Bacterial Infections and Mycoses Commons^™

Case Report: When Confusion Signals A Crisis: Rethinking The Diagnosis Of Meningitis In Geriatric Sepsis, Asma Zahid

Rowan-Virtua Research Day

We report the case of an 88-year-old female who presented with altered mental status, initially suspected to have urosepsis but ultimately diagnosed with streptococcal meningitis. The patient had a history of lethargy and anorexia over the past few days and was found to have sepsis. Despite initial focus on urosepsis, blood cultures revealed Streptococcus, and cerebrospinal fluid analysis confirmed bacterial meningitis. This case highlights the potential for meningitis to be overlooked in elderly patients with suspected sepsis, underscoring the importance of broad diagnostic considerations and early intervention. This case highlights the importance of considering meningitis in elderly patients presenting with …

Case Report: Dissecting Retroperitoneal Abscess With Gas Formation, David F. Koziel Jr.

Rowan-Virtua Research Day

Presenting as a case to the emergency department was a 53-year-old male with a complaint of diffuse abdominal pain and focal right flank pain at site of recent percutaneous abscess drain site performed exactly one month prior. This followed hospitalization in the preceding year for complicated multifocal intra-abdominal infections requiring surgical interventions including exploratory laparotomy and surgical debridement for intra-abdominal abscess and scrotal abscess formation. Despite prior aggressive management and extensive coverage with broad-spectrum antibiotics, this patient was found to have fulminant recurrance of infection in the right retroperitoneal space with an expanding abscess dissecting through the retroperitoneal structures into …

‭Prevalence Of Potentially Pathogenic Bacteria In Showers At A Long-Term Nursing Care Facility, Joseph Caleb Kulon

Honors Theses

Pathogenic bacteria on environmental surfaces in nursing homes may contribute to the‬ growing burden of healthcare-associated infections (HAIs), particularly as the U.S. population‬ ages and more individuals transition into long-term care. In this study, 70 swab samples were‬ collected from five community shower rooms at a nursing home over three sampling trips. Five‬ common shower surfaces were sampled: the floor drain, shower bench, faucet/valves, shower‬ curtain, and grab bars. Samples were processed in the UTC CIDC microbiology lab and‬ inoculated onto four selective and differential media: Hardy CHROM MRSA agar (for‬ methicillin-resistant‬‭ Staphylococcus aureus‬‭ [MRSA]‬‭ and‬‭ S. pseudintermedius‬‭ [SIM]), mannitol‬ …

Bacterial Contamination Of Wheelchairs In A Long-Term Rehabilitation Facility, Storm A. Welch

Honors Theses

The presence of bacterial contamination on wheelchair surfaces in long-term care facilities poses a significant risk to infection control and patient safety. This study aimed to assess the prevalence and diversity of bacterial species, including Staphylococcus aureus (SA), methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis (SE), Pseudomonas spp., and enteric bacteria on five key components of wheelchairs at a local long-term care facility. A total of 320 swabs were collected from wheelchair components, including handles for pushing, armrests, seats, wheel handles, and tires. Samples were analyzed using selective culture media, and bacterial species were identified based on colony morphology. The results …

Molecular Insights Into Antibiofilm Inhibitors Of Streptococcus Mutans Glucosyltransferases Through In Silico Approaches, Lubna Atta, Ali Raza Siddiqui, Mamona Mushtaq, Sajida Munsif, Mohammad Nur-E-Alam, Aftab Ahmad, Zaheer Ul-Haq

Pharmacy Faculty Articles and Research

Streptococcus mutans, a primary cariogenic bacterium, plays a central role in dental caries, one of the most widespread chronic diseases globally. Glucosyltransferases (GTFs) are key virulence factors in this process, as they synthesize extracellular polysaccharides that contribute to biofilm formation and pathogenicity. Targeting GTFs has emerged as a promising strategy for preventing dental caries, with previous studies demonstrating its potential efficacy. This study builds on our prior work by providing detailed molecular insights into the binding modes of previously identified GTF inhibitors. Using computational tools, including density functional theory, molecular docking, and molecular dynamics simulations, we examined the binding …

Central-Line Dressing Protocols: The Effectiveness Of A Standardized Dressing Change Protocol In Reducing Central-Line Associated Bloodstream Infections (Clabsi) In Critically Ill Patients Requiring Central Lines, Cody Jones, Melissa Marino, Ryan Mcfarland, Asia White, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

