Infectious Disease Commons^™

An Interesting Case Of Candida Tropicalis Endocarditis, Abbas Mallick Md, Farrah R. Khan Md, Sohrab Singh Md, Salman Ayaz Md, Prandeep Kumar Devarakonda Md, Iyad Al-Bustami Md

Posters

Infective Endocarditis (IE) is a disease characterized by microbe and fibrin rich complex adhesion to the cardiac valvular apparatus. Common culprit microorganisms include gram positive bacteria however valvular infections with fungal organisms are rare. We present an uncommon case of Candida Tropicalis endocarditis.

Increased Red Cell Distribution Width (Rdw) Is Associated With Culture Positive Sepsis And With Increased Need Of Escalation In Respiratory Support In Very Low Birth Weight Infants More Than Seven Days Of Life Undergoing Sepsis Workup Secondary To Vitals Instability In The Form Of Multiple Episodes Of True Apneas Or Bradycardia And Desaturations Associated With Apnea, Kedar Tilak, Aashka Patel, Anna Zylak

Posters

Background Apnea of prematurity is nearly universal among very low birth weight infants (VLBW). In VLBW infants, changes in clinical status usually occur due to sepsis or non-infectious causes and it is challenging to differentiate between the two. We as clinicians use irregularities in vital signs as an early warning sign of sepsis to facilitate early treatment and improve patient outcomes. Adults have used RDW as a marker of worsening respiratory status and mortality from acute respiratory distress syndrome (ARDS). In this study, we seek to investigate elevations in Red Cell Distribution Width (RDW) as markers for culture positive sepsis …

Influenza C Virus In U.S. Children With Acute Respiratory Infection 2016-2019., Bethany K. Sederdahl, Geoffrey A. Weinberg, Angela P. Campbell, Rangaraj Selvarangan, Jennifer E. Schuster, Joana Y. Lively, Samantha M. Olson, Julie A. Boom, Pedro A. Piedra, Natasha B. Halasa, Laura Stewart, Peter G. Szilagyi, G K Balasubramani, Theresa Sax, Judith M. Martin, Robert W. Hickey, Marian G. Michaels, John V. Williams, New Vaccine Surveillance Network

Manuscripts, Articles, Book Chapters and Other Papers

Influenza C virus (ICV) is an orthomyxovirus related to influenza A and B, yet due to few commercial assays, epidemiologic studies may underestimate incidence of ICV infection and disease. We describe the epidemiology and characteristics of ICV within the New Vaccine Surveillance Network (NVSN), a Centers for Disease Control and Prevention (CDC)-led network that conducts population-based surveillance for pediatric acute respiratory illness (ARI). Nasal or/combined throat swabs were collected from emergency department (ED) or inpatient ARI cases, or healthy controls, between 12/05/2016-10/31/2019 and tested by molecular assays for ICV and other respiratory viruses. Parent surveys and chart review were used …

Relative Effectiveness And Immunogenicity Of Quadrivalent Recombinant Influenza Vaccine Versus Egg-Based Inactivated Influenza Vaccine Among Adults Aged 18-64 Years: Results And Experience From A Randomized, Double-Blind Trial, Lauren Grant, Jennifer A Whitaker, Sarang K Yoon, Karen Lutrick, Shivam Bhargava, C Perry Brown, Emily Zaragoza, Rebecca V Fink, Jennifer Meece, Kristina Wielgosz, Hana El Sahly, Kurt T Hegmann, Ashley A Lowe, Alia Southworth, Tanya Tatum, Sarah W Ball, Min Z Levine, Matthew S Thiese, Steph Battan-Wraith, John Barnes, Andrew L Phillips, Alicia M Fry, Fatimah S Dawood, Randomized Assessment Of Influenza Vaccine Efficacy Network (Raiven)

Faculty, Staff and Students Publications

BACKGROUND: Immunogenicity studies suggest that recombinant influenza vaccine (RIV) may provide better protection against influenza than standard-dose inactivated influenza vaccines (SD IIV). This randomized trial evaluated the relative vaccine effectiveness (VE) and immunogenicity of RIV versus SD IIV in frontline workers and students aged 18-64 years.

