Bacteria Commons^™

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Adhesion Of Antibiotic-Resistant Bacteria To Thermoplastic Materials Used In Fabricating Medical Devices: Patient Consequences, Dev V. Mehta

Poster Presentations

Burn injury patients wear supportive orthoses made by heat-forming sheets of thermoplastic material (Figs. 1 & 2). Bacteria cause severe soft tissue infections in patients wearing contaminated orthoses. Thermoplastic medical devices can develop biofilms that include antibiotic-resistant (AR) bacteria, which significantly reduces the number of available treatment options. A biofilm is a community of microorganisms that share resources allowing them to exist in a nutrient-limited environment. Biofilm microbes secrete extracellular polymeric substance (EPS) that attaches them firmly to a substrate surface while protecting them from harmful substances, including antibiotics. Bacteria living within biofilms on inanimate surfaces can survive for extended …

Comparative Investigation Of Bacterial Adhesion On Medical Device Thermoplastics, Dev V. Mehta

Honors Theses

This project will focus on determining if differences in bacterial cell wall composition influences adhesiveness to thermoplastic materials used to construct patient orthotic splints. Bacteria with decreased adhesion are unable to remain bonded to orthotic splints, increasing its ability to transfer to a patient’s wound, leading to an infection. Antibiotic resistant bacteria used in this investigation included gram-positive cocci vancomycin-resistant (VRE) Enterococcus faecalis, methicillin-resistant Staphylococcus aureus (MRSA), and gram-negative rods extended-spectrum beta-lactamase (ESBL) Escherichia coli and Pseudomonas aeruginosa. Each test bacterium is a major pathogen causing healthcare-associated infections (HAIs). Saline, artificial perspiration, and ascites fluids were used to determine the …

Acute Gastropericardial Fistula With Cardiac Tamponade And Septic Pericarditis Due To Helicobacter Pylori–Induced Gastric Ulcer Perforation, Stephen J. Bordes, Christopher D. Oubre, Preethi H. Kanumuri, Nicholas Leblanc, Richard Lewis, Thomas Marsden, Terry Stelly

School of Medicine Faculty Publications

No abstract provided.

Case Report: Sarcina Ventriculi, A Masquerade Of Motility, Katherine Westbrook Cates, Catherine Hudson

School of Medicine Faculty Publications

Sarcina ventriculi is a rare bacterium that has the potential to cause severe disease in the gastric mucosa. According to our search, there are less than 100 prior published case reports. This case discusses a 69-year-old man who presented to the hospital with severe gastric distention noted on CT of the abdomen with intractable nausea and emesis, for which endoscopy was performed and ruled out gastric outlet obstruction, with biopsies resulting as S. ventriculi. This bacterium has previously been reported to cause gastric dysmotility, as well as severe side effects including gastric perforation.

Diffuse Unilateral Leg Swelling, Bruce M. Lo, Kylie Butler, Navjot Kaur, Kirsten Pennell

Department of Emergency Medicine Faculty Publications

[Patient Presentation] A 46-year-old woman with a history of hypertension presented with 14 days of right leg pain. The pain began after straining her leg while lifting heavy boxes at work, with diffuse leg swelling noted 3 days later. She reported subjective fever but no other complaints. Patient denies any illicit drug use. Initial vital signs included a temperature of 100.1 °F, heart rate of 122 beats per minute, and blood pressure of 158/91 mm Hg. Physical examination revealed a diffusely swollen and tender right leg (Fig 1). Computed tomography (CT) of the right leg identified a 19 X 7 …

Blood Culture Utilization: How Many Follow-Up Cultures Are Needed?, George Jones, Jennifer Hanrahan

Department of Medicine Faculty Publications

Background: Follow-up blood cultures (BCx) are ordered after an initial positive culture in many instances. The number of follow-up cultures needed is not clear. Obtaining unnecessary BCx may cause unintended consequences. The optimal balance between stewardship and patient safety warrants investigation. We sought to assess the frequency with which a third set is positive after a negative second BCx. Methods: We conducted a retrospective study of BCx submitted to the microbiology laboratory from 1/1/18-11/1/23. We included all patients ≥18 years who had at least two follow-up BCx drawn 24-72 hours after an initial positive culture. Data were collected from electronic …

Copula-Based Bayesian Model For Detecting Differential Gene Expression, Prasansha Liyanaarachchi, N. Rao Chaganty

Mathematics & Statistics Faculty Publications

Deoxyribonucleic acid, more commonly known as DNA, is a fundamental genetic material in all living organisms, containing thousands of genes, but only a subset exhibit differential expression and play a crucial role in diseases. Microarray technology has revolutionized the study of gene expression, with two primary types available for expression analysis: spotted cDNA arrays and oligonucleotide arrays. This research focuses on the statistical analysis of data from spotted cDNA microarrays. Numerous models have been developed to identify differentially expressed genes based on the red and green fluorescence intensities measured using these arrays. We propose a novel approach using a Gaussian …

