Bacterial Infections and Mycoses Commons^™

Reexamining Cytolethal Distending Toxin's Host Cell Entry And Trafficking: The First Steps Down A Long Road, George Huhn

Electronic Theses and Dissertations, 2020-2023

Cytolethal distending toxin (CDT) is a virulence factor produced by many Gram-negative bacteria, including Haemophilus ducreyi, the causative agent of genital chancroid. CDT is a heterotrimeric toxin consisting of a cell-binding domain (CdtA + CdtC) and a catalytic domain (CdtB) that has DNase activity. After binding to the host plasma membrane, CDT undergoes endocytosis and travels through the endosomes en route to the endoplasmic reticulum (ER). Only CdtB and CdtC arrive in the Golgi before moving to the ER. Only then does CdtB move into the nucleus, causing DNA damage that induces cell-cycle arrest and apoptosis. The previous CDT trafficking …

Improving Disinfectant Cap Use On Central Lines In The Icu To Reduce Patient Risk For Clabsi: A Quality Improvement Project, Tali Cherim

Master's Theses and Capstones

BACKGROUND: Central line-associated bloodstream infections (CLABSI) are the most common type of preventable healthcare-associated bloodstream infection, and may increase length of stay (LOS), facility treatment costs, and patient mortality rates. Intensive Care Unit (ICU) patients are especially vulnerable to CLABSI due to their critical health conditions and other comorbid factors. A literature review provided evidence supporting the use of alcohol-impregnated disinfectant caps, such as SwabCap®, on central line (CL) ports to significantly reduce patients’ risk for CLABSI. This quality improvement project took place within an adult ICU of a Level II trauma facility in New England, where the Infection Prevention …

Continuing Medical Education On Immunothombosis In Sepsis, Vivienne Van Nguyen

Capstone Showcase

In the past decades, the incidence of sepsis complicated by immunothrombosis has increased in critically ill patients, especially those with sepsis and septic shock. Despite intensive surveillance and prevention of the underlying causes, these disease syndromes are frequently fatal. The increased incidence of immunothrombosis in sepsis has been accompanied by many critical issues and concerns regarding current diagnostic and treatment protocols. This paper offers a concise critical assessment of the current state of knowledge about sepsis and immunothrombosis among clinicians in the ICU as well as problem concerning the recognition of sepsis and immunothrombosis and their management.

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 …

Antibiotic Permeation In Gram-Negative Bacteria And Contribution Of Inflammasome Activation And Pyroptosis In Pathogenesis Of Salmonella Systemic Infection, Ankit Pandeya

Theses and Dissertations--Chemistry

Antibiotic resistance is one of the major global issues in the field of public health and medicine. Good antibiotic candidates need to be selectively toxic, inhibit cellular target, and effectively penetrate and accumulate in bacterial cells. The last factor is a formidable barrier in the development of antimicrobials effective in Gram-negative bacteria, due to the presence of two layers of cell envelope. The first half of my thesis focuses on understanding the permeation of small molecules through this formidable cell envelope, distribution inside the cell of Gram-negative bacteria, and design of novel methods to make small molecules effectively cross the …

Nicotine And Cotinine: Microbial Modulators Of The Immune Response, Jourdan Lakes

Theses and Dissertations--Chemistry

The consumption of tobacco products is a known contributor to a variety of health conditions and disease pathologies including cardiovascular and lung diseases. In addition to these well-known pathological effects of tobacco use, it has been established recently that tobacco consumption as well as nicotine consumption alone results in distinct, dysbiotic perturbations to the enteric microflora of the gastrointestinal tract. Previous research into the intestinal microbiome has demonstrated that these microbes are active contributors to the maintenance of a homeostatic and tolerogenic environment within the host. In fact, the presence of our enteric microflora is necessary for the proper development …

Retropharyngeal Abscess And Pott’S Disease Due To Tuberculosis: A Case Report, Bailey N. Hassman, Steven D. Curry, Jonathan H. Ryder, Angela L. Hewlett, Jayme R. Dowdall

Graduate Medical Education Research Journal

Introduction: Extrapulmonary mycobacterial infection can lead to vertebral spondylitis and osteomyelitis (Pott’s disease). Retropharyngeal abscess with concurrent spinal osteomyelitis is a rare presentation of tuberculosis in the US. Chart review on a patient was completed, and the relevant published literature was reviewed.