METHODS: Participants were randomized to receive RIV or SD IIV and followed for reverse-transcription polymerase chain reaction (RT-PCR)-confirmed influenza during the 2022-2023 influenza season. Sera were collected from a subset of participants before and at 1 and 6 months postvaccination and tested by hemagglutination inhibition for A/H1N1, A/H3N2, B/Yamagata, and B/Victoria and against cell-grown …

Nilai Diagnostik Italian Score Untuk Memprediksi Infeksi Bakteri Extended Spectrum Beta-Lactamase (Esbl) Pada Pasien Sepsis Di Rsup Dr. M. Djamil Padang, Fadrian Fadrian, Armen Ahmad, Khairat Khairat

Jurnal Penyakit Dalam Indonesia

Introduction. Infections caused by Extended-Spectrum Beta-Lactamase (ESBL) bacteria, especially in septic patients, require adequate management. Giving definitive antibiotics according to culture results takes a long time. Therefore, a clinical scoring system is needed to predict ESBL bacterial infection, one of which is the Italian score.

Methods. This research used a cross-sectional design and was conducted in the inpatient room of RSUP Dr. M. Djamil Padang for 6 months. The samples in this study were septic patients who underwent culture examination at RSUP Dr. M. Djamil Padang who met the research inclusion and exclusion criteria. Sampling was carried out …

Molecular Testing Of Environmental Samples As A Potential Source To Estimate Parasite Infection, Rojelio Mejia, Barton Slatko, Cristina Almazan, Ruben Cimino, Alejandro Krolewiecki, Natalia Montellano Duran, Jacob Edwin Valera Aspetty, Paola Andrea Vargas, Chiara Cássia Oliveira Amorim, Stefan Michael Geiger, Ricardo Toshio Fujiwara, Juan David Ramirez, Luz Marina Llangarí-Arizo, Irene Guadalupe, Liliana E Villanueva-Lizama, Julio Vladimir Cruz-Chan, María Leticia Ojeda, Eva Mereles Aranda, Sandra Ocampos Benedetti, Maritza Dalí Camones Rivera, Eddyson Montalvo Sabino, Carlos Pineda, Eric J Wetzel, Philip J Cooper

Faculty, Staff and Students Publications

We discuss the potential usefulness of molecular testing of soil, dust, and water samples to detect medically important parasites, and where such testing could be used to supplement stool sampling in humans. A wide variety of parasites including protozoa and helminths, many of which are zoonotic, have an important infection reservoir in the environment. In some cases, this environmental period is essential for further parasite development. We describe the progress in implementing methods for the molecular detection of these parasites in soil across eight collaborating centers in Latin America and represent a variety of potential applications in improving our understanding …

The Hcv-Melanoma Paradox: First Multi-Cohort And Molecular Net-Work Analysis Reveals Lower Incidence But Worse Outcomes—Integrating Clinical, Real-World, And In Silico Data, Essam Al Ageeli, Jawaher A. Abdulhakim, Mohammad H. Hussein, Maryam M. Alnoman, Samia S. Alkhalil, Peter P. Issa, Nader A. Nemr, Ahmed Abdelmaksoud, Dhaifallah A. Alenizi, Manal S. Fawzy, Eman A. Toraih

School of Medicine Faculty Publications

Background and Objectives: The relationship between hepatitis C virus (HCV) infection and melanoma remains poorly understood. This study aimed to investigate the association between HCV and melanoma, assess outcomes in patients with both conditions, and explore potential molecular mechanisms connecting the two diseases. Materials and Methods: We conducted a retrospective cohort study of 142 melanoma patients, including 29 with HCV-related cirrhosis, and analyzed their clinical outcomes. For external validation, we used the TriNetX Global Collaborative Network database, comprising 219,960 propensity-matched patients per group. An in silico analysis was performed to identify the molecular pathways linking HCV and melanoma. Results: In …

