A5035007857- Antifungal resistance and susceptibility
- Fungal Infections and Studies
- Antimicrobial Resistance in Staphylococcus
- Bacterial Identification and Susceptibility Testing
- Antibiotic Use and Resistance
- Health and Medical Research Impacts
- Science, Research, and Medicine
- Pneumocystis jirovecii pneumonia detection and treatment
- Infective Endocarditis Diagnosis and Management
- Antibiotics Pharmacokinetics and Efficacy
- Nail Diseases and Treatments
- Antibiotic Resistance in Bacteria
- Infectious Diseases and Mycology
- Neutropenia and Cancer Infections
- Cytomegalovirus and herpesvirus research
- Complementary and Alternative Medicine Studies
- Streptococcal Infections and Treatments
- Mycobacterium research and diagnosis
- Orthopedic Infections and Treatments
- Infection Control in Healthcare
- Nosocomial Infections in ICU
- Infectious Diseases and Tuberculosis
- Tuberculosis Research and Epidemiology
- Organ Transplantation Techniques and Outcomes
- Mosquito-borne diseases and control
Rush University Medical Center
2021-2025
VA Portland Health Care System
2016-2022
Rush University
2021
Oregon Health & Science University
2008-2020
Portland VA Medical Center
2009-2020
Biology of Infection
2018
Engineering Associates (United States)
2018
University of Maryland, Baltimore
2002-2014
Veterans Health Administration
2010-2014
Oklahoma Foundation for Medical Quality
2013
Alternative therapies for Staphylococcus aureus bacteremia and endocarditis are needed.We randomly assigned 124 patients with S. or without to receive 6 mg of daptomycin intravenously per kilogram body weight daily 122 initial low-dose gentamicin plus either an antistaphylococcal penicillin vancomycin. The primary efficacy end point was treatment success 42 days after the therapy.Forty-two therapy in modified intention-to-treat analysis, a successful outcome documented 53 120 who received as...
Unique characteristics, impact of therapy with antifungal agents, and outcome infections Scedosporium species were assessed in transplant recipients.The patients comprised a total 80 recipients infections, including 13 from our institutions (University Pittsburgh Medical Center [Pittsburgh, PA], University Maryland [Baltimore], Duke [Durham, NC], Emory [Atlanta, GA], Hospital Gregorio Maranon [Madrid, Spain]) 67 reported the literature. The compared 190 non-transplant scedosporiosis who...
Background. The efficacy of the combination voriconazole and caspofungin when used as primary therapy for invasive aspergillosis in organ transplant recipients has not been defined. Methods. Transplant who received (n=40) (proven or probable) a prospective multicenter study between 2003 2005 were compared to control group comprising cohort consecutive 1999 2002 had lipid formulation AmB (n=47). In vitro antifungal testing Aspergillus isolates was correlated with clinical outcome. Results....
An antimicrobial stewardship program was fully implemented at the University of Maryland Medical Center in July 2001 (beginning fiscal year [FY] 2002). Essential to an monitoring team (AMT) consisting infectious diseases-trained clinical pharmacist and a part-time diseases physician that provided real-time orders active intervention education when necessary. The continued for 7 years terminated order use resources increase consults throughout medical center as alternative mode stewardship.A...
Importance Practice guidelines often provide recommendations in which the strength of recommendation is dissociated from quality evidence. Objective To create a clinical guideline for diagnosis and management adult bacterial infective endocarditis (IE) that addresses gap between evidence strength. Evidence Review This consensus statement systematic review applied an approach previously established by WikiGuidelines Group to construct collaborative guidelines. In April 2022 call new existing...
Abstract To combat antimicrobial resistance (AMR), advocates have called for passage of the Pioneering Antimicrobial Subscriptions End Upsurging Resistance (PASTEUR) Act in United States, which would appropriate $6 billion new taxpayer-funded subsidies antibiotic development. However, number antibiotics clinical development, and US Food Drug Administration approvals antibiotics, already markedly increased last 15 years. Thus, instead focusing on more economic subsidies, we recommend reducing...
Clinical characteristics, risks, and outcomes in solid organ transplant (SOT) recipients with zygomycosis the era of modern immunosuppressive newer antifungal agent use have not been defined.In a matched case-controlled study, SOT were prospectively studied. The primary outcome measure was success (complete or partial response) at 90 days.Renal failure (odds ratio [OR], 3.17; P = .010), diabetes mellitus (OR, 8.11; < .001), prior voriconazole and/or caspofungin 4.41; .033) associated higher...
ABSTRACT The impact of rapid identification Candida albicans blood isolates by peptide nucleic acid fluorescence in situ hybridization (PNA FISH) on the selection and expenditure antifungal therapy was evaluated. PNA FISH 100% sensitive specific 31 out 72 candidemias as C. resulted a significant reduction caspofungin usage, with an overall cost savings $1,729 per patient.
