Bacterial Infections and Mycoses Commons^™

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 …

Typical Hus: Evidence Of Acute Phase Complement Activation From A Daycare Outbreak, T M. Brady, C Pruette, L F. Loeffler, Darcy Weidemann, J J. Strouse, E Gavriilaki, R A. Brodsky

Manuscripts, Articles, Book Chapters and Other Papers

The clinical manifestations of typical hemolytic uremic syndrome (HUS) encompass a wide spectrum. Despite the potentially severe sequelae from this syndrome, treatment approaches remain supportive. We present the clinical course of a child who contracted Shiga toxin-positive E. coli (STEC) from a daycare center during an outbreak. Utilizing the modified Ham test which is a rapid, serum-based functional assay used to detect activation of the alternative pathway of complement as observed in atypical HUS, patient sera revealed evidence of increased complement activation in the acute phase of the syndrome but not after resolution. Further, this complement activation was attenuated by …

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 …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Commentary On "Systemic Candidiasis And Cytomegalovirus Infection In The Setting Of Artificial Cardiac Device Deployment", Moises A. Huaman

The VAD Journal

No abstract provided.

The Medical Response To The Black Death, Joseph A. Legan

Senior Honors Projects, 2010-2019

This paper discusses the medical response to the Black Death in both Europe and the Middle East. The Black Death was caused by a series of bacterial strands collectively known as Yersinia pestis. The Plague originated in the Mongolian Steppes. It was spread westward by the east-west trading system. Once it arrived in the Crimea in 1346, Italian merchants helped spread it throughout the Mediterranean. Medicine in Europe and the Middle East were centered on Galen’s theory of humors. There were many religious explanations for the Plague, but the main medical explanation was the spread of bad air, or …

Infectious Diseases, Bert Chapman

Libraries Faculty and Staff Scholarship and Research

Provides information about the role of infectious diseases in the early years of U.S. History, with particular emphasis on how they impacted injuries sustained in military conflict.

Bacteria On Shared Mobile Phones Can Lead To Infections, Roberta Basol, Jean Beckel, Judy Gilsdorf-Gracie, Amy Hilleren-Listerud, Terri Mccaffrey, Sherri Reischl, Pamela Rickbeil, Mary Schimnich, Kirsten Skillings, Mary A. Struffert

Articles

It's now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers, sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs) if they aren't properly disinfected. The Guidelines for Disinfection and Sterilization in Healthcare Facilities describe "non-critical environmental surfaces" as items that are frequently touched by the hand and may pose a risk of secondary infection transmission.

Characterizing The Response Of Multidrug-Resistant Klebsiella Pneumoniae Species To The Application Of A Phage Cocktail, Steven Liu

Symposium

Project Summary: The application of bacteriophages to treat bacterial infections is known as phage therapy, which takes advantage of bacteriophage’s natural ability to infect and lyse bacterial hosts. Phages have been shaped by billions of years of evolution to be highly specialized deliverers of bactericidal agents to the cytoplasm of their target bacteria. Ever since discovery of bacteriophages in 1915, phage therapy was recognized as a potentially powerful tool for eliminating bacterial infections. The effectiveness of phage therapy can be increased by creating a mixture of multiple phages to target a wider variety of bacterial strains. Furthermore, phage therapy has …

Eculizumab In The Successful Treatment Of Postpartum Hemolytic Uremic Syndrome - A Case Report, Craig A. Mackaness Do, Frederick S. Fleszler Md

Department of Medicine

No abstract provided.

Age Related Clinical Manifestation Of Acute Bacterial Meningitis In Children, Jabeen Fayyaz, Arshalooz Rehman, Akhter Hamid, Munawar Khursheed, Nukhbha Zia, Asher Feroze

Department of Emergency Medicine

Objective: To determine the signs and symptoms of acute bacterial meningitis (ABM) in different age grops of a paediatric population.

Methods: The retrospective study comprised patients who had been admitted through the Emergency Department of Aga Khan University Hospital, Karachi with the relevant diagnosis from September 2009 to September 2011. Case record forms were used to collect data from patient files. Data was collected using variables such as age, gender, presenting complaints, clinical signs and symptoms, computed tomography scan findings and final outcome of patients. There was a minimal risk of breach in patient confidentiality. SPSS 19 was used for …

Vaccine-Preventable Diseases In Travelers, Edith Mirzaian, Jeffery A. Goad, Ani Amloian, Fady Makar

Pharmacy Faculty Articles and Research

Travel to the developing world is increasing among those from developed countries, placing them at risk for vaccine preventable and non-vaccine preventable diseases. From 2007-2011, the GeoSentinel Network reported 737 returned travelers with a vaccine preventable disease. While it is essential that clinicians use vaccines when available for a disease of risk, they should also be aware that the vast majority of diseases acquired by travelers are non-vaccine preventable. The vaccine preventable diseases can be divided into routine travel vaccines, special travel vaccines and routine vaccines used for travel. The routine travel vaccines include Hepatitis A and B, typhoid; special …