In the Intensive Care Units (ICU), central lines are an essential way of life. However, central lines have risks such as central line-associated bloodstream infections (CLABSI), which increase hospital stays and mortality. CLABSI significantly impacts patient outcomes in critical care, increases mortality and morbidity, increases medical costs, increases hospital-acquired infections, and reduces hospital reimbursements. Typically, antimicrobial dressing has been associated with decreased mortality and improved CLABSI rates. The scoping review will evaluate the literature and examine the effectiveness of various antimicrobial dressing strategies on CLABSI rates. This study aims to synthesize these findings to develop improved CLABSI prevention protocols …

Use Of Procalcitonin In Therapeutic Decisions In The Pediatric Intensive Care Unit, Pierre Tissières, Elisabeth Esteban Torné, Johannes Hübner, Adrienne Randolph, Corsino Rey Galán, Scott Weiss

Department of Medicine Faculty Papers

Procalcitonin (PCT) is frequently used by clinicians in children with suspected bacterial infections and sepsis. However interpretation in the critically ill child may be challenging due to the complexity of underlying conditions and its impact on PCT values. Herein, we propose a guidance for the use of procalcitonin in critically ill children, supported by a comprehensive analysis of the literature, to help the clinician for interpreting PCT in the various clinical conditions encountered in pediatric intensive care units. We describe the importance of the clinical context, timing of measurement and evidence on PCT values in diagnosing sepsis and to guide …

The Effects Of Cyclic Peptide [R4w4] In Combination With First-Line Therapy On The Survival Of Mycobacterium Avium, Melissa Kelley, Kayvan Sasaninia, Ali Badaoui, Ira Glassman, Arbi Abnousian, Nadia Rai, Rakesh K. Tiwari, Vishwanath Venketaraman

Pharmacy Faculty Articles and Research

Background: Mycobacterium avium (M. avium) is a nontuberculous mycobacterium (NTM) that can cause pulmonary and extrapulmonary infections mostly in immunocompromised individuals, such as those with HIV and diabetes. Traditionally, rifampicin (RIF) and azithromycin (AZ) have been used for a 12-month duration as first-line antibiotics against M. avium. Due to the increased multidrug resistance, novel ways, such as enhancement of macrophages response, are needed to provide adequate immune response required to clear M. avium infection.

Methods and findings: In this study, we aim to study the effects of using THP-1 cells, which are monocyte-like cells, to induce a …

24 Hours Of Postoperative Oral Antibiotics For Same-Day Discharge After Hip And Knee Arthroplasty Has Low Rate Of Prosthetic Joint Infection, Phillip Mckegg, Colton L. Clymer, Hamza Raja, Alexander Driessche, Gabriel Boudagh, W. Trevor North Md, Michael A. Charters Md

Medical Student Research Symposium

Title: 24 Hours of Postoperative Oral Antibiotics for Same-Day Discharge After Hip and Knee Arthroplasty Has Low Rate of Prosthetic Joint Infection

Authors: Phillip C. McKegg, MS, Colton Clymer, BS, Hamza Raja, BS, Alexander Driessche, MSE, Gabriel Boudagh, BS, W. Trevor North, MD, Michael A. Charters, MD

Introduction:

There is no clear consensus on postoperative antibiotic protocols for same-day discharge hip and knee arthroplasties. This study evaluates prosthetic joint infection (PJI) rates in patients discharged with 24 hours of oral antibiotics after surgery.

Methods:

A retrospective review was conducted on 1,843 patients who underwent primary hip or knee …

Clinical Characteristics And Outcomes Of Pediatric Staphylococcal Scalded Skin Syndrome (Ssss) At An Inner-City Tertiary Care Center, Nina Kb Gust Md, Ashley Frei Bs, Rebecca M. Adams Bs, Elika Ridelman Phd, Christina Shanti Md, Ronald Thomas Phd, Jocelyn Y. Ang Md

Medical Student Research Symposium

Introduction

Staphylococcal Scalded Skin Syndrome (SSSS) is a blistering skin condition caused by a toxin-producing staphylococcus species. Epidemiologic studies on pediatric SSSS in the United States are limited, with a reported incidence of 7.67 cases per million children and 45.1 per million infants. Immature renal function, lack of protective antibodies, and increased exotoxin target desmoglein-1 are hypothesized to increase incidence in younger children. We aimed to determine clinical and microbiological characteristics of pediatric SSSS and factors that could help predict disease severity.