To evaluate the impact of rapid differentiation Staphylococcus aureus from coagulase-negative staphylococci (CoNS) in blood cultures using peptide nucleic acid fluorescence situ hybridization (PNA FISH) on vancomycin usage, length patient hospital stay and costs.This was a retrospective, cost-effective analysis PNA FISH its initial 3 month implementation period 2004 650 bed academic medical centre. Blood with Gram-positive cocci clusters (GPCC) that were negative for S. assay compared an...
Objective: Many hospitals utilize antimicrobial management teams (AMTs) to improve patient care. However, most function with minimal computer support. We evaluated the effectiveness and cost-effectiveness of a computerized clinical decision support system for utilization.
ABSTRACT Hospital-acquired vancomycin-resistant enterococcal bacteremia has been associated with increased hospital costs, length of stay, and mortality. The peptide nucleic acid fluorescent in situ hybridization (PNA FISH) test for Enterococcus faecalis other enterococci (EFOE) is a multicolor probe that differentiates E. from species within 3 h directly blood cultures demonstrating gram-positive cocci pairs chains (GPCPC). A quasiexperimental study was performed over two consecutive years...
Electronic health records (EHRs) and clinical decision support systems (CDSSs) have the potential to enhance antimicrobial stewardship. Numerous EHRs CDSSs are available enable all clinicians stewardship programs (ASPs) more efficiently review pharmacy, microbiology, data. Literature evaluating impact of on patient outcomes is lacking, although with integrated demonstrated improvements in economic outcomes. Both technologies can be used existing ASPs their implementation core ASP strategies....
Background and Objective. Contact precautions are a cornerstone of infection prevention but have also been associated with less healthcare worker (HCW) contact adverse events. We studied how modified HCW behavior in 4 acute care facilities. Design. Prospective cohort study. Participants Setting. Four facilities the United States performing active surveillance for methicillin-resistant Staphylococcus aureus . Methods. Trained observers performed “secret shopper” monitoring activities during...
Abstract These updated guidelines from the Infectious Diseases Community of Practice American Society Transplantation review diagnosis, prevention, and management cryptococcosis in pre‐ post‐transplant period. The current update now includes a discussion cryptococcosis, which is third most common invasive fungal infection SOT recipients. Infection often occurs year after transplantation; however, early infections occur donor‐derived have been described within 3 months transplant. There are...
Traditional approaches to practice guidelines frequently result in dissociation between strength of recommendation and quality evidence.To construct a clinical guideline for pyogenic osteomyelitis management, with new standard evidence resolve the gap evidence, through use novel open access approach utilizing social media tools.This consensus statement systematic review study used from WikiGuidelines Group, an collaborative research project, osteomyelitis. In June 2021 February 2022, authors...
Staphylococcus aureus is a common cause of native valve infective endocarditis (IE). Rifampin often added to traditional therapy for the management serious S. infections. There are no large, prospective studies documenting safety and efficacy adjunctive with rifampin treatment IE. We reviewed all cases definite IE confirmed by modified Duke criteria in large urban hospital between 1 January 2004 31 December 2005. A retrospective cohort analysis was used assess impact addition standard...
Rhino-orbital-cerebral disease is a significant manifestation of zygomycosis in solid organ transplant (SOT) recipients. However, its characteristics and outcome are not well addressed.SOT recipients with as per the European Organization for Research Treatment Cancer Mycoses Study Group criteria cohort study at our centers published previously those identified PubMed search from 1950s to November 2009 were studied. Patients mycosis involving sinuses, orbits, or central nervous system (CNS)...
Risk factors including how changes in immunosuppression influence the occurrence of immune reconstitution syndrome (IRS) solid organ transplant (SOT) recipients with cryptococcosis have not been fully defined.SOT were identified and followed for 12 months. IRS was defined based on previously proposed criteria.Of 89 SOT recipients, 13 (14%) developed IRS. Central nervous system (CNS) disease (adjusted odds ratio [AOR], 6.23; P = .03) discontinuation calcineurin inhibitor (AOR, 5.11; .02)...
Cryptococcosis is the third most commonly occurring invasive fungal infection in solid organ transplant (SOT) recipients. Approximately 8% of infections SOT recipients are due to cryptococcosis (1Kontoyiannis DP Marr KA Park BJ et al.Prospective surveillance for hematopoietic stem cell recipients, 2001–2006: Overview Transplant-Associated Infection Surveillance Network (TRANSNET) Database.Clin Infect Dis. 2010; 50: 1091-1100Crossref PubMed Scopus (1064) Google Scholar). The overall incidence...