Pseudomonas Aeruginosa Exotoxin Y-Mediated Tau Hyperphosphorylation Impairs Microtubule Assembly In Pulmonary Microvascular Endothelial Cells, Ron Balczon, Nutan Prasain, Cristhiaan Ochoa, Jason Prater, Bing Zhu, Mikhail Alexeyev, Sarah Sayner, Dara W. Frank, Troy Stevens

University Faculty and Staff Publications

Pseudomonas aeruginosa uses a type III secretion system to introduce the adenylyl and guanylyl cyclase exotoxin Y (ExoY) into the cytoplasm of endothelial cells. ExoY induces Tau hyperphosphorylation and insolubility, microtubule breakdown, barrier disruption and edema, although the mechanism(s) responsible for microtubule breakdown remain poorly understood. Here we investigated both microtubule behavior and centrosome activity to test the hypothesis that ExoY disrupts microtubule dynamics. Fluorescence microscopy determined that infected pulmonary microvascular endothelial cells contained fewer microtubules than control cells, and further studies demonstrated that the microtubule-associated protein Tau was hyperphosphorylated following infection and dissociated from microtubules. Disassembly/reassembly studies determined that …

Comparison Of The Virulence Markers Of Helicobacter Pylori And Their Associated Diseases In Patients From Pakistan And Afghanistan, Javed Yakoob, Zaigham Abbas, Wasim Jafri, Muhammad W. Usman, Fatima Jafri, Safia Awan

Section of Gastroenterology

BACKGROUND/AIM: Helicobacter pylori is a Gram-negative bacteria, which is associated with development of gastroduodenal diseases. The prevalence of H. pylori and the virulence markers cytotoxin-associated gene A and E (cagA, cagE) and vacuolating-associated cytotoxin gene (vacA) alleles varies in different parts of the world. H. pylori virulence markers cagA, cagE, and vacA alleles in local and Afghan nationals with H. pylori-associated gastroduodenal diseases were studied.

PATIENTS AND METHODS:Two hundred and ten patients with upper gastrointestinal symptoms and positive for H. pylori by the urease test and histology were included. One hundred and nineteen were local nationals and 91 were Afghans. …

Multicenter Study Of High-Dose Daptomycin For Treatment Of Enterococcal Infections, Anthony M. Casapao, Ravina Kullar, Susan L. Davis, Donald P. Levine, Jing J. Zhao, Brian A. Potoski, Debra A. Goff, Christopher W. Crank, John Segreti, George Sakoulas, Sara E. Cosgrove, Michael J. Rybak

Internal Medicine Faculty Publications

Enterococci are among the leading pathogens isolated in hospital-acquired infections. Current antimicrobial options for vancomycin-resistant enterococci (VRE) are limited. Prior data suggests that daptomycin > 6mg/kg/day may be used to treat enterococcal infections. We retrospectively evaluated the effectiveness and safety of high-dose daptomycin (HD-daptomycin) therapy (> 6 mg/kg) in a multicenter cohort of adult patients with enterococcal infections to describe the characteristics and outcomes. Two-hundred and forty-five patients were evaluated. Enterococcus faecium was identified in 175 (71%), followed by 49 (20%) Enterococcus faecalis and 21 (9%) Enterococcus spp., overall 204 (83%) were VRE. Enterococcal infections included bacteremia (173, 71%), intra-abdominal (35, …

Effects Of Clostridium Difficile On The Human Immune Response, Mike Mcgovern

Honors Projects in Science and Technology

Clostridium difficile is a bacterium that is rapidly becoming a large issue in the medical community due to its tendency to infect hospital patients and its resistance to antibiotics. By studying the way in which the pathogen interacts with the human immune system, it is possible to better understand how the body naturally fights off the disease. This knowledge can allow medical professionals to develop treatments that can help curtail the infection before serious symptoms occur. Working under a grant program alongside Professors Kirsten Hokeness and Chris Reid, I was able to research the effects that exposure to the C. …

Prevalence And Antimicrobial Agent Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Healthy Pediatric Outpatients In Las Vegas, Echezona E. Ezeanolue, Mark P. Buttner, Patricia Cruz, Joanne L. Henry, Chad L. Cross, Linda D. Stetzenbach

Nevada Journal of Public Health

Colonization and infection by community-associated resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The purpose of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children and to characterize the MRSA isolates in the laboratory with regard to antimicrobial agent susceptibility patterns, and the presence of the mecA and the Panton-Valentine leukocidin (PVL) genes. Nasal swabs were collected at two pediatric clinics from a total of 505 children during health maintenance visits. A brief questionnaire was administered to collect demographic data and pertinent medical, family, and social history. Samples were cultured …

Clostridium Septicum Growth From A Total Knee Arthroplasty Associated With Intestinal Malignancy: A Case Report, Demetri M. Economedes, Jerome Santoro, Carl A. Deirmengian

PCOM Scholarly Works

BACKGROUND: Previous reports of infection with Clostridium septicum have identified an unexpected association with concurrent malignancy. The reported rate of associated malignancy has been found to be as high as 81 percent. The purpose of this case report was to present a case of a total knee arthroplasty infected with C. septicum and the subsequent finding of an occult colonic malignancy.

