Infectious Disease Commons^™

The Durability Of Antibody Responses Of Two Doses Of High-Dose Relative To Two Doses Of Standard-Dose Inactivated Influenza Vaccine In Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial., Jennifer E. Schuster, Lubna Hamdan, Daniel E. Dulek, Carrie L. Kitko, Einas Batarseh, Zaid Haddadin, Laura S. Stewart, Anna Stahl, Molly Potter, Herdi Rahman, Spyros A. Kalams, Claire E. Bocchini, Elizabeth A. Moulton, Susan E. Coffin, Monica I. Ardura, Rachel L. Wattier, Gabriela Maron, Michael Grimley, Grant Paulsen, Christopher J. Harrison, Jason L. Freedman, Paul A. Carpenter, Janet A. Englund, Flor M. Munoz, Lara Danziger-Isakov, Andrew J. Spieker, Natasha B. Halasa, Pediatric Hct Flu Study

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Our previous study established a 2-dose regimen of high-dose trivalent influenza vaccine (HD-TIV) to be immunogenically superior compared to a 2-dose regimen of standard-dose quadrivalent influenza vaccine (SD-QIV) in pediatric allogeneic hematopoietic cell transplant (HCT) recipients. However, the durability of immunogenicity and the role of time post-HCT at immunization as an effect modifier are unknown.

METHODS: This phase II, multi-center, double-blinded, randomized controlled trial compared HD-TIV to SD-QIV in children 3-17 years old who were 3-35 months post-allogeneic HCT, with each formulation administered twice, 28-42 days apart. Hemagglutination inhibition (HAI) titers were measured at baseline, 28-42 days following each …

Targeted Repression Of Topa By Crispri Reveals A Critical Function For Balanced Dna Topoisomerase I Activity In The Chlamydia Trachomatis Developmental Cycle, Li Shen, Leiqiong Gao, Abigail R. Swoboda, Scot P. Ouellette

School of Medicine Faculty Publications

Chlamydia trachomatis is an obligate intracellular bacterium that is responsible for the most prevalent bacterial sexually transmitted infection. Changes in DNA topology in this pathogen have been linked to its pathogenicity-associated developmental cycle. Here, evidence is provided that the balanced activity of DNA topoisomerases contributes to controlling Chlamydia developmental processes. Utilizing catalytically inactivated Cas12 (dCas12)-based clustered regularly interspaced short palindromic repeats interference (CRISPRi) technology, we demonstrate targeted knockdown of chromosomal topA transcription in C. trachomatis without detected toxicity of dCas12. Repression of topA impaired the developmental cycle of C. trachomatis mostly through disruption of its differentiation from a replicative form …

Multivalent Epigraph Hemagglutinin Vaccine Protects Against Influenza B Virus In Mice, Erika M. Petro-Turnquist, Brigette Corder Kampfe, Amber Gadeken, Matthew J. Pekarek, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

Influenza B virus is a respiratory pathogen that contributes to seasonal epidemics, accounts for approximately 25% of global influenza infections, and can induce severe disease in young children. While vaccination is the most commonly used method of preventing influenza infections, current vaccines only induce strain-specific responses and have suboptimal efficacy when mismatched from circulating strains. Further, two influenza B virus lineages have been described, B/Yamagatalike and B/Victoria-like, and the limited cross-reactivity between the two lineages provides an additional barrier in developing a universal influenza B virus vaccine. Here, we report a novel multivalent vaccine using computationally designed Epigraph hemagglutinin proteins …

Interplay Between Acetylation And Ubiquitination Of Imitation Switch Chromatin Remodeler Isw1 Confers Multidrug Resistance In Cryptococcus Neoformans, Yang Meng, Yue Ni, Zhuoran Li, Tianhang Jiang, Tianshu Sun, Yanjian Li, Xindi Gao, Hailong Li, Chenhao Suo, Chao Li, Sheng Yang, Tian Lan, Guojian Liao, Tongbao Liu, Ping Wang, Chen Ding

