending more time at home …