Comparison Of Multi-Parallel Quantitative Real-Time Pcrs Targeting Different Dna Regions And Detecting Soil-Transmitted Helminths In Stool, Marina Papaiakovou, Rubén O Cimino, Nils Pilotte, Julia Dunn, D Timothy J Littlewood, Steven A Williams, Alejandro J Krolewiecki, Rojelio Mejia

Faculty, Staff and Students Publications

BACKGROUND: Soil-transmitted helminths infect an estimated 18% of the world's population, causing a significant health burden. Microscopy has been the primary tool for diagnosing eggs from fecal samples, but its sensitivity drops in low-prevalence settings. Quantitative real-time polymerase chain reaction (qPCR) is slowly increasing in research and clinical settings. However, there is still no consensus on preferred qPCR targets.

METHODS: We aimed to compare soil-transmitted helminth (STH) DNA detection methods by testing naïve stool samples spiked with known quantities of STH eggs and larvae. DNA extracts from spiked samples were tested using independent quantitative realtime PCR (qPCR) assays targeting ribosomal …

Houston, We Have A Problem: Diagnostic Difficulties In The Aids Patient With Tuberculosis Infection, Hector D. Preciado, Maria E. Torres, Muhammad A. Siddiqui, Liza Salloum, Lee Gelpi, Jose E. Campo Maldonado

Research Colloquium

Background: Tuberculosis (TB) is the leading cause of infectious death worldwide with 1.5 million deaths annually and nearly 1/4th of the world’s population (1.7 billion) infected with latent tuberculosis infection (LTBI) in 2014. Its diagnosis conventionally relies on tuberculin skin testing (TST), and Interferon-Gamma Release Assay (IGRA) which relies on the production of Interferon Gamma (IFN-y) in response to Mycobacterium tuberculosis (MTB) specific antigens. IGRA is a useful tool for detecting latent TB disease, and can be used as an adjunct for the diagnosis of active TB cases. Increases in IFN-y levels might support the diagnosis of a new TB …

Atypical Clinical Presentation Of Murine Typhus Infection In Relative Immunosuppressed Patient In South Texas, Johanna Mora, Kirhyn Stein, Hernan Guanajuato, Sobia Memon, Laura Garcia, Jose Campo Maldonado

Research Colloquium

Background: Murine typhus, caused by Rickettsia typhi, is a zoonotic infection transmitted to humans via fleas. It typically begins with nonspecific symptoms such as fever, headache, and nausea. Most cases resolve without complications after a 7–14-day incubation period. The primary reservoirs are rats, opossums, cats, and dogs. This case highlights an atypical presentation of murine typhus in an immunosuppressed patient in South Texas.

Case Presentation: 34-year-old female with ankylosing spondylitis treated recently with secukinumab presented to her Primary Care Physician (PCP) due to fevers. PCP ordered laboratory workup which was unrevealing. Four days later, the patient went to the …

Pleural Effusions In Patients Diagnosed With Pneumonia In Urgent Care Clinics, Nathan C. Dean, Jacqueline R. Eve, Allison M. Butler, James H. Hart, Theadora Sakata, Karen E. Connor, Edward A. Stenehjem, Y.C.G. Lee

The University of Louisville Journal of Respiratory Infections

Introduction: Pleural effusions in patients with community-acquired pneumonia have been associated with worse outcomes in emergency department and hospital inpatient populations, but the incidence of effusions and their outcomes in outpatient urgent care clinics is unknown. This observational cohort study describes patients diagnosed with pneumonia and pleural effusions on upright 2-view chest X-rays performed in urgent care clinics.

