A5063938865- Pneumonia and Respiratory Infections
- Streptococcal Infections and Treatments
- Antimicrobial Resistance in Staphylococcus
- Respiratory viral infections research
- Pneumocystis jirovecii pneumonia detection and treatment
- Neonatal and Maternal Infections
- Bacterial Infections and Vaccines
- Antibiotics Pharmacokinetics and Efficacy
- Bacterial Identification and Susceptibility Testing
- Infective Endocarditis Diagnosis and Management
- Pharmaceutical studies and practices
- Emergency and Acute Care Studies
- Sepsis Diagnosis and Treatment
- Influenza Virus Research Studies
- Homelessness and Social Issues
- Immunodeficiency and Autoimmune Disorders
- Otolaryngology and Infectious Diseases
- Antibiotic Resistance in Bacteria
- Pancreatitis Pathology and Treatment
- Tuberculosis Research and Epidemiology
- Cardiac Valve Diseases and Treatments
- Viral gastroenteritis research and epidemiology
- Aortic aneurysm repair treatments
- Clinical Reasoning and Diagnostic Skills
- Infections and bacterial resistance
Centers for Disease Control and Prevention
2016-2025
National Center for Immunization and Respiratory Diseases
2015-2024
Madigan Army Medical Center
2023
Seoul St. Mary's Hospital
2023
Catholic University of Korea
2023
CDC Foundation
2023
Government of the United States of America
2023
Alabama Department of Public Health
2021
United States Department of Health and Human Services
2016-2020
Emory University
2007-2019
During fall 2022, a resurgence of invasive group A Streptococcus (iGAS) infection in children and adolescents was observed two CDC's Emerging Infections Program (EIP)* surveillance sites: Colorado (Denver metropolitan area) Minnesota (entire state).This increase followed historic declines bacterial diseases during 2020, concurrent with mitigation strategies implemented the COVID-19 pandemic † (1).Whereas reports iGAS increased among all age groups, including adults, notable, occurred earlier...
<h2>Abstract</h2> The effect of second-generation pneumococcal conjugate vaccines on invasive disease (IPD) strain distributions have not yet been well described. We analysed IPD isolates recovered from children aged <5 years through Active Bacterial Core surveillance before (2008–2009; <i>n</i> = 828) and after (2011–2013; 600) 13-valent vaccine (PCV13) implementation. employed conventional testing, PCR/electrospray ionization mass spectrometry whole genome sequence (WGS) analysis to...
ABSTRACT β-Lactam antibiotics are the drugs of choice to treat pneumococcal infections. The spread β-lactam-resistant pneumococci is a major concern in choosing an effective therapy for patients. Systematically tracking β-lactam resistance could benefit disease surveillance. Here we developed classification system which isolate assigned “PBP type” based on sequence signatures transpeptidase domains (TPDs) three critical penicillin-binding proteins (PBPs), PBP1a, PBP2b, and PBP2x. We...
ObjectivesOur objective was to evaluate and exploit a whole genome sequence (WGS) bioinformatics pipeline for predicting antimicrobial resistance capsular serotypes from invasive group B streptococci (iGBS).MethodsFor 1975 iGBS recovered during 2015 CDC's Active Bacterial Core surveillance, we compared predictions with broth dilution testing. Fifty-six isolates earlier surveillance were included testing β-lactams. Conventional serotyping WGS-based assignments 302 isolates.ResultsAll 28...
Our whole genome sequence (WGS) pipeline was assessed for accurate prediction of antimicrobial phenotypes. For 2316 invasive pneumococcal isolates recovered during 2015 we compared WGS data to broth dilution testing (BDT) 18 antimicrobials. 11 antimicrobials categorical discrepancies were assigned when WGS-predicted MICs and BDT predicted different categorizations susceptibility, intermediate resistance or resistance, ranging from 0.9% (tetracycline) 2.9% (amoxicillin). β-lactam antibiotics,...
ABSTRACT Group A streptococci (GAS) are genetically diverse. Determination of strain features can reveal associations with disease and resistance assist in vaccine formulation. We employed whole-genome sequence (WGS)-based characterization 1,454 invasive GAS isolates recovered 2015 by Active Bacterial Core Surveillance performed conventional antimicrobial susceptibility testing. Predictions were made for genotype, carbohydrate, resistance, surface proteins (M family, fibronectin binding, T,...