School of Medicine Faculty Publications

Cryptococcus neoformans poses a threat to human health, but anticryptococcal therapy is hampered by the emergence of drug resistance, whose underlying mechanisms remain poorly understood. Herein, we discovered that Isw1, an imitation switch chromatin remodeling ATPase, functions as a master modulator of genes responsible for in vivo and in vitro multidrug resistance in C. neoformans. Cells with the disrupted ISW1 gene exhibited profound resistance to multiple antifungal drugs. Mass spectrometry analysis revealed that Isw1 is both acetylated and ubiquitinated, suggesting that an interplay between these two modification events exists to govern Isw1 function. Mutagenesis studies of acetylation and ubiquitination sites …

Exploring The Role Of Information And Communication Technologies In Allergic Rhinitis In Specialist Centers: Patient Perspectives On Usefulness, Value, And Impact On Healthcare, Ivan Cherrez-Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda-Ortega, Guillermo Guidos, Ulbio Alcivar Molina

Department of Paediatrics and Child Health

Introduction: Information and communication technologies (ICTs) improve patient-centered care and are routinely used in Allergic Rhinitis (AR), but patients' preferences and attitudes are unexplored. This study examines AR-related information preferences and ICT use by AR patients.
Methods: A survey-based cross-sectional study was carried out in Ecuador from July to September 2019 in seven centers of reference for allergic disease. Participants were 18 years or older, diagnosed with AR and had access to ICT and the Internet. Descriptive and binomial logistic regressions were performed. A value of less than 0.05 was considered statistically significant.
Results: 217 patients were included. 47% (n …

The Hiv/Aids Epidemic In Miami: Perspectives Of Stakeholders And Frontline Providers, Tracy Pugh, Carrigan L. Parish, Pedro C. Castellon, Allan Rodriguez, Michael A. Kolber, Lisa R. Metsch

Florida Public Health Review

Background: Miami, Florida persists as an epicenter of HIV/AIDS nationally and has been more delayed than other areas with high HIV burden in implementing public health measures that mitigate transmission risk. These issues among other social and structural-level determinants have complicated progress in addressing HIV/AIDS in Miami.

Purpose: The stagnated progress in improving HIV outcomes in Miami necessitated a more comprehensive understanding of the experiences and insights of stakeholders within the system. We used a stakeholder analysis approach to understand the complexity of driving factors and key challenges facing this HIV epidemic.

Methods: A stakeholder analysis was conducted …

Exploring The Role Of Information And Communication Technologies In Allergic Rhinitis In Specialist Centers: Patient Perspectives On Usefulness, Value, And Impact On Healthcare, Ivan Cherrez Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda Ortega, Guillermo Guidos, Ulbio Alcivar Molina

Department of Paediatrics and Child Health

Introduction: Information and communication technologies (ICTs) improve patient-centered care and are routinely used in Allergic Rhinitis (AR), but patients' preferences and attitudes are unexplored. This study examines AR-related information preferences and ICT use by AR patients.
Methods: A survey-based cross-sectional study was carried out in Ecuador from July to September 2019 in seven centers of reference for allergic disease. Participants were 18 years or older, diagnosed with AR and had access to ICT and the Internet. Descriptive and binomial logistic regressions were performed. A value of less than 0.05 was considered statistically significant.
Results: 217 patients were included. 47% (n …

Clarification Of Adverse Drug Reactions By A Pharmacovigilance Team Results In Increased Antibiotic Re-Prescribing At A Freestanding United States Children's Hospital., Keith Feldman, Sarah Suppes, Jennifer Goldman

Manuscripts, Articles, Book Chapters and Other Papers

Documentation of adverse drug reactions (ADRs) is a key factor in guiding future prescribing. However, incomplete documentation is common and often fails to distinguish implicated drugs as true allergies. This in turn leads to unnecessary avoidance of implicated drug classes and may result in sub-optimal prescribing. Pharmacovigilance (PV) programs utilize a systematic approach to clarify ADR documentation and are known to improve patient safety. Yet it remains unclear if PV alters prescribing. Or, if the existence of the ADR documentation itself continues to prompt avoidance of implicated drugs. To address this, our work presents a retrospective cohort study assessing if …