Methods

A retrospective chart review was performed for admitted patients under 18 years old diagnosed with SSSS from …

Streamlining The Journey Of Research Into Clinical Practice: Making Your Patients And Practice Flourish Evaluation And Treatment Of Pyogenic Spondylodiscitis Of The Spine: Ao Spine Knowledge Forum Trauma And Infection, Sebastian F. Bigdon, Emiliano Vialle, Charlotte Dandurand, Julian Scherer, Gaston Camino-Willhuber, Andrei F. Joaquim, Harvinder S. Chhabra, Mohammad El-Sharkawi, Richard Bransford, Charles G. Fisher, Klaus J. Schnake, Gregory D. Schroeder

Rothman Institute Papers

Study DesignLiterature Review with clinical recommendations.ObjectiveTo highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.MethodsFive influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.ResultsFive studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, …

First Report Of A Multidrug-Resistant Staphylococcus Coagulans Urinary Tract Infection Associated With A Medical Device., Carlos Ramírez-Pfeiffer, Defne Esmeralda Esparza-Galván, Allan Guzmán Cardenas, Jania Jazmin Gutiérrez-Carreño, Martín Segura-Chico, Juan Carlos López-Alvarenga

Research Symposium

Background: The identification of Staphylococcus schleiferi subsp. coagulans (recently reclassified as S. coagulans) was part of a previous retrospective study on antibiotic resistance in urinary tract infections (UTIs) in older adults conducted at a Tamaulipas state hospital in 2023 (Esparza 2023, unpublished data). S. coagulans is an emerging human pathogen, initially associated with veterinary infections, particularly dermatitis and otitis in dogs. Like other Staphylococcus species, it is known for its biofilm-forming ability, which enhances its persistence and resistance to treatment. Recent studies have linked S. coagulans to severe human infections, including endocarditis, meningitis, and hepatocellular carcinoma, particularly in patients with …

The Impact Of Testosterone Therapy On The Vaginal Microbiota Of Transgender Men And Non-Binary People: A Prospective Study, Olivia T. Van Gerwen, Kristal J. Aaron, Emma Sophia Kay, Krishmita Siwakoti, Angela Pontius, Saralyn Richter, Z Alex Sherman, Keonte J. Graves, Ashutosh Tamhane, Jacob H. Elnaggar, Meng Luo, Evelyn Toh, David E. Nelson, Nicholas J. Van Wagoner, Christopher M. Taylor, Christina A. Muzny

School of Medicine Faculty Publications

BACKGROUND: Understanding the impact of testosterone on the vaginal microbiota of transgender men (TGM) and non-binary people assigned female sex at birth over time is imperative as vaginal dysbiosis and incident bacterial vaginosis (iBV) may cause bothersome genital symptoms and increase HIV/STI acquisition risk. We investigated shifts in the composition of the vaginal microbiota over time in TGM initiating testosterone for gender-affirming hormone therapy, including development of vaginal dysbiosis and iBV.

METHODS: Participants ages ≥18 years, assigned female sex at birth and reporting TGM or non-binary identity, interested in starting injectable testosterone, demonstrating optimal vaginal microbiota, with no current STI(s) …

External Validation Of The Phoenix Sepsis Score In Children With Suspected Community-Acquired Sepsis, Elliot Long, Meredith Borland, Shane George, Shefali Jani, Eunicia Tan, Natalie Phillips, Amit Kochar, Simon Craig, Anna Lithgow, Arjun Rao, Stuart Dalziel, Ed Oakley, Stephen Hearps, Ben Gelbart, Sarah Mcnab, Fran Balamuth, Scott Weiss, Nathan Kuppermann, Charlotte Brad, Amanda Williams, Franz Babl

Department of Medicine Faculty Papers

IMPORTANCE: The novel Phoenix Sepsis Score and sepsis criteria were derived and validated using a multicountry dataset and proposed as a new definition for sepsis in children.

OBJECTIVE: To externally validate the Phoenix Sepsis Score and sepsis criteria in a cohort of children hospitalized with suspected community-acquired sepsis.

DESIGN, SETTING, AND PARTICIPANTS: This diagnostic study used data from the multicenter, multicountry Sepsis Epidemiology in Australian and New Zealand Emergency Departments (SENTINEL) study, collected from 2021 to 2023 and including 90-day follow-up. Children admitted to the hospital through 11 emergency departments in Australia and New Zealand and treated with parenteral antibiotics …

Increasing Risk Of Postlung Transplant Hospitalizations For Infection: An Analysis Of Recent Trends, Shi Nan Feng, Armaan F. Akbar, Alice L. Zhou, Andrew Kalra, Sean Agbor-Enoh, Christian A. Merlo, Errol L. Bush

SKMC Student Presentations and Publications

BACKGROUND: Despite advancements in lung transplantation (LT), infection remains a major cause of morbidity and mortality following LT. We examined trends in hospitalizations for infection in the first year after LT.