Two near-identical clinical Streptococcus pyogenes isolates of emm subtype emm43.4 with a pbp2x missense mutation (T553K) were detected. Minimum inhibitory concentrations (MICs) for ampicillin and amoxicillin 8-fold higher, the MIC cefotaxime was 3-fold higher than near-isogenic control isolates, consistent first step in developing β-lactam resistance.
Abstract Background Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis an important invasive infections in pregnant nonpregnant adults. Vaccines targeting capsule polysaccharides common proteins are under development. Methods Using whole genome sequencing, validated bioinformatics pipeline, targeted antimicrobial susceptibility testing, we characterized 6340 GBS isolates recovered during 2015–2017 through population-based Active Bacterial Core surveillance...
A U.S. case-control study (2010-2014) demonstrated vaccine effectiveness (VE) for ≥ 1 dose of the thirteen-valent pneumococcal conjugate (PCV13) against vaccine-type (VT) invasive disease (IPD) at 86 %; however, it lacked statistical power to examine VE by number doses and individual serotypes.
Importance Invasive group A Streptococcus (GAS) infections are associated with substantial morbidity, mortality, and economic burden. Objective To update trends in invasive GAS disease incidence rates 10 US states between 2013 2022. Design, Setting, Participants Clinical, demographic, laboratory data for cases were collected as part of population-based surveillance the Active Bacterial Core network covering 34.9 million persons across states. case was defined isolation from a normally...
Genomic sequence-based deduction of antibiotic minimum inhibitory concentration (MIC) has great potential to enhance the speed and sensitivity antimicrobial susceptibility testing. We previously developed a penicillin-binding protein (PBP) typing system two methods (Random Forest (RF) Mode MIC (MM)) that accurately predicted β-lactam MICs for pneumococcal isolates carrying characterized PBP sequence type (phenotypic known at least one isolate this type). This study evaluates prediction...
Abstract Background Treatment of severe group A Streptococcus (GAS) infections requires timely and appropriate antibiotic therapy. We describe the epidemiology antimicrobial-resistant invasive GAS (iGAS) in United States (US). Methods analyzed population-based iGAS surveillance data at 10 US sites from 2006 through 2017. Cases were defined as infection with isolated normally sterile or wounds patients necrotizing fasciitis streptococcal toxic shock syndrome. isolates emm typed. Antimicrobial...
From 2015-2018 to 2019‒2021, hypertoxigenic M1UK lineage among invasive group A Streptococcus increased in the United States (1.7%, 21/1,230 11%, 65/603; p<0.001). was observed 9 of 10 states, concentrated Georgia (n = 41), Tennessee 13), and New York 13). Genomic cluster analysis indicated recent expansions.
We aimed to provide population-based and whole-genome sequence (WGS) -based characterization of invasive pneumococcal disease isolates collected from multistate surveillance in the USA during 2017.We obtained short-read WGS 2881 with associated bioinformatics pipeline strain feature predictions. For quality control, capsular serotypes antimicrobial MICs were also conventionally 442 isolates. Annotated provided (inclusive serotypes, MICs, multilocus types, pilus type(s)) 2723 158 suboptimal...
In May 2022, CDC learned of three children in California hospitalized concurrently for brain abscess, epidural empyema, or subdural empyema caused by Streptococcus intermedius. Discussions with clinicians multiple states raised concerns about a possible increase pediatric intracranial infections, particularly those bacteria, during the past year and contributing role SARS-CoV-2 infection (1). Pediatric bacterial abscesses, empyemas, rare complications respiratory infections sinusitis, are...
We used whole-genome sequencing to characterize 199 nonvaccine serotype 35B pneumococcal strains that caused invasive disease (IPD) in the United States during 2015-2016 and related these findings previous IPD data obtained by Active Bacterial Core surveillance. Penicillin-nonsusceptible increased post-pneumococcal 7-valent conjugate vaccine years (2001-2009) further after implementation of 13-valent 2010. This increase was primarily 35B/sequence type (ST) 558 lineage. 35B/ST558 9V/ST156...
