Bacterial Infections and Mycoses Commons^™

Molecular Subtyping Of Staphylococcus Aureus Isolates From The U.P. Community For The Presence Of Toxin-Encoding Genes, Carol I. Kessel

All NMU Master's Theses

Staphylococcus aureus is the most common cause of human bacterial infections; however, humans can also be asymptomatically colonized with S. aureus. Asymptomatic carriers can potentially spread S. aureus infection to others. These infections can range from mild to severe. The pathology of a S. aureus infection is often dependent on which toxins are expressed and the virulence factors with which they are associated. One goal of this study was to isolate S. aureus from healthy, consenting adult volunteers who submitted nasal swabs for culture and qRT-PCR analysis to determine which strains are present in the community. This knowledge could …

The Msaabcr Operon Mutant Staphylococcus Aureus Is Deficient In Persister Cells, Aaliyah D. Cole

Honors Theses

Persister cells comprise a phenotypic variant that shows extreme antibiotic tolerance resulting in chronic infections. While this phenomenon has posed a great threat in public health, mechanism underlying their formation in Staphylococcus aureus remains largely unknown. Increasing evidence of the presence of persister cells in recalcitrant infections underscores the great urgency to unravel the mechanism by which these cells are developed. The Elasri Research group characterized msaABCR operon that plays roles in regulation of virulence, biofilm development and antibiotic resistance. It was hypothesized that the operon also plays a role in persister cell formation. In this study, the persister cell …

Antibiotic Prophylaxis Is Associated With Subsequent Resistant Infections In Children With An Initial Extended-Spectrum-Cephalosporin-Resistant Enterobacteriaceae Infection., Sibani Das, Amanda L. Adler, Arianna Miles-Jay, Matthew P. Kronman, Xuan Qin, Scott J. Weissman, C A. Burnham, Alexis Elward, Jason G. Newland, Rangaraj Selvarangan, Kaede V. Sullivan, Theoklis Zaoutis, Danielle M. Zerr

Manuscripts, Articles, Book Chapters and Other Papers

The objective of this study was to assess the association between previous antibiotic use, particularly long-term prophylaxis, and the occurrence of subsequent resistant infections in children with index infections due to extended-spectrum-cephalosporin-resistant Enterobacteriaceae We also investigated the concordance of the index and subsequent isolates. Extended-spectrum-cephalosporin-resistant Escherichia coli and Klebsiella spp. isolated from normally sterile sites of patients aged species, resistance determinants, and fumC-fimH (E. coli) or tonB (Klebsiella pneumoniae) type were identical to those of the index isolate. In total, 323 patients had 396 resistant isolates; 45 (14%) patients had ≥1 subsequent resistant infection, totaling 73 …

Study Of Rickettsia Parkeri Colonization And Proliferation In The Tick Host Amblyomma Maculatum (Acari: Ixodidae), Khemraj Budachetri

Dissertations

Amblyomma maculatum (Gulf coast tick) ticks are prevalent across the Atlantic to Gulf Coast region of United States. These ticks are recognized vectors of Rickettsia parkeri, a spotted fever group of Rickettsia (SFGR) known to cause American boutonneuse fever associated with fever and eschar rashes localized to the site of bites. We hypothesized that Rickettsia parkeri colonization and proliferation in the tick vector involve pathogen-symbiont dynamics and tick-pathogen interactions, which influence rickettsial transmission to the victims after tick bites. The rickettsial infection is maintained across the tick life cycle for many generations due to transovarial and transstadial transmission of …

Ticked Off: An Analysis Of The Inadequate Diagnosis And Treatment Of Lyme Disease, Virginia P. Yoder

Senior Honors Theses

Lyme disease is the most common vector-borne disease in the United States and has a high prevalence among people in the northeast. Lyme disease can be a debilitating illness if not diagnosed early, and can lead to long-term health problems for many patients. This thesis serves as a review of scientific literature on Lyme disease, with the prevalence, symptomology, the bacterial mechanism of infection, the diagnostic process, transmission, and treatment therapies. Further research and development could lead to better primary care for those suffering with Lyme disease.