Methods: We extracted electronic health record data from January 2019 through December 2020 on all patients over 12 years old with an International Statistical Classification of Diseases 10^th revision diagnosis of pneumonia entered by the treating clinician, plus “possible” or “likely” …

Fcrider: A Recombinant Fc Nanoparticle With Endogenous Adjuvant Activities For Hybrid Immunization, Changchuin Mao, Karen Eberle, Xiaojie Chen, Yiming Zhou, Jun Li, Hong Xin, Wenda Gao

School of Graduate Studies Faculty Publications

Active immunization (vaccination) induces long-lasting immunity with memory, which takes weeks to months to develop. Passive immunization (transfer of neutralizing antibodies) provides immediate protection, yet with high cost and effects being comparatively short-lived. No currently approved adjuvants are compatible with formulations to combine active and passive immunizations, not to mention their huge disparities in administration routes and dosage. To solve this, we engineered the Fc fragment of human IgG1 into a hexamer nanoparticle and expressed its afucosylated form in Fut8−/− CHO cells, naming it “FcRider.” FcRider is highly soluble with long-term stability, easily produced at high levels equivalent to those …

Evaluation For Mothers' Knowledge Of Childhood Tonsillitis, Ali Tahssen Alwan, Shukiryia Shadhan Chyad, Sahira Ayyed Abdul-Sahib

Maaen Journal for Medical Sciences

Background: the inflammation of the tonsils is known as Tonsillitis; it is a well-known clinical condition that an infection of either virus or bacteria. It significantly affects children especially.

The aim of the present study was to identify knowledge of mother toward childhood tonsillitis and to find the relationship between mothers' knowledge of childhood of tonsillitis and some variables.

Methods: A cross section study design was adopted in order to achieve the objectives of study. data collection began from 17th September 2023 until 30th January 2024. A non-probability convenience sample of 160 mothers were recruited to the study. …

Parasitic Contamination Of Soil In The Southern United States, Christine Crudo Blackburn, Sally Mingshuang Yan, David Mccormick, Lauren Nicholas Herrera, Roumen Borilov Iordanov, Mark Daniel Bailey, Maria Elena Bottazzi, Peter J Hotez, Rojelio Mejia

Faculty, Staff and Students Publications

Parasites are generally associated with lower income countries in tropical and subtropical areas. Still, they are also prevalent in low-income communities in the southern United States. Studies characterizing the epidemiology of parasites in the United States are limited, resulting in little comprehensive understanding of the problem. This study investigated the environmental contamination of parasites in the southern United States by determining each parasite's contamination rate and burden in five low-income communities. A total of 499 soil samples of approximately 50 g were collected from public parks and private residences in Alabama, Louisiana, Mississippi, South Carolina, and Texas. A technique using …

The Il-6 Hypothesis In Covid-19: A Phase 2, Randomised, Double-Blind, Placebo-Controlled Study To Evaluate The Efficacy And Safety Of Free Il-6 Sequestration By The Monoclonal Antibody Sirukumab In Severe And Critical Covid-19, Robert L. Gottlieb, Meredith Clement, Paul Cook, Audra Deveikis, Kap Sum Foong, Philip Robinson, Jihad Slim, Cedric W. Spak, Annemie Buelens, Katleen Callewaert, Sandra De Meyer, Wai Ling Mo, Inge Verbrugge, Liesbeth Van Wesenbeeck, Yanli Zhuang, Jason W. Chien, Magda Opsomer, Erika Van Landuyt