CASE PRESENTATION: A 74 year-old man underwent uneventful bilateral total knee arthroplasties. Two weeks post-operatively, he presented with acute swelling, redness and pain of the left knee. Aspiration of the knee was sent for cell count and …

Inhibition Of Adhesion And Invasion Of Pseudomonas Aeruginosa To Lung Epithelial Cells: A Model Of Cystic Fibrosis Infection, Ayman Noreddin, Ghada Sawy, Walid Elkhatib, Ehab Noreddin, Atef Shibl

Pharmacy Faculty Books and Book Chapters

"Over their life time, CF patients experience multiple infections by various pneumoniacausing bacteria [6]. With more patients surviving to adulthood, chronic infections with Pseudomonas aeruginosa are coming to the forefront as a leading cause of death [7]. Problems presented by infected CF lung are multi-dimensional; the electrolyte balance and pH of the fluids are abnormal. The mucus is thick and of an alternative composition compared to normal lung and may contribute to colonization with Pseudomonas aeruginosa [2, 3, 5]. As such, research is multi-pronged and includes gene therapy to correct the defective protein, amelioration of inflammatory response and thinning of …

Puerperal Fever From Hippocrates To Pasteur, Hunter A. Hammill

Houston History of Medicine Lectures (2006-2012)

The death of a mother in childbirth leaving a newborn deserted is a sort of a desecration. This was a frequent event for early physicians. It was felt to be caused by miasmas or punishment from the gods. DaVinci felt the cause was milk stasis, Hippocrates - lochia, Virchow - weather. Then came Semmelweis, Pasteur and Lister. They started a battle with ignorance, hospital administration, budget and academic politics. Ending with the murder of Semmelweis!

Retrospective Comparison Of The Incidence Of Acute Kidney Injury In Patients Treated With Intravenous Polymyxin B Or Intravenous Colistimethate Sodium, Rebecca A. Sumner Pharmd, Jarrod W. Kile Rph, Bcps

Department of Pharmacy

No abstract provided.

Infectious Intracranial Aneurysms: Collaboration For Treatment Success, Erin M. Conahan Rn, Bsn, Cnrn

Patient Care Services / Nursing

No abstract provided.

Executive Summary: The Management Of Community-Acquired Pneumonia In Infants And Children Older Than 3 Months Of Age: Clinical Practice Guidelines By The Pediatric Infectious Diseases Society And The Infectious Diseases Society Of America., John S. Bradley, Carrie L. Byington, Samir S. Shah, Brian Alverson, Edward R. Carter, Christopher Harrison, Sheldon L. Kaplan, Sharon E. Mace, George H. Mccracken, Matthew R. Moore, Shawn D. St Peter, Jana A. Stockwell, Jack T. Swanson, Pediatric Infectious Diseases Society And The Infectious Diseases Society Of America

Manuscripts, Articles, Book Chapters and Other Papers

Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

Analysis Of Chlamydia Pneumoniae And Ad-Like Pathology In The Brains Of Balb/C Mice Following Direct Intra-Cranial Infection, Jessica Rachel Barton, Christine J. Hammond, Amy L. Brady, Denah M. Appelt, Brian J. Balin, Christopher Scott Little

Scholarly Posters

Alzheimer’s disease (AD) is an age-related progressive neurodegenerative disorder and the most common form of dementia. The pathology in the central nervous system (CNS) impairs memory and cognition, hindering the capabilities and the quality of life of the individual. This project continues studying the role of infection and Alzheimer’s disease, as previous studies in this laboratory have done, and contributes to the overall understanding of the possible causes of this disease. In this study, BALB/c mice were infected, via direct intracranial injection, with a respiratory isolate (AR-39) of Chlamydia pneumoniae. Their brains were analyzed at 7 and 14 days post-infection, …

Analysis Of Chlamydia Pneumoniae-Infected Monocytes Following Incubation With A Novel Peptide, Acaly18, Implicates The Inflammasome In Clearance Of Infection, Brian J. Balin, James D. Thacker, Charles Lim, Corey M. Caruthers, Susan T. Hingley, Juliana Zoga, Denah M. Appelt