Rare Case Of Mycobacterium Avium Complex Peritonitis In A Patient With Multiple Myeloma Undergoing Peritoneal Dialysis, Sacide S. Ozgur, Nida Ansari, Dhruv Patel, Ryan Rahman, Raymond Shih

Journal of Community Hospital Internal Medicine Perspectives

Mycobacterium avium complex (MAC) infections can present as a variety of severe diseases. While it has a predilection for immunocompromised patients such as those with Human immunodeficiency virus (HIV), it can also affect immunocompetent patients as well. One of the rare yet severe diseases that MAC infections can present is MAC peritonitis. Often hard to distinguish from other causes of peritonitis, high clinical suspicion should be maintained for those who are susceptible. Here we present an 85-year-old female with a past medical history of end-stage renal disease on peritoneal dialysis who presented with nausea and vomiting. She was found to …

Case Study: A Severe Presentation Of Chronic Eosinophilic Pneumonia, Revati Kalluri, Md, Mari Kai, Md

Poster Presentations

No abstract provided.

From Dormant To Dangerous: Hepatitis B Reactivation Under Immunosuppression, Adam Knott, Md, Amy Dechet, Md

Poster Presentations

No abstract provided.

A Potentially Cat-Astrophic Missed Diagnosis: Systemic Autoimmune Disease, Or Something More Sinister?, Cameron Smith, Do, Mph, Amy Dechet, Md

Poster Presentations

No abstract provided.

Clinical Outcomes Associated With Mrsa Naat Utilization., Shannon B. Leighton, Pharmd, Emily Fox, Greg Tallman

Books, Presentations, Posters, Etc.

Abstract: A recent analysis by the Oregon Regional Antimicrobial Stewardship Program demonstrated that across the Oregon region, MRSA NAAT from the nares have a high negative predictive value (NPV) of 99.4%. These findings were consistent when stratified by culture site. The high NPV suggests that MRSA NAAT nasal swabs can be useful in promoting de-escalation (e.g., discontinuation) of anti-MRSA treatment. Few studies have evaluated if use of the MRSA NAAT influences anti-MRSA treatment de-escalation, and even fewer have assessed important clinical outcomes related to MRSA NAAT utilization and de-escalation. The goal of this study is to evaluate the frequency of …

Not Just A Biblical Disease: Hansen’S Disease (Leprosy) Oregon’S Unique Differential, Zach Taylor, Justin Jin, Andrea Roast, Amy Dechet

Books, Presentations, Posters, Etc.

Background: Hansen’s disease (leprosy) is caused by a gram-positive, acid-fast bacilli called Mycobacterium leprae. It is very slow growing and has an indolent disease process. The disease is more prevalent in underdeveloped countries with poor access to care including Brazil, India, sub-Saharan Africa, and the Pacific Islands including Micronesia and the Philippines. However, it is becoming in creasingly common in the United States, specifically in areas with high levels of immigration from Micronesia. Case: Our patient was a 35-year-old Micronesian man who presented with 7 days of non-traumatic right hand pain with progressive swelling. He migrated to US from Micronesia …

Don’T Poke The Bear: Pheochromocytoma Unmasked By Covid-10, Taylor Virtue, Andrea Roast

Books, Presentations, Posters, Etc.

Introduction: Pheochromocytomas are tumors of the adrenal gland which produce excess catecholamines. The classic clinical triad is paroxysmal headache, diaphoresis, and tachycardia. The rare incidence makes this a challenging diagnosis which is even more challenging in the environment of the COVID-19 pandemic. Case Presentation: Setting: Establishing care visit at a primary care office Demographic: 42 year old male Medical history: Previously well-controlled hypertension, prediabetes HPI: • Weeks of profound, persistent fatigue and lightheadedness after the resolution of acute symptoms (fever, chills) from COVID-19 infection. Denies any headaches or palpitations. • Meticulously measuring vital signs at home. He has noticed that …