Fungal Infections From Human And Animal Contact, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America. Other human-acquired and zoonotic fungal infections also are discussed in brief.

Aspergillus Fumigatus Trehalose-Regulatory Subunit Homolog Moonlights To Mediate Cell Wall Homeostasis Through Modulation Of Chitin Synthase Activity, Arsa Thammahong, Alayna K. Caffrey-Card, Sourabh Dhingra, Joshua J. Obar, Robert Cramer

Dartmouth Scholarship

Trehalose biosynthesis is found in fungi but not humans. Proteins involved in trehalose biosynthesis are essential for fungal pathogen virulence in humans and plants through multiple mechanisms. Loss of canonical trehalose biosynthesis genes in the human pathogen Aspergillus fumigatus significantly alters cell wall structure and integrity, though the mechanistic link between these virulence-associated pathways remains enigmatic. Here we characterize genes, called tslAand tslB, which encode proteins that contain domains similar to those corresponding to trehalose-6-phosphate phosphatase but lack critical catalytic residues for phosphatase activity. Loss of tslA reduces trehalose content in both conidia and mycelia, impairs cell wall …

Filamentous Fungal Carbon Catabolite Repression Supports Metabolic Plasticity And Stress Responses Essential For Disease Progression, Sarah R. Beattie, Kenneth Mark, Arsa Thammahong, Laure Nicolas Annick Ries, Sourabh Dhingra, Alayna Caffrey-Carr, Chao Cheng

Dartmouth Scholarship

Aspergillus fumigatus is responsible for a disproportionate number of invasive mycosis cases relative to other common filamentous fungi. While many fungal factors critical for infection establishment are known, genes essential for disease persistence and progression are ill defined. We propose that fungal factors that promote navigation of the rapidly changing nutrient and structural landscape characteristic of disease progression represent untapped clinically relevant therapeutic targets. To this end, we find that A. fumigatus requires a carbon catabolite repression (CCR) mediated genetic network to support in vivo fungal fitness and disease progression. While CCR as mediated by the transcriptional repressor CreA is …

Chagas, Enfermedad Olvidada: Una Perspectiva Histórica De La Prevención Y Control Del Chagas En La Provincia De Salta, Argentina (1909 – 2017) \ Chagas, A Forgotten Disease: A Historical Perspective On The Prevention And Control Of Chagas In Salta Province, Argentina (1909 – 2017), Tara Shea

Independent Study Project (ISP) Collection

El Chagas es una enfermedad vectorial más conocida en zonas rurales de América Latina y en Argentina es endémica en la región noroeste del país (MSAL, 2017). Designada una enfermedad tropical desatendida (Neglected Tropical Disease, NTD) por la OMS, la crónica del Chagas desde su “hallazgo casual” en 1909 siempre se trató de abandono (INP, 2017; MSF, 2012; OMS, 2017; Reyes López, 2009; Stamboulian, 2015; Zabala, 2009). En toda la Argentina se identifican 1.600.000 casos y 7.300.000 personas expuestas al Chagas, dando el país una de las tasas chagásicas más altas del mundo (Bär, 2015; MSAL, 2017).1

El modo de …

Abordajes De Nuevos Tratamientos Para La Enfermedad De Chagas Y Su Potencial Aplicación En Pacientes Desde Las Perspectivas De Los Profesionales En La Ciudad Autónoma De Buenos Aires, Argentina / Approaches To New Treatments For Chagas Disease And Their Potential Application In Patients From The Perspectives Of Professionals In The Autonomous City Of Buenos Aires, Argentina, Chelsea Hipwell

Independent Study Project (ISP) Collection

Más de cien años después del descubrimiento de la enfermedad de Chagas, esta enfermedad desatendida sigue afectando más de 6 millones de personas en Latinoamérica, de las cuales 1.5 millones son de Argentina. Al día de hoy, solo existen dos medicamentos para tratar esta enfermedad. El presente proyecto se basa sobre un estudio exploratorio de los desafíos de tratar la enfermedad de Chagas en sus distintas fases y los abordajes actuales para nuevos tratamientos.