Background We assessed nasopharyngeal (NP) carriage of five pathogens in febrile children with and without acute respiratory infection (ARI) the upper (URTI) or lower tract, attending health facilities Tanzania. Methods NP swabs collected from (N = 960) aged 2 months to 10 years, a temperature ≥38°C, were utilized quantify bacterial density S. pneumoniae (Sp), H. influenzae (Hi), M. catarrhalis (Mc), aureus (Sa), N. meningitidis (Nm). determined associations between presence individual...
Background:Streptococcus agalactiae (Group B Streptococcus, GBS) is a leading cause of meningitis, sepsis and pneumonia in neonates the United States. GBS also causes invasive disease older infants, pregnant women, children young adults with underlying medical conditions, adults. Resistance to lincosamides absence erythromycin resistance rare GBS, but has been previously reported clinical isolates, both on its own or combination streptogramins A pleuromutilins (L/LSA/LSAP phenotypes)....
Invasive pneumococcal disease (IPD) has greatly decreased since implementation in the U.S. of 7 valent conjugate vaccine (PCV7) 2000 and 13 (PCV13) 2010. We used whole genome sequencing (WGS) to predict phenotypic traits (serotypes, antimicrobial phenotypes, pilus determinants) determine multilocus genotypes from 5334 isolates (~90% cases) recovered during 2015-2016 through Active Bacterial Core surveillance. identified 44 serotypes; 26 accounted for 98% isolates. PCV13 serotypes (inclusive...
Bacterial mutations predisposing pneumococcus to causing meningitis, a more severe form of invasive pneumococcal disease (IPD), are largely unknown. Knowledge such may improve our understanding pathogenesis and inform preventive strategies. Here we report pbp1b gene mutation (pbp1bA641C N214T change in PBP1b transglycosylase domain) that is associated with meningitis an exploratory cohort IPD patients (n = 2054, p 6.8 × 10-6), independent confirmatory 2518, 2.3 combined analysis 4572, 3.0...
Background Streptococcus pyogenes is a major cause of severe, invasive infections in humans. The bacterial pathogen harbors wide array virulence factors and exhibits high genomic diversity. Rapid changes circulating strains community are common. Understanding the current prevalence dynamics S. lineages could inform vaccine development disease control strategies. Methods We used whole-genome sequencing (WGS) to characterize all isolates obtained through Center for Disease Control Prevention's...
Abstract We analyzed 9630 invasive GAS surveillance isolates in the USA. From 2015–2017 to 2018–2019, significant increases erythromycin-nonsusceptibility (18% vs 25%) and clindamycin-nonsusceptibility (17% 24%) occurred, driven by rapid expansions of genomic subclones. Prevention control clustered infections appear key containing antimicrobial resistance.
All known group A streptococci [GAS] are susceptible to β-lactam antibiotics. We recently identified an invasive GAS (iGAS) variant ( emm43.4 /PBP2x-T553K) with unusually high minimum inhibitory concentrations (MICs) for ampicillin and amoxicillin, although clinically β-lactams. aimed quantitate PBP2x variants, small changes in MICs, lineages within contemporary population-based iGAS. substitutions were comprehensively among 13,727 iGAS recovered during 2015-2021, the USA. Isolates subjected...
Abstract Background Group A streptococci (GAS), although usually responsible for mild infections, can sometimes spread into normally sterile sites and cause invasive GAS disease (iGAS). Because both the risk of iGAS occurrence outbreaks are elevated within certain communities, such as those comprising people who inject drugs (PWID) experiencing homelessness (PEH), understanding transmission dynamics is major relevance to public health. Methods We used a cluster detection tool scan genomes...
Children with hematologic malignancies (HMs) are at increased risk of invasive pneumococcal disease (IPD). Data on long-term IPD trends in U.S. children HM after 13-valent conjugate vaccine (PCV13) introduction limited. We assessed before and PCV13 the proportion cases caused by serotypes contained new vaccines (PCV15 PCV20, introduced 2019). During 2005-2019, among aged <18 years were identified through Active Bacterial Core surveillance. characterized underlying conditions (HM, other...