Synovial Fluid Cutibacterium Acnes Antigen Is Detected Among Shoulder Samples With High Inflammation And Early Culture Growth, Krista Toler, Pearl Paranjape, Alex Mclaren, Thomas Jefferson University

Rothman Institute Papers

Background: An emerging paradigm suggests that positive Cutibacterium acnes shoulder cultures can result from either true infection or contamination, with true infections demonstrating a host inflammatory response and early culture growth. This clinical retrospective study examines the relationship between C. acnes antigen, C. acnes culture results, and inflammation.

Methods: From January 2021 to July 2023, 1,365 periprosthetic synovial fluid samples from 347 institutions were tested for shoulder infection at a centralized clinical laboratory. A biomarker scoring system based on the 2018 International Consensus Meeting (ICM) definition was utilized to assign each sample an inflammation score. Associations between inflammation, culture results, …

Clostridium Perfringens Sepsis From A Hepatic Abscess With Hemolysis And Renal Failure, Requiring Hemodialysis, Joel Collins Ii, Katelyn Courtney, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

The prognosis of sepsis caused by Clostridium perfringens is extremely poor, with a mortality rate of 70%-100%. Management includes antibiotic regimens specific to toxin production as well as source control via surgical or interventional mechanisms. We report a case of a 64-year-old male who presented with right upper quadrant (RUQ) abdominal pain and was diagnosed with Clostridium perfringens bacteremia with associated acalculous cholecystitis, hepatic abscess, and acute renal failure requiring hemodialysis. It is felt that early hemodialysis was an associated factor in the patient's survival.

Evaluation Of The Efficacy Of Novel Drugs And Combinations Against Extensively- And Pan-Drug Resistant Acinetobacter Baumannii Isolates, Keertana Jonnalagadda, Rachel Carr, Valerie Carabetta

Rowan-Virtua Research Day

Acinetobacter baumannii, a Gram-negative, nosocomial, opportunistic pathogen is commonly infectious in immunocompromised patients. More specifically patients develop healthcare-associated infections (HAI) spanning beyond sepsis, pneumonia, meningitis, and urinary tract infections. Due to its rapid ability to acquire antibiotic resistance, it has raised the necessity to discern a novel therapeutic treatment that can be effectively used against the multidrug resistant (MDR) A. baumannii. Cooper University Hospital (CUH) faced an increased case load of patients that were infected with MDR A. baumannii. The patient isolates obtained from CUH were highly resistant to the 22 standard-of-care antibiotics. With the recent introduction …

Analysis Of Antibiotic Sensitivity Patterns In Pasteurellaceae Family Isolates: A Microbial And Molecular Investigation, Jillian Barron

Honors Scholar Theses

Bacteria in the Pasteurellaceae family are known to cause disease in both human and animal species. Like all species of bacteria, the pathogens in the Pasteurellaceae family evolve and acquire antimicrobial-resistant traits. Antimicrobial resistance of bacteria is a significant public health concern, as treatment of resistant pathogens becomes more difficult, if not impossible, with current medical capabilities. In this project, phenotypic and genotypic analyses were performed on Pasteurellaceae family isolates sourced from the Connecticut Veterinary Medical Diagnostic Laboratory. Phenotypic antibiotic sensitivity patterns of each isolate were assessed against a panel of antibiotics through a Kirby-Bauer disk diffusion test. Disk diffusion …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Additive Effects Of Cyclic Peptide [R4w4] When Added Alongside Azithromycin And Rifampicin Against Mycobacterium Avium Infection, Melissa Kelley, Kayvan Sasaninia, Arbi Abnousian, Ali Badaoui, James Owens, Abrianna Beever, Nala Kachour, Rakesh Kumar Tiwari, Vishwanath Venketaraman

Pharmacy Faculty Articles and Research

Mycobacterium avium (M. avium), a type of nontuberculous mycobacteria (NTM), poses a risk for pulmonary infections and disseminated infections in immunocompromised individuals. Conventional treatment consists of a 12-month regimen of the first-line antibiotics rifampicin and azithromycin. However, the treatment duration and low antibiotic tolerability present challenges in the treatment of M. avium infection. Furthermore, the emergence of multidrug-resistant mycobacterium strains prompts a need for novel treatments against M. avium infection. This study aims to test the efficacy of a novel antimicrobial peptide, cyclic [R4W4], alongside the first-line antibiotics azithromycin and rifampicin in reducing M. avium survival. Colony-forming unit (CFU) …

Analyzing Pseudomonas Aeruginosa With Bacteriophage Tags Using Photoacoustic Flow Cytometry, Jennifer C. Schinke

