Bacterial Infections and Mycoses Commons^™

Mechanistic Study Of Antimicrobial Effectiveness Of Cyclic Amphipathic Peptide [R4W4] Against Methicillin-Resistant Staphylococcus Aureus Clinical Isolates, Ajayi David Akinwale, Keykavous Parang, Rakesh Kumar Tiwari, Jason Yamaki

Pharmacy Faculty Articles and Research

Antimicrobial peptides (AMPs) are being explored as a potential strategy to combat antibiotic resistance due to their ability to reduce susceptibility to antibiotics. This study explored whether the [R₄W₄] peptide mode of action is bacteriostatic or bactericidal using modified two-fold serial dilution and evaluating the synergism between gentamicin and [R₄W₄] against Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) by a checkered board assay. [R₄W₄] exhibited bactericidal activity against bacterial isolates (MBC/MIC ≤ 4), with a synergistic effect with gentamicin against E. coli (FICI = 0.3) but …

Effectiveness Of Empiric Carbapenem Versus Non-Carbapenem Therapy For Extended-Spectrum Β-Lactamase Producing Enterobacterales Infections In Non-Intensive Care Unit Patients: A Real-World Investigation In A Hospital With High-Prevalence Of Extended-Spectrum Β-Lactamase Producing Enterobacterales, Amy Y. Kang, Mary Elkomos, Danny Pham, Michelle Guerrero, Deborah Kupferwasser, Loren G. Miller

Pharmacy Faculty Articles and Research

Objective:

To investigate whether empiric carbapenem therapy, compared to empiric non-carbapenem therapy, was associated with improved clinical outcomes among hospitalized, non-intensive care unit (ICU) patients with extended-spectrum β-lactamase (ESBL)-producing Enterobacterales infections.

Methods:

We performed a retrospective cohort study of adult, non-ICU patients admitted with ESBL-producing Enterobacterales infections. Primary outcome was time to clinical stability from the first empiric antibiotic dose. Secondary outcomes were early clinical response and 30-day all-cause hospital readmission. We used multivariate regression methods to examine time to clinical stability.

Results:

Of the 142 patients, 59 (42%) received empiric carbapenems and 83 (58%) received empiric …

Medmicromaps, A Novel Decision-Tree Guide For Infectious Diseases Differential Diagnoses, And Evaluation Of Pre- And Post-Pandemic User Engagement By Preclinical Medical Students, Jason Ceballos, Tavsimran Luthra, Lucia Garces-Torres, Valerie Lentz, Jack Nelson, Claudia Carceles-Roman, Ian Holyoak, Jane Harrington

International Journal of Emerging and Disruptive Innovation in Education : VISIONARIUM

Background: Medical education has undergone major changes in the past 5 years to adapt to the digital-centered student population with diverse learning preferences. To address the challenges of shifting delivery modalities, multimedia resources were created to provide interactive e-learning material on infectious diseases for year 2 medical students.

Methods: Medical students at a USA-accredited Caribbean medical school were provided with supplemental e-learning materials including animations, illustrations, diagnostic algorithms aka MedMicroMaps, and Case-Based tutorials. Participants were classified by semester and lecture delivery: In-person: Cohort 1 (n=526); Virtual: Cohort 2 (n=651); and Hybrid: Cohort 3 ( …

Increased Usage Of Doxycycline For Young Children With Lyme Disease, Amy Thompson, Desiree Neville, Laura Chapman, Fran Balamuth, Meagan Ladell, Anupam Kharbanda, Rachael Aresco, Lise Nigrovic

Department of Emergency Medicine Faculty Papers

Background: The 2018 Infectious Disease Committee of the American Academy of Pediatrics stated that up to 3 weeks or less of doxycycline is safe in children of all ages. Our goal was to examine trends in doxycycline treatment for children with Lyme disease.

Methods: We assembled a prospective cohort of children aged 1 to 21 years with Lyme disease who presented to one of eight participating Pedi Lyme Net centers between 2015 and 2023. We defined a Lyme disease case with an erythema migrans (EM) lesion or positive two-tier Lyme disease serology categorized by stage: early-localized (single EM lesion), early-disseminated …

Characterizing New Invasive Infections In Children’S Mercy Extracorporeal Membrane Oxygenation And And Continuous Renal Replacement Therapy Patients, Samantha M. Davidson, Jay F. Rilinger, Jenna O. Miller, Caroline Holten, Josh Herigon

Research Days

This abstract characterizes the patients at Children's Mercy who developed a new serious bacterial infection while on extracorporeal support.