Los objetivos de este trabajo fueron los siguientes: en primer lugar, estudiar el contexto socio-económico en que existe esta enfermedad y las implicaciones de este contexto …

Fungus Amungus -- A Common Disease State That Is Commonly Missed: A Survey Based Study, Ramsin Yadgar, Adam Friedman, Neal Bhatia

GW Research Days 2016 - 2020

Background: Dermatophyte infections involving the skin, hair, or nails affect an estimated 25% of the world's population, and accounted for 51 million outpatient visits over a ten-year period (1995-2004) in the United States alone. Dermatomycosis is routinely managed by dermatologists, though given the diversity of clinical presentations, is sometimes misdiagnosed, which can result in inappropriate therapy, worsening of symptoms, and even result in additional skin and soft tissue infections.

Methods: An interactive survey of board-certified dermatologists was conducted at the 2016 Orlando Dermatology Aesthetic & Clinical Conference, during a seminar on superficial mycotic infections. The structure of the survey entailed …

Understanding The Patterns Of Distribution And Abundance Of Lyme Disease Carrying Ticks And Their Hosts, Julio Ruiz

Honors Theses

Lyme disease is caused by the bacteria Borrelia burgodorferi and spreads to their hosts by the bites of infected Ixodes scapularis ticks. In the United States, Lyme disease is typically found in the northeast but in recent years the disease has begun to be found further south and west than previously before. Yet, today, little information can be found about the patters of distribution and abundance of ticks and their host. The main goal of this research work was to expand the knowledge of the abundance and distribution of ticks and host. Based on tick collection data obtained from Maikis …

Complex Multimodality Central Airway Management Of Aspergillus Pseudomembranous Tracheobronchitis, S Dhillon, M Saoud, Kassem Harris

NYMC Faculty Publications

A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted …

Hemophagocytic Lymphohistiocytosis Associated With Anaplasmosis, T Johnson, M Brown, M Rabbat, Jihad Slim

NYMC Faculty Publications

Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome characterized by unregulated macrophage and T-lymphocyte activation resulting in cytokine overproduction and subsequent histiocytic phagocytosis. Variant infections, particularly viruses have been postulated as the inciting factor for this potentially fatal disease. Herein, we will report a case of HLH associated with anaplasmosis.

Diagnostic Challenges And Treatment Difficulties In A Patient With Excoriated Acne Conglobata, Simona R. Georgescu, Maria I. Sârbu, Cristina I. Mitran, Mădălina I. Mitran, Vasile Benea, Mircea Tampa

Journal of Mind and Medical Sciences

Acne conglobata is a rare and severe form of acne vulgaris, characterized by the presence of comedones, papules, pustules, nodules and sometimes hematic or meliceric crusts. Acne excoriée is a form of self-inflicted skin condition in which the patient picks on imaginary or real acne lesions.

We report the case of a 16 year old Caucasian female patient from the urban area who addressed our dermatology department for erythematous, edematous plaques covered by pustules and crusts, located on the face. The anamnesis revealed that during the last weeks she had had a depressive mood after ending a relationship with her …

Pulmonary Surfactant Fortified With Cath-2 As A Novel Therapy For Bacterial Pneumonia, Brandon J. Baer

Western Research Forum

Background: Bacterial pneumonia is a leading cause of death worldwide, with high mortality rates persisting even after antibiotic treatment. Current treatments for pneumonia involve administration of antibiotics, however after the bacteria are killed they release toxic substances that induce inflammation and lung dysfunction. Host defense peptides represent a potential solution to this problem through their ability to down regulate inflammation. However, effective delivery to the lung is difficult because of the complex branching structure of the airways. My study addresses this delivery problem by using exogenous surfactant, a pulmonary delivery vehicle capable of improving spreading of these peptides throughout the …