School of Medicine Faculty Publications

Background: Upregulation of IL-6 has been associated with worse prognosis in COVID-19 patients. Impact on IL-6 signalling has mostly been limited to clinical outcomes in IL-6 receptor antagonist trials. Methods: We performed a phase 2, randomised, double-blind, placebo-controlled trial (NCT04380961) of US-based hospitalised adults (< 85 years) with laboratory-confirmed SARS-CoV-2 infection and severe (low levels of supplemental oxygen) or critical disease (high levels of oxygen supplementation). Patients received sirukumab 5 mg/kg or placebo single dose IV on Day 1 plus standard of care. The primary endpoint was time to sustained clinical improvement up to Day 28 based on an ordinal scale. Secondary endpoints included clinical improvement, all-cause mortality, and safety. Following an interim analysis, the protocol was amended to only recruit patients with critical COVID-19. Findings: From May 2020 to March 2021, 209 patients were randomised; 112 had critical disease (72 sirukumab, 40 placebo) at baseline. Median time to sustained clinical improvement in critical patients was 17 and 23 days in the sirukumab and placebo groups (HR, 1∙1; 95% CI, 0∙66–1∙88; p > 0∙05). At Day 28, 59∙4% versus 55∙0% of patients achieved clinical improvement with sirukumab versus placebo and rates of all-cause mortality were 24∙6% versus 30∙0%, respectively. Rates of grade ≥ 3 adverse events were comparable between the sirukumab and placebo groups (25∙9% vs 32∙9%; all patients). Interpretation: In critical COVID-19 patients who received sirukumab, there …

Understanding Your Sepsis Diagnosis (Español), Providence Mmhm

Posters with QR Codes

Please see additional files:

1. Patient Education Graphic: Understand Your Sepsis Diagnosis
2. Patient Education Flyer: SEPTICEMIA Todo lo que necesita saber / SEPSIS What You Need to Know (Spanish)

Understanding Your Sepsis Diagnosis (English), Providence Mmhm

Posters with QR Codes

Please see additional files:

1. Patient Education Graphic: Understand Your Sepsis Diagnosis
2. Patient Education Flyer: Sepsis What You Need to Know

Emerging Special Pathogen C4i: Readiness Is Achieved Through Commitment, Collaboration, Coordination, Cooperation, And Innovation, Darrell Ruby, Christa Arguinchona, Lindsey Bandow, David Brett-Major, Barb Dunham, Heather M. Flavell, Jake Lacore, James Lawler, Patti Lord, Brian Rogge, Mark Vazquez, Jana Broadhurst

Conferences

High Consequence Infectious Disease preparedness in Alaska, a partnership. This presentation will detail how civilian and military stakeholders worked together to enhance readiness for management of an emerged special pathogen. Providence, as the Region 10 Emerging Special Pathogen Treatment Center (RESPTC), leveraged regional relationships and partnered with the University of Nebraska Medical Center (UNMC) to integrate frontline special pathogen preparedness training in Alaska with an operational exercise to test interoperability of local high consequence infection prevention and control and case management workflows with the Isolation System for Treatment and Agile Response for High-Risk Infections (ISTARI). Providence led detailed frontline training …

Complete Genome Sequence Of An Indian Outbreak Strain Of Chikungunya Virus, Eshna Laha, Deepak Jena, Viplov K. Biswas, Sharad Singh, Sunil K. Raghav, Asit K. Pattnaik, Soma Chattopadhyay

Nebraska Center for Virology: Faculty Publications

Here, we report the complete genome sequence of an Indian strain of chikungunya virus isolated from an infected patient from Hyderabad, Andhra Pradesh, India, during a massive outbreak in 2005–2006. The genome length spans 11,811 nucleotides and has a poly(A) tail of 29 residues at the 3′ end.

Clinical Features Of Chagas Disease Progression And Severity, Maria Carmo P Nunes, Caryn Bern, Eva H Clark, Antonio L Teixeira, Israel Molina

Faculty, Staff and Students Publications

Chagas disease, the most common form of nonischaemic cardiomyopathy globally, is one of the leading causes of morbidity and mortality in Latin America. Chagas cardiomyopathy has a wide clinical spectrum and prognosis, which is primarily determined by the severity of left ventricular dysfunction. Chagas disease also affects the brain, particularly manifesting as cardioembolic strokes and cognitive impairments. Disease progression is influenced by various factors such as anti-parasite treatments, host-parasite interactions, and other determinants. This review explores Chagas disease, covering clinical presentations, the range of severity of Chagas cardiomyopathy, and neurological manifestations. We investigate factors that influence the progression of cardiomyopathy, …