Impact Of Sepsis Education For Emergency Department Staff: A Quality Improvement Project, Shayna E. Thoene, Shannon Mills

Doctor of Nursing Practice Projects: College of Nursing

Background: Sepsis continues to be a critical issue worldwide. New sepsis guidelines instituted by the Centers of Medicare and Medicaid Services (CMS) list evidence-based standards to comply with regarding care for sepsis patients. To help a new acute care facility meet compliance, a sepsis educational program has been developed to assess staff knowledge and confidence in caring for these patients.

Methods: This quality improvement (QI) project was developed using a pre-post study design to assess the impact of implementing a sepsis educational program for emergency department staff at this new acute care institution. A sepsis educational program was derived from …

The Physiological Significance Of Nitric Oxide Synthase In Staphylococci, Ryan M. Singh

Theses & Dissertations

Staphylococci, particularly Staphylococcus epidermidis, are common causes of implant-associated infections that may result in notable morbidity and mortality. One of the ways the innate immune system attempts to combat these invading pathogens is via the respiratory burst, in which free radical species such as nitric oxide (NO^•), toxic to bacterial respiration, are released in large quantities. Despite the toxicity of NO^•, some bacteria, including staphylococci, encode an endogenous bacterial nitric oxide synthase (bNOS), whose physiological role has been unclear until now. In this dissertation, we demonstrate that S. epidermidis is able to overcome the toxicity …

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.

Soluble Antimicrobial Peptide (Amp) Screening To Rationally Design Amp-Hydrogels That Selectively Prevent Biofilm Formation, Matthias Recktenwald, Muskanjot Kaur, Mohammed M. Benmassaoud, Aryanna Copling, Tulika Khanna, Michael Curry, Denise Cortes, Gilbert Fleischer, Valerie J. Carabetta, Sebastián L. Vega

Rowan-Virtua Research Day

Staphylococcus aureus is an opportunistic pathogen that lives on surfaces and skin and can cause serious infections once inside the body. While antibiotics effectively kill bacteria, there are a growing number of infections with antibiotic-resistant strains. Antimicrobial peptides (AMPs) are part of the innate immune system and can eliminate pathogens including bacteria, fungi, and viruses, and are a promising alternative to antibiotics. Although studies have reported that AMP-functionalized hydrogels can prevent bacterial adhesion and biofilm formation, these materials generally consist of one AMP at an arbitrary concentration, and AMP dosing and the combined effects of multiple AMPs are not well …

‘Not So Atypical’: An Atypical Presentation Of West Nile Virus And Guillain-Barre Syndrome, Matthew Orap, Sana Tahir, Ugonna Ononuju, Naresh Kumar

Rowan-Virtua Research Day

Guillain-Barre Syndrome (GBS) is defined by acute areflexic paralysis, usually starting in the distal lower extremities, and ascending to the upper extremities. It is associated with albuminocytologic dissociation, which involves elevated protein levels and normal cell counts in the cerebrospinal fluid. One of the types of GBS, called Miller-Fischer Syndrome (MFS), is characterized by ophthalmoplegia, ataxia, and areflexia. This case report focuses on a 49-year-old male with an atypical presentation of Guillain-Barre syndrome. Guillain-Barre syndrome can be classically caused by Campylobacter jejuni. However, there can be other infectious causes as well, namely Cytomegalovirus, Epstein-Barr virus, Varicella-Zoster virus, …

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 …

Investigating The Antibacterial Properties Of Capsaicin In Synergy With Antibiotics Against A. Baumannii, Jack Guffey

Undergraduate Theses

As the ever-increasing issue of antibiotic resistance looms, naturally derived compounds have been increasingly investigated as possible synergists with antibiotics. One of these compounds, capsaicin, is a potent vanilloid that is the dominant cause of Capsicum peppers’ spiciness. Capsaicin’s intrinsic ability to inhibit a wide array of bacterial growth has been well documented. The focal organism of this study, Acinetobacter baumannii, has become an increasingly common hospital acquired infection due to its persistence on fomites. Capsaicin, however, is able to inhibit this growth at higher concentrations as well as reduce the necessary minimum inhibitory concentration while decreasing biofilm formation …

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 …

A Meta-Analysis For Laboratory Diagnostics For Coccidioidomycosis, Mary C. Cowen

Biological Sciences Undergraduate Honors Theses

Coccidioidomycosis, commonly referred to as Valley Fever, is a fungal infection found in arid regions of the southwestern United States and Mexico. Infection occurs through inhalation of airborne spores from Coccidioides species, Coccidioides immitis and/or Coccidioides posadasii, and proceeds in both pulmonary and disseminated fashions. Approximately 60% of patients with coccidioidomycosis remain asymptomatic, while 40% will experience symptoms. Within the literature, there are no papers that summarize sensitivity and specificity values between different tests; therefore, this paper presents sensitivity and specificity results across different tests and companies (Meridian, IMMY, and MiraVista).