Enhanced Control Of Mycobacterium Tuberculosis Extrapulmonary Dissemination In Mice By An Arabinomannan-Protein Conjugate Vaccine, R Prados-Rosales, L Carreno, T Cheng, C Blanc, B Weinrick, Aharona Glatman-Freedman, A Casadevall, S Hung, A Tripathi, J Xu, Aharona Glatman-Freedman, W Jacobs Jr., J Chan, S Porcelli, J Achkar, A Casadevall

NYMC Faculty Publications

Currently there are a dozen or so of new vaccine candidates in clinical trials for prevention of tuberculosis (TB) and each formulation attempts to elicit protection by enhancement of cell-mediated immunity (CMI). In contrast, most approved vaccines against other bacterial pathogens are believed to mediate protection by eliciting antibody responses. However, it has been difficult to apply this formula to TB because of the difficulty in reliably eliciting protective antibodies. Here, we developed capsular polysaccharide conjugates by linking mycobacterial capsular arabinomannan (AM) to either Mtb Ag85b or B. anthracis protective antigen (PA). Further, we studied their immunogenicity by ELISA and …

Outpatient Parenteral Antimicrobial Therapy In Pediatric Medicaid Enrollees., Jennifer Goldman, Troy Richardson, Jason G. Newland, Brian R. Lee, Jeffrey S. Gerber, Matt Hall, Matthew Kronman, Adam L. Hersh

Manuscripts, Articles, Book Chapters and Other Papers

Background: Outpatient parenteral antimicrobial therapy (OPAT) is overused in cases where highly bioavailable oral alternatives would be equally effective. However, the scope of OPAT use for children nationwide is poorly understood. Our objective was to characterize OPAT use and clinical outcomes for a large population of pediatric Medicaid enrollees treated with OPAT.

Methods: We analyzed the Truven MarketScan Medicaid claims database between 2009 and 2012. An OPAT episode was identified by capturing children with claims data indicating home infusion therapy for an intravenous antimicrobial. We characterized OPAT use by describing patient demographics, diagnoses, and antimicrobials prescribed. We categorized an antimicrobial …

Plasmid Diversity And Phylogenetic Consistency In The Lyme Disease Agent Borrelia Burgdorferi, Sherwood R. Casjens, Eddie B. Gilcrease, Marija Vujadinovic, Emmanuel F. Mongodin, Benjamin J. Luft, Steven E. Schutzer, Claire M. Fraser, Wei-Gang Qiu

Publications and Research

Background: Bacteria from the genus Borrelia are known to harbor numerous linear and circular plasmids. We report here a comparative analysis of the nucleotide sequences of 236 plasmids present in fourteen independent isolates of the Lyme disease agent B. burgdorferi.

Results: We have sequenced the genomes of 14 B. burgdorferi sensu stricto isolates that carry a total of 236 plasmids. These individual isolates carry between seven and 23 plasmids. Their chromosomes, the cp26 and cp32 circular plasmids, as well as the lp54 linear plasmid, are quite evolutionarily stable; however, the remaining plasmids have undergone numerous non-homologous and often duplicative recombination …

Orientia Tsutsugamushi Secretes Two Ankyrin Repeat-Containing Effectors Via A Type 1 Secretion System To Inhibit Host Nf-Κb Function, Sean M. Evans

Theses and Dissertations

Scrub typhus is a potentially fatal infection that threatens one billion persons in the Asia-Pacific region and is caused by the obligate intracellular bacterium, Orientia tsutsugamushi. How this organism facilitates its intracellular survival and pathogenesis is poorly understood. Intracellular bacterial pathogens utilize the Type 1 (T1SS) or Type 4 secretion system (T4SS) to translocate ankyrin repeat-containing proteins (Anks) into the host cell to modulate host cell processes. The O. tsutsugamushi genome encodes one of the largest known bacterial Ank libraries as well as Type 1 and Type 4 secretion systems (T1SS and T4SS), which are expressed during infection. In …