Korean: 패혈증 알아야 할 사항 - Sepsis What You Need To Know, Providence

All Sepsis Education Materials

패혈증 알아야 할 사항 SEPSIS What You Need to Know (Korean Language)

Chinese-Simplified: 败血症须知事项 - Sepsis What You Need To Know, Providence

All Sepsis Education Materials

败血症须知事项 SEPSIS What You Need to Know (Chinese-Simplified Language)

Armenian: Սեպսիս Ինչ Պետք Է Իմանաք - Sepsis What You Need To Know, Providence

All Sepsis Education Materials

ՍԵՊՍԻՍ Ինչ պետք է իմանաք SEPSIS What You Need to Know (Armenian Language)

Arabic: متالزمة االستجابة االلتهابية الجهازية ما تحتاج إىل معرفته تحتاج إىل معرفته - Sepsis What You Need To Know, Providence

All Sepsis Education Materials

متالزمة االستجابة االلتهابية الجهازية ما تحتاج إىل معرفته SEPSIS What You Need to Know (Arabic Language)

Farsi: Understanding Your Sepsis Diagnosis, Providence

All Sepsis Education Materials

Graphic Novel: Understanding Your Sepsis Diagnosis (Farsi)

Impacts Of Climate Change On Vector-Borne Disease Burden In The United States: Exploring The Epidemiological Evidence, Leah V. Loetman

Honors Theses

Climate change models predict shifts in vector-borne diseases (VBDs) around the world, including in the United States. However, to my knowledge there has yet to be a comprehensive descriptive epidemiological study examining prevalence, geographic distribution, and trends for all tick- and mosquito-borne diseases in the United States. I compiled data from the U.S. Centers for Disease Control (CDC), which publishes yearly case numbers for 17 vector-borne diseases. However, these publications depend on a scattered framework of state regulations regarding disease reporting. I compiled data from the CDC to determine the current geographic distribution, prevalence, and trends of tick- and mosquito-borne …

Pancytopenia And Disseminated Varicella-Zoster Virus In A Patient With T-Cell Lymphoblastic Lymphoma In Maintenance Phase Of Treatment: A Case Report, Kathryn Jordan, Paul Bryant, Clinton Carroll, Jennifer Domm

TriStar Division GME Research Day 2024

No abstract provided.

Informing A Care Plan For Hepatitis C Treatment On The Street, Claire Campbell

Scripps Senior Theses

This thesis aims to use community knowledge to inform clinical street treatment of Hepatitis C and to unpack the intersections of social systems within the realms of Street Medicine and healthcare for the unsheltered unhoused population. During the summer of 2023, 15 qualitative interviews were conducted with patients of the USC Keck School of Medicine Department of Street Medicine who received treatment for Hepatitis C infections. Using grounded theory analysis, participant responses were analyzed to identify key concepts and ideas from interview transcripts. Core themes fell into the following categories: how treatment affected patients’ lives, facilitators and barriers to treatment, …

Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.

Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). …

Guideline For Screening Of Trichomonas Vaginalis Infections In The Correctional Setting, Nahirobi J. Madrid Antunez

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Objective: This guideline project focused on creating a screening guideline for T. vaginalis that would benefit healthcare providers in a correctional healthcare setting for incarcerated females entering the facility.

Methods: A literature review was conducted. The PubMed and MEDLINE search engines, were used to obtain medical, biomedical and life sciences literature, and CINAHL for nursing and allied health resources, Governmental agency sites, such as the Centers for Disease Control and Prevention (CDC), were also explored. Guideline recommendations were extrapolated from the literature review, and then rated by, stakeholders.

Results: Several overarching themes were identified. Screening of asymptomatic women for T. …

Novel Engineering Approaches For Orthopedic Injury Treatment And Infection Diagnosis, Cynthia Co

Bioengineering Dissertations - Archive

Bioengineering has made significant contributions to the treatment of orthopedic injury through interdisciplinary approaches. Central to these advancements are many orthopedic implants, including anchors and joint replacements, which have been designed to restore mobility. Despite their functional efficacy, these products have limited lifespan and are associated with many complications, such as implant-associated infection. The success of implant design and function, both in the short and long term, is paramount for enhancing patient outcomes and overall well-being. Therefore, my thesis work is dedicated to addressing these critical challenges, aiming to maximize their treatment effect while minimizing the implant-associated complications.