Electronic Theses and Dissertations

The number of daily bacterial infections is climbing and the CDC explains that this is due to the antibiotic-resistant threat in the United States. Finding a faster way of bacterial identification is necessary as it currently takes 1-4 days for a medical lab to culture and identify bacteria. Photoacoustic flow cytometry (PAFC) can be used as an alternative method resulting in swift identification within an hour (Edgar, 2019). Pseudomonas aeruginosa, cell line PA01, will be coated in up to a few hundred red dyed phages making it detectible by the photoacoustic flow cytometry system. Bacteriophages (phages) are viruses that …

Outpatient Sexually Transmitted Infection Testing And Treatment Patterns In The United States: A Real-World Database Study, Rebecca Lillis, Louis Kuritzky, Zune Huynh, Rodney Arcenas, Avneet Hansra, Roma Shah, Baiyu Yang, Stephanie N. Taylor

School of Medicine Faculty Publications

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most common notifiable sexually transmitted infections (STIs) in the United States. Because symptoms of these infections often overlap with other urogenital infections, misdiagnosis and incorrect treatment can occur unless appropriate STI diagnostic testing is performed in clinical settings. The objective of this study was to describe STI diagnostic testing and antimicrobial treatment patterns and trends among adolescent and adult men and women with lower genitourinary tract symptoms (LGUTS). Methods: We analyzed insurance claims data from the IBM® MarketScan® Research Databases. Patients included were between 14 and 64 years old with …

Diagnosis Of Urinary Tract Infections And Rapid Molecular Characterization Of Antibiotic Resistance, Mohammed Harris

All Dissertations

Urinary tract infections (UTIs) are one of the most common infectious clinical entities in both community and hospital settings. They have a broad range of clinical severity yet inflict large epidemiological burden of morbidity and mortality on patients and the healthcare system with billions of dollars in cost of treatment. Understanding what methods are optimal for diagnosing UTIs are critical to mitigate the marked impact and cost of these infections.

Chapter 1 and 2 in this work surveys the broad array of diagnostic modalities for UTIs and highlights their advantages and limitations in the context of the current standard of …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

Expansion On The Use Of The Novel Compound, Elp-004, Using A Mycobacterium Tuberculosis Experimentation Model, Kendyl Marie Berry

Graduate Theses, Dissertations, and Problem Reports (ETD)

Osteoarticular tuberculosis (OAT) is a bone degenerative disease that results in bone erosion, joint effusion, joint swelling, and sometimes, nerve compression. OAT occurs from the hematogenous dissemination of Mycobacterium tuberculosis (Mtb) bacilli spreading from the primary site of infection to the bones and joints; the primary site of infection tends to be the lungs as pulmonary tuberculosis infections are the most common. OAT can occur as the result of an active or latent infection. Latent infections result in OAT when bacilli are able to escape granulomas. The incidence of OAT is not as high as pulmonary infections, making up about …

Effectiveness Of Stabilized Hypochlorous Acid In Acute Peritonitis Treatment: A Murine Surgical Study, Benjamin Michael Pomeroy

Graduate Theses/Dissertations

Peritonitis is an inflammatory condition affecting the mesothelial cells that line the peritoneal cavity and is commonly induced by bowel perforations. This medical emergency is treated through antibiotic therapy and surgical intervention followed by tissue irrigation (lavage). Acute treatments aim to remove the bacterial burden, however recurring peritoneal infections occur at high rates and contribute to patient morbidity. These recurring infections are likely due to the inability of lavage solutions to remove the entire massive intra-abdominal bacterial load due to intestinal perforation. Numerous antiseptic solutions and antibiotic additives have been evaluated in their ability to improve source control by abdominal …

Refining The Optimal First Treatment For Pediatric Breast Abscesses, Kayla B. Briggs

Research Days

Background: We previously reported treatment and outcomes of children with untreated, not spontaneously draining (UTND) breast abscesses. What has not been well defined however are those with previously treated, not spontaneously draining (PTND) pediatric breast abscesses. In general, a more conservative approach is favored in children with breast abscesses to avoid damage to the developing breast bud.

Objectives/Goal: We sought to determine if care at a pediatric tertiary referral center impacts disease persistence rate.

Methods/Design: Following IRB approval, patientstherapy.