Targeting Coenzyme A Biosynthesis For Antifungal Development., Jessica Regan

Theses and Dissertations (ETD)

An estimated 1.5 million people die each year from invasive fungal infections (IFIs) involving dissemination to the deeper organs via the bloodstream, with estimated healthcare costs of over $7 billion in the U.S. alone. Collectively, several Candida species account for more than 75% of disseminated fungal infections in the U.S., with attributable mortality rates ranging 35-75%. Unfortunately, the prospect of curing these infections is limited by the modest efficacy of the available antifungal drugs: the azoles, echinocandins, and amphotericin B. Approximately one-third of patients with disseminated Candida infections are non-responsive to treatment with the azoles, and favorable response rates are …

The Case For Using Composition Tomography To Evaluate Perirectal Necrotizing Fasciitis: Is It Really Necessary?, Tyler Bayliss, David Denning

Marshall Journal of Medicine

Clinical reviews of Fournier’s Gangrene state that diagnostic protocol includes interpreting CT, MRI, or Ultrasound imaging along with clinical symptoms and lab findings. We think that the use of imaging techniques as a diagnostic tool is no longer needed as Fournier’s Gangrene is specific enough of a disease that clinicians can diagnose using labs and physical examination alone.

Cases of perirectal necrotizing soft tissue infection recorded at St. Marys Medical Center were reviewed. Results of physical exams and imaging were compared along with measurements of severity upon admittance and length of stay. Due to the COVID-19 pandemic, we investigated if …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

The Role Of Prevotella Species In Female Genital Tract Infections, Sheridan D. George, Olivia T. Van Gerwen, Chaoling Dong, Lúcia G. Sousa, Nuno Cerca, Jacob H. Elnaggar, Christopher M. Taylor, Christina A. Muzny

School of Graduate Studies Faculty Publications

Female genital tract infections (FGTIs) include vaginal infections (e.g., bacterial vaginosis [BV]), endometritis, pelvic inflammatory disease [PID], and chorioamnionitis [amniotic fluid infection]. They commonly occur in women of reproductive age and are strongly associated with multiple adverse health outcomes including increased risk of HIV/sexually transmitted infection acquisition and transmission, infertility, and adverse birth outcomes such as preterm birth. These FGTIs are characterized by a disruption of the cervicovaginal microbiota which largely affects host immunity through the loss of protective, lactic acid-producing spp. and the overgrowth of facultative and strict anaerobic bacteria. species (spp.), anaerobic Gram-negative rods, are implicated in the …

Dispelling The Malaria-Typhoid Co-Infection Myth In Nigeria. A Literature Review, Olawale Akinola

Dartmouth Library Staff Publications

Malaria and typhoid fever are public health concerns in Nigeria, with high prevalence rates. The perception of a widespread co-infection between these diseases may be misleading, due to limitations in diagnostic methods, particularly the Widal test for typhoid fever. This literature review examines the prevalence of malaria-typhoid co-infection in Nigeria and identifies factors contributing to misdiagnosis, including non-specific symptoms, limited diagnostic resources, and the diagnostic accuracy of tests employed. Additionally, the review discusses the implications of misdiagnosis, such as the overuse of broad-spectrum antibiotics leading to a rising incidence of antimicrobial resistance. Strategies to address this issue are explored, emphasizing …

Broad-Spectrum Activity Of Membranolytic Cationic Macrocyclic Peptides Against Multi-Drug Resistant Bacteria And Fungi, Sandeep Lohan, Anastasia G. Konshina, Rakesh K. Tiwari, Roman G. Efremov, Innokentiy Maslennikov, Keykavous Parang

Pharmacy Faculty Articles and Research

The emergence of multidrug-resistant (MDR) strains causes severe problems in the treatment of microbial infections owing to limited treatment options. Antimicrobial peptides (AMPs) are drawing considerable attention as promising antibiotic alternative candidates to combat MDR bacterial and fungal infections. Herein, we present a series of small amphiphilic membrane-active cyclic peptides composed, in part, of various nongenetically encoded hydrophilic and hydrophobic amino acids. Notably, lead cyclic peptides 3b and 4b showed broad-spectrum activity against drug-resistant Gram-positive (MIC = 1.5–6.2 µg/mL) and Gram-negative (MIC = 12.5–25 µg/mL) bacteria, and fungi (MIC = 3.1–12.5 µg/mL). Furthermore, lead peptides displayed substantial antibiofilm action comparable …