Long-term patient …

Pharmacokinetic-Pharmacodynamic Evidence From A Phase 3 Trial To Support Flat-Dosing Of Rifampicin For Tuberculosis, Huy X. Ngo, Ava Y. Xu, Gustavo E. Velásquez, Nan Zhang, Vincent K. Chang, Ekaterina V. Kurbatova, William C. Whitworth, Erin Sizemore, Kia Bryant, Wendy Carr, Marc Weiner, Kelly E. Dooley, Melissa Engle, Susan E. Dorman, Payam Nahid, Susan Swindells, Richard E. Chaisson, Pheona Nsubuga, Madeleine Lourens, Rodney Dawson, Radojka M. Savic

Journal Articles: Infectious Diseases

BACKGROUND: The optimal dosing strategy for rifampicin in treating drug-susceptible tuberculosis (TB) is still highly debated. In the phase 3 clinical trial Study 31/ACTG 5349 (NCT02410772), all participants in the control regimen arm received 600 mg rifampicin daily as a flat dose. Here, we evaluated relationships between rifampicin exposure and efficacy and safety outcomes.

METHODS: We analyzed rifampicin concentration time profiles using population nonlinear mixed-effects models. We compared simulated rifampicin exposure from flat- and weight-banded dosing. We evaluated the effect of rifampicin exposure on stable culture conversion at 6 months; TB-related unfavorable outcomes at 9, 12, and 18 months using …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Case Report: A Nurses Experience With A Surgical Site Infection (Ssi); Lessons From The Frontlines, Anna Tabor, Rachel Tommeraasen, Joshua E Drumm

Articles, Abstracts, and Reports

Case Report: A Nurses Experience with a Surgical Site Infection (SSI); Lessons from the Frontlines

Objectives:

1. After reviewing this presentation participants will be able to understand the impacts an SSI can have on the life of an experienced nurse.

2. After reviewing this content participants will understand how interprofessional collaboration is key to supporting patients, reducing SSI’s, and raising awareness of this important topic.

Purpose/Aims: Postoperative wound infection is a common complication of orthopedic surgery & accounts for the highest proportion of all hospital-acquired infections, with an incidence rate of about 2.6%–7.83% (Zhu & Luo, 2023). These infections affect …

Using Phosphatidylethanol As An Adjunct To Self-Reported Alcohol Use Improves Identification Of Liver Fibrosis Risk, Pamela M. Murnane, Majid Afshar, Gabriel Chamie, Robert L. Cook, Tekeda Ferguson, Lamia Y. Haque, Karen R. Jacobson, Amy C. Justice, Theresa W. Kim, Mandana Khalili, Evgeny Krupitsky, Kathleen A. Mcginnis, Patricia Molina, Winnie R. Muyindike, Bronwyn Myers, Veronica L. Richards, Kaku So-Armah, Scott Stewart, Mark S. Sulkowski, Phyllis C. Tien, Judith A. Hahn

School of Public Health Faculty Publications

Introduction: Accurate assessment of alcohol use informs prevention and management of liver disease. We examined whether phosphatidylethanol (PEth, an alcohol metabolite) blood concentrations are associated with liver fibrosis risk independently of self-reported alcohol use, among persons with and without HIV. Methods: We pooled individual-level data from 12 studies from the United States, Russia, Uganda, and South Africa with PEth, AUDIT-C (Alcohol Use Disorders Identification Test-Consumption), and FIB-4 measurements. We conducted mixed-effects logistic regression of the relationship between PEth and AUDIT-C as continuous variables (after checking linearity), with high FIB-4 ( ≥ 2.67). We divided PEth (range 0-1000) by 83.3 to …