Results: In all, 114 patients met inclusion criteria, 96 in the UTND group and 18 in the PTND group (Figure 1). …

Identification And Characterization Of Butyrate-Producing Species In The Human Gut Microbiome, Grace Maline

Theses/Capstones/Creative Projects

Inflammatory Bowel Diseases (IBD) including ulcerative colitis, indeterminate colitis, and Crohn’s disease are increasingly common conditions that places a high physical and financial burden on individuals and global healthcare systems. Though many treatments exist for these conditions, their unpredictable nature and causation make them difficult to manage across the variety of IBD patients. Additionally, many of these treatments come with undesirable side effects or modes of delivery. Therefore, it is worthwhile to explore the use of Short Chain Fatty Acids (SCFAs) such as butyrate whose affects in the human gut include decreased inflammation and decreased risk of colorectal cancer. As …

Epidemiologic Survey Of Legionella Urine Antigen Testing Within A Large Wisconsin-Based Health Care System, Caroline P. Toberna, Hannah M. William, Jessica J. F. Kram, Kayla Heslin, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Legionella pneumophila pneumonia is a life-threatening, environmentally acquired infection identifiable via Legionella urine antigen tests (LUAT). We aimed to identify cumulative incidence, demographic distribution, and undetected disease outbreaks of Legionella pneumonia via positive LUAT in a single eastern Wisconsin health system, with a focus on urban Milwaukee County.

Methods: A multilevel descriptive ecologic study was conducted utilizing electronic medical record data from a large integrated health care system of patients who underwent LUAT from 2013 to 2017. A random sample inclusive of all positive tests was reviewed to investigate geodemographic differences among patients testing positive versus negative. Statistical comparisons …

Chrysin‐Loaded Chitosan Nanoparticles Potentiates Antibiofilm Activity Against Staphylococcus Aureus, Busi Siddhardha, Uday Pandey, K. Kaviyarasu, Rajasekharreddy Pala, Asad Syed, Ali K. Bahkali, Abdallah M. Elgorban

Pharmacy Faculty Articles and Research

The application of nanotechnology in medicine is gaining popularity due to its ability to increase the bioavailability and biosorption of numerous drugs. Chrysin, a flavone constituent of Orocylumineicum vent is well‐reported for its biological properties. However, its therapeutic potential has not been fully exploited due to its poor solubility and bioavailability. In the present study, chrysin was encapsulated into chitosan nanoparticles using TPP as a linker. The nanoparticles were characterized and investigated for their anti‐biofilm activity against Staphylococcus aureus. At sub‐Minimum Inhibitory Concentration, the nanoparticles exhibited enhanced anti‐biofilm efficacy against S. aureus as compared to its bulk counterparts, chrysin …

Tick-Borne Infections In New Hampshire: An Evaluation Of The Diagnostic Process In A Local Patient Population, Katherine Anderson

Honors Theses and Capstones

Overall, approximately 95 percent of reported cases of vector-borne disease were associated with ticks, making these the most medically important group of arthropods in the United States.¹ Despite the prevalence of tick-borne infections, the process for the diagnosis of this condition is not well studied. This study aims to analyze data from a pool of 100 patients who underwent testing for tick-borne disease in the same institution in Dover, New Hampshire during the most recent peak tick season of 2019. Information utilized in this study included: patient age, sex, location of testing (inpatient versus outpatient), diagnostic testing methods used …

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Use Of Urine Antigen Testing For Blastomyces In An Integrated Health System, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Blastomycosis, an endemic fungal infection, mimics many other diseases. We explored the use of Blastomyces urine antigen (BuAg), reportedly the most sensitive noninvasive test, in clinical practice and compared it to other noninvasive tests.

Methods: A total of 836 BuAg tests performed on unique patients (first test only) at one large integrated health system from June 2013 to May 2016 were retrospectively reviewed to examine test characteristics and demographic features. Of these, 100 cases from 2015, a year containing a large local blastomycosis outbreak, were randomly selected for detailed analysis.

Results: Demographics for the BuAg-tested population: mean age 54.9 …

In Vitro Assay Development As An Alternative To The Use Of Laboratory Animals For Measuring Clostridium Perfingens Type C Toxoid, Lauren M. Wilmes

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Clostridium perfringens type C produces beta toxin, which is a primary virulence determinate that can cause necrotic enteritis in neonatal animals. Vaccines directed against C. perfringens toxins have shown to be efficacious in preventing disease. However, the production of a commercial vaccine requires not only an efficacious antigen, but also testing methods for quantifying antigens and potency on final product. This research was undertaken to fulfill a need for the reduction in small animal usage to produce and deliver vaccines. The current testing methods are performed in vivo according to the Code of Federal Regulations number 9 (9CFR) United …

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …

Changing Diagnostic Methods And Increased Detection Of Verotoxigenic Escherichia Coli, Ireland, Thomas Rice, Noreen Quinn, Roy D. Sleator, Brigid Lucey

Department of Biological Sciences Publications

The recent paradigm shift in infectious disease diagnosis from culture-based to molecular-based approaches is exemplified in the findings of a national study assessing the detection of verotoxigenic Escherichia coli infections in Ireland. The methodologic changes have been accompanied by a dramatic increase in detections of non-O157 verotoxigenic E. coli serotypes.