Case Presentation: A previously healthy 34-year-old male originally from Sudan presented to an outside hospital with a 2-month history of neck pain, sore throat, odynophagia, fevers, and chills. MRI showed a retropharyngeal abscess and suspected cervical spine osteomyelitis. Acid-fast bacillus (AFB) smear was positive from a neck drain specimen, but sputum was negative. Chest imaging did not show …

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 …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Optimizing Empiric Vancomycin Use In Febrile Neutropenia Patients, Nicole Tadros, Erika Dittmar, Radhan B. Gopalani

Nursing & Health Sciences Research Journal

Introduction: National guidelines do not support routine empiric vancomycin use in the initial management of febrile neutropenia (FN) and only recommend it in patients with specific clinical indications. This bi-phasic quality improvement project aimed to evaluate current vancomycin use in FN and improve compliance with a guideline-driven algorithm (GDA) to ensure appropriate prescribing and therapy duration in a community hospital.

Methods: Phase I was a retrospective review of charts of adults receiving empiric vancomycin therapy for FN at a community hospital. Phase II was a prospective review of charts of patients with FN, who received pharmacist-led interventions, to improve de-escalation …

Genomic Epidemiology Of Clostridium Difficile Colonization And Transmission In An Intensive Care Unit Cohort, Brianne Ciferri

Dissertations and Theses

Abstract

Genomic epidemiology of Clostridium difficile colonization and transmission in an intensive care unit cohort

by Brianne Ciferri, MPH

Advisor: C. Mary Schooling, PhD

Introduction: Clostridiodes difficile (C. difficile) is a leading cause of healthcare associated infections (HAI) in the United States and responsible for an estimated incidence of 223,900 cases and 12,800 deaths per year^1,2. C. difficile can cause gastrointestinal illness with symptoms ranging from mild diarrheal illness to a life-threatening condition. C. difficile is an opportunistic pathogen in which spores can live in an undisturbed dormant state within the intestinal tract and become …

Genital Chlamydia Infection Is Influenced By The Female Sex Hormones Estrogen And Progesterone In Vivo, Amy Gail Gravitte

Electronic Theses and Dissertations

Chlamydia is the most common bacterial sexually transmitted infection in the United States and worldwide. It often goes unnoticed due to lack of symptoms and left untreated it can ascend the female genital tract to cause sequelae like pelvic inflammatory disease and irreversible tubal infertility. In reproductive-aged women, female sex hormones estrogen (E2) and progesterone (P4) concentrations fluctuate during the menstrual cycle and are influenced by hormonal contraceptives and hormone replacement therapy. E2 and P4 influence genital Chlamydia infection in women and mice, but these multifactorial interactions are not entirely mapped out. The complex interplay of E2 and P4 with …

Eradication Of Enterococcus Faecalis In Conventional Endodontic Retreatments (A Randomized Clinical Trial), Fadl H. Khaled, Roula S. Abiad, Khaled Abd El Galil, Essam Osman

BAU Journal - Creative Sustainable Development

Enterococcus faecalis is the most common bacteria isolated in conventional endodontic retreatments. Aim: To compare the impact of three irrigation modalities on the elimination of the isolated microbial strains of Enterococcus faecalis. Materials and Methods: Thirty patients requiring conventional endodontic retreatment for one of their mandibular premolars and tested positive for E. faecalis were chosen. Patients were randomly divided into three groups (n=10) according to the irrigation modality to be used; group I: syringe irrigation (NaOCl 2.625%), group II: NaOCl 2.625%+EndoActivator and group III: NaOCl 2.625%+diode laser. Before obturation, samples S2 were collected and PCR analysis was performed to identify …

Impact Of Central Line Bundle Care On Reduction Of Central Line Associated-Infections: A Scoping Review, Alisha James-Scott Msn, Fnp-C, Rachel Savoy Msn, Fnp-Bc, Donna Lynch-Smith Dnp, Acnp-Bc, Apn, Ne-Bc, Cnl, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Apn

Doctor of Nursing Practice Projects

Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use.