METHODS: We identified adult LT recipients in the United States (March 1, 2018-March 9, 2023) using the Organ Procurement and Transplantation Network database. We categorized transplants into 3 eras to account for the Composite Allocation Score allocation policy change and coronavirus disease 2019: March 2018 to March 2020, March 2020 to March 2022, and March 2022 to March 9, 2023. One-year post-LT survival was compared using Kaplan-Meier survival analysis …

Ultrasound-Triggered Release Of Vancomycin From A Novel Spinal Device: Antibiotic Release And Efficacy In Vivo, Lauren J. Delaney, Priscilla Machado, Ji-Bin Liu, Rachel Evans, Asia Winslow, Neil Zhao, Christopher K. Kepler, Rajkishen Narayanan, Teeto Ezeonu, Viren Soni, Gagan Kaushal, Rachel Hilliard, Thomas P. Schaer, Noreen J. Hickok, Flemming Forsberg

Department of Orthopaedic Surgery Faculty Papers

Post-surgical spinal infection occurs in up to 20 % of patients, despite aggressive peri-operative antibiotic treatments. To improve prophylaxis, we have designed and evaluated an ultrasound-activated prophylactic antibiotic release system to combat post-surgical bacterial survival. Polylactic acid (PLA) clips (1 cm³) were 3D-printed with an interior reservoir (0.8 cm³) for carrying drug payload, specifically vancomycin (VAN). Under IACUC approval, clips were surgically implanted into the spines of sheep (n = 9) and swine (n = 2) by removing the spinous process at several levels of the lumbar spine. In the sheep, clips were insonated and the …

Bloom: Behavioral Learning And Outcome Observation In Microbes, Sean Sarwar Haque, Luke Compton Wharton, Ming Lin, Razvan Voicu

Symposium of Student Scholars

Understanding how pathogens respond to physical changes in their environment is crucial for developing effective treatments and preventative measures. Current research often relies on static models or experimental data that either fail to capture the dynamic interactions within cellular environments or are not generalizable to other types of pathogens. This project aims to address this gap by creating a comprehensive cell simulation that models pathogens and their response to chemical, physical, and physiological changes. The proposed solution is a simulation that integrates biological data and computational modeling to replicate the behavior of pathogens in real time as they are affected …

Trichosporon Asahii And Candida Guilliermondii As A Source Of Orbital Infection In An Immunocompromised Individual, David Morcos, Kevin Hardy, Anthony Makovec, Morgan Schill, John Foxworth

School of Medicine Faculty Publications

A 47-year-old male with a history of immunosuppression and recent intensive care unit admission presented with progressive orbital swelling and pain. Blood cultures grew Trichosporon asahii and Candida guilliermondii, with matching positive cultures from peripheral and central venous samples. Given his fungemia and worsening orbital involvement, induction therapy with amphotericin B and isavuconazole was initiated. Within weeks, clinical improvement was noted, prompting a transition to long-term consolidation therapy with oral posaconazole and isavuconazole. At follow-up, the patient demonstrated sustained clinical stability with no recurrence of infection. Orbital involvement from fungemia due to T. asahii and C. guilliermondii is rare, and …

Jarisch-Herxheimer Reaction After Benzathine Penicillin G Treatment In Adults With Early Syphilis: Secondary Analysis Of A Randomized Clinical Trial., Jodie A. Dionne, Chunming Zhu, Jorge Mejia-Galvis, Kimberly Workowski, Teresa A. Batteiger, Julia C. Dombrowski, Kenneth H. Mayer, Candice J. Mcneil, Arlene C. Seña, Stephanie Taylor, Harold C. Wiesenfeld, Matthew M. Hamill, Charlotte Perlowski, Edward W. Hook Iii

School of Medicine Faculty Publications

Key Points: Question: What proportion of patients with early syphilis have symptoms of the Jarisch-Herxheimer reaction (JHR) after treatment with benzathine penicillin G, and what are the associated characteristics? Findings: This prespecified secondary analysis of a multisite US randomized clinical trial found that, among 249 adults with early syphilis, JHR symptoms occurred after benzathine penicillin G treatment in 59 participants (23.7%). Onset of JHR was within 12 hours of treatment for 86.0% of participants, and JHR was associated with successful treatment response, secondary syphilis, and absence of HIV. Meaning: This study suggests that patients treated with benzathine penicillin G for …

Associations Of Time To The Operating Room On Outcomes In Odontogenic Infection, Jeffrey N. James, Ryan Bloomquist, Kiara Brown, Stephen Looney, Dylan Walker, Tyler Day

School of Dentistry Faculty Publications

The purpose of this study was to determine if there were correlations between the length of time from hospital admission to surgical intervention and the frequency of complications in patients with odontogenic infections. While odontogenic infection is well studied in terms of interventions and outcomes, less is known about hospital utilization and resource burden of odontogenic infection with respect to timeliness to intervention. A retrospective cohort analysis was used to examine correlations between time from admission to surgical intervention and clinical outcomes. Patients included in this study were divided into three categories of length of time to the operating room: …