Scholarly Posters

Chlamydia pneumoniae infection may be a trigger for the pathology observed in sporadic lateonset Alzheimer’s disease as a function of initiating neuroinflammation following entry of the organism into the brain. We have hypothesized that one entry mechanism may be by bloodborne infected monocytes trafficking the infection into the brain. This study focuses on infection of monocytes in vitro followed by analysis using immunofluorescence labeling and RT-PCR-microarray techniques. The microarrays utilized consisted of an Alzheimer’s disease pathway array and an innate and adaptive immunity array from SAbiosciences. Analysis by real time PCR for both gene arrays was performed on uninfected and …

Gestational Diabetes Clinic For Indigent Latinos, Sara Wilson Reece

Scholarly Posters

Gestational diabetes mellitus (GDM), “carbohydrate intolerance of variable severity with onset or fist recognition during pregnancy,” results from insulin resistance and relative insulin deficiency usually in second trimester.¹ • Gestational diabetes (GDM) impacts between 4% and 9% of all pregnancies. • Gestational diabetes (GDM) results in increased fetal complications of macrosomia, shoulder dystocia and neonatal hyperglycemia as well as maternal risks of preeclampsia and polyhydramnois. • Women who are Hispanic or Asian decent are at highest risk of developing GDM. • Diagnosis ² • Perform 75-gramoral glucose tolerance test (OGTT) at 24 – 28 weeks of gestation in women not …

Tca Cycle Inactivation In Staphylococcus Aureus Alters Nitric Oxide Production In Raw 264.7 Cells, Chandirasegaran Massilamany, Arunakumar Gangaplara, Donald J. Gardner, James M. Musser, David J. Steffen, Greg A. Somerville, Jay Reddy

Jay Reddy Publications

Inactivation of the Staphylococcus aureus tricarboxylic acid (TCA) cycle delays the resolution of cutaneous ulcers in a mouse soft tissue infection model. In this study, it was observed that cutaneous lesions in mice infected with wild-type or isogenic aconitase mutant S. aureus strains contained comparable inflammatory infiltrates, suggesting the delayed resolution was independent of the recruitment of immune cells. These observations led us to hypothesize that staphylococcal metabolism can modulate the host immune response. Using an in vitro model system involving RAW 264.7 cells, the authors observed that cells cultured with S. aureus aconitase mutant strains produced significantly lower amounts …

Β-Lactams Interfering With Pbp1 Induce Panton-Valentine Leukocidin Expression By Triggering Sara And Rot Global Regulators Of Staphylococcus Aureus, Oana Dumitrescu, Priya Choudhury, Sandrine Boisset, Cedric Badiou, Michele Bes, Yvonne Benito, Christiane Wolz, Francois Vandenesch, Jerome Etienne, Ambrose L. Cheung

Dartmouth Scholarship

Previous articles reported that beta-lactam antibiotics increase the expression of Staphylococcus aureus Panton-Valentine leukocidin (PVL) by activating its transcription. We investigated the mechanisms underlying the inductor effect of beta-lactams on PVL expression by determining targets and regulatory pathways possibly implicated in this process. We measured PVL production in the presence of oxacillin (nonselective), imipenem (penicillin-binding protein 1 [PBP1] selective), cefotaxime (PBP2 s

Is There An Association Of Giardiasis With Beta-Thalassemia Minor?, Javed Yakoob, Wasim Jafri, Hizbullah Shaikh

Section of Gastroenterology

Beta–thalassemia minor is a symptomless carrier state of a hemoglobinopathy which predisposes to bacterial infections. We report three cases presenting with giardiasis, a parasitic infection of gastrointestinal tract caused by Giardia lamblia. Patients presented with recurrent diarrhea and abdominal pain for over a year. An esophagogastroduodenoscopy finding varied from normal to acute duodenitis. Duodenal biopsy demonstrated changes consistent with mild chronic non-specific inflammation with G. lamblia trophozoites. All three patients were diagnosed as β -thalassemia minor hemoglobin electrophoresis. They were treated with Diloxanide furoate 500 mg and Metronidazole 400mg three times daily for five days. Their symptoms resolved and a …

Evaluating Children With Otitis Media For Bacteremia Or Urinary Tract Infection., Daniel Yawman, Patrick Mahar, Aaron Blumkin, Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Background. It is unclear if clinicians evaluate for concurrent bacteremia or UTI in young patients diagnosed with acute otitis media (AOM). Objectives. To describe how often, and under which circumstances, emergency providers investigate for bacteremia or UTI in 2-36 month olds with AOM. Methods. Cases of AOM were analyzed from the 2001-2004 National Hospital Ambulatory Medical Care Survey (NHAMCS)-Emergency Department dataset. Results. AOM was diagnosed in 17% of the 10,847 recorded visits of 2-36 month olds. Of these visits, laboratory testing included: CBC: 7%, Blood culture: 4%, urinalysis or urine culture: 5%, and any of these tests: 9%. Rates of …