Methods A literature review was …

Septic Pulmonary Embolism Causing Recurrent Pneumothorax In An Intravenous Drug User Without Right-Sided Valvular Vegetation In Infective Endocarditis, Mason Montano, Kevin Lee, Kushal Patel, Mutsumi Kioka

Department of Internal Medicine Faculty Research

The following report illustrates a case of a 36-year-old Caucasian male with intravenous drug use (IVDU) induced septic thrombophlebitis presenting with recurrent unilateral pneumothoraces from septic pulmonary embolism (SPE) without the presence of obvious right-sided valvular vegetation in infective endocarditis (IE), defined as tricuspid or pulmonary valve lesions. Pneumothorax (PTX) has been observed as a rare complication of SPE and is commonly associated with infective right-sided IE, IVDU, and intravascular indwelling catheters. However, this case is novel as it is the very rare documented case of recurrent, unilateral, spontaneous right PTX refractory to multiple chest tube placements in such a …

Type Vi Secretion System Mutations Reduced Competitive Fitness Of Classical Vibrio Cholerae Biotype, Benjamin Kostiuk, Francis J. Santoriello, Laura Diaz-Satizabal, Fabiana Bisaro, Kyung-Jo Lee, Anna N. Dhody, Daniele Provenzano, Daniel Unterweger, Stefan Pukatzki

Publications and Research

The gram-negative bacterium Vibrio cholerae is the causative agent of the diarrhoeal disease cholera and is responsible for seven recorded pandemics. Several factors are postulated to have led to the decline of 6th pandemic classical strains and the rise of El Tor biotype V. cholerae, establishing the current 7th pandemic. We investigated the ability of classical V. cholerae of the 2nd and 6th pandemics to engage their type six secretion system (T6SS) in microbial competition against non-pandemic and 7th pandemic strains. We report that classical V. cholerae underwent sequential mutations in T6SS genetic determinants that initially exposed 2nd pandemic strains …

Role Of Aim2 Inflammasome In Pulmonary Host Defense Against Staphylococcus Aureus-Induced Pneumonia, Bibek Dhakal

LSU Master's Theses

Bacterial pneumonia is the leading cause of death in children under the age of five, claiming the lives of two million children each year. Staphylococcus aureus is the extracellular Gram-positive bacteria that causes necrotizing pneumonia. Moreover, the spread of antibiotic-resistant and hypervirulent strains has made treatment more challenging. Absent in melanoma 2 (AIM2) is a dsDNA-sensing cytosolic innate immune receptor that activates inflammasomes and is crucial for host defense against intracellular bacteria and DNA viruses. However, its role in extracellular bacterial pathogen-induced pneumonia is unclear. Therefore, understanding how AIM2 initiates host responses during Staphylococcus aureus is crucial for the development …

Effect Of Different Irrigation Regimens On Enterococcus Faecalis Elimination From Infected Root Canals (An In-Vitro Comparative Study), Fadl Khaled, Roula Abiad, Khaled Abd El Galil, Essam Osman

BAU Journal - Health and Wellbeing

Microorganisms harbored in the complexities of root canal systems might lead to endodontic failures and development of apical periodontitis. Enterococcus faecalis is the most common isolated bacteria in these cases. Aim: This study was conducted to compare the efficiency of four irrigation regimens on the elimination of an inoculated strain of E. faecalis. Materials and Methods: Forty single rooted extracted premolars were inoculated with a standard strain of Enterococcus faecalis (ATCC 29212) and incubated at 37˚C for two weeks to allow infection of the dentinal tubules. The bacterial suspension was replaced with a new one every 48 hours. The teeth …

Ecthyma Gangrenosum And Panniculitis Secondary To Acute Pseudomonas Myositis Without Bacteremia, Heather Gosnell, Matthew Burke, Joseph Shnouda

HCA Healthcare Journal of Medicine

Introduction

Ecthyma gangrenosum (EG) is a relatively uncommon cutaneous manifestation of an underlying Pseudomonas aeruginosa infection and is clinically described as necrotic with gangrenous ulcers surrounded by erythematous halos. Cases of EG may occur in the absence of bacteremia and have been increasingly reported in literature. Here we present a patient with features of both EG and panniculitis, despite the lack of underlying bacteremia.

Clinical Findings

A 57-year-old male presented to the emergency department with unrelenting right-sided lower back pain and an “itchy and painful” rash of four to five day duration. The patient had an extensive history of intravenous …

A Research Framework For Evaluating Next Generation Sequencing In Community-Acquired Pneumonia, Ashley M. Wilde, Elena Swingler, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Matthew Song Pharmd, Bcidp, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.