Echinocandins are recommended for Candia glabrata candidemia. Mutations in the FKS1 and FKS2 genes associated with echinocandin resistance. Few studies have assessed risk factors FKS mutant isolates outcomes patients receiving micafungin treatment.Patients C. bloodstream infection admitted to a large, tertiary care hospital between 2009 2012 were included this study. For each isolate, sequenced identify mutations. Risk mutations treatment an using multivariate logistic regression.Seventy-two...

To determine whether early administration of adjuvant β-lactam in combination with vancomycin (COMBO) affects clinical outcomes compared to standard therapy alone (STAN) among patients methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection.Retrospective, multicenter cohort study.Five academic or community hospitals throughout the United States.Adults MRSA infections treated (≥ 72 hrs) without an intravenous 48 initiated within 24 hours initiating vancomycin.The primary...

Candida auris is an emerging, often MDR, yeast pathogen. Efficient animal models are needed to study its pathogenicity and treatment. Therefore, we developed a C. fruit fly infection model.TollI-RXA/Tollr632 female flies were infected with 10 different strains from the CDC Antimicrobial Resistance bank panel. We used three clinical albicans as controls. For drug protection assays, survival was assessed along measurement of fungal burden (cfu/g tissue) histopathology in auris-infected fed...

Background: Rapid diagnostic tests for Candida are becoming available that may supplement traditional microbiological identification. Objective: Assess clinical practice patterns in patients with or at risk of candidiasis who benefit from the use rapid tests. Methods: This was a prospective cohort study candidemia receiving systemic antifungals conducted university-affiliated tertiary care hospital. Time to initiation therapy, species, time identification, and indications antifungal were...

ABSTRACT Candiduria is common in hospitalized patients, and asymptomatic candiduria contributes to antifungal overuse. The guidelines for management of do not recommend use, but rather the elimination predisposing factors. It unknown whether these recommendations are being followed. primary objective this study was characterize among patients. This a retrospective cohort random sample 305 patients with at four U.S. medical centers from January 2010 December 2013. Patients were classified as...

The T2Candida assay is a novel, non-culture-based for the diagnosis of candidemia directly from whole blood. impact antifungals on performance and blood culture bottles has not been well described. In this study, was compared to that in detecting Candida spp. spiked cultures with or without presence antifungals. Clinical bloodstream isolates were inoculated into human at low (1 5 cells/ml) high (10 50 concentrations caspofungin fluconazole. Time detection (TTD) assessed prepared samples...

The human microbiome project has revolutionized our understanding of the interaction between commensal microbes and health. By far, biggest perturbation involves use broad-spectrum antibiotics excreted in gut. Thus, pharmacodynamics changes relation to drug exposure pharmacokinetics is an emerging field. However, reproducibility studies are necessary develop A simple fast high-performance liquid chromatography-photodiode array detector (HPLC) method was validated for quantitative fecal...

We analyzed the impact of vancomycin (VAN) combined with adjuvant β-lactam therapy (Combo) on persistent (≥5 days) methicillin-resistant Staphylococcus aureus bacteremia versus VAN alone by using pooled data from two previously published observational studies (n = 156). Combo was inversely associated (adjusted odds ratio, 0.460; 95% confidence interval, 0.229 to 0.923). Acute kidney injury more common than (18.9% and 7.6%, respectively; P 0.062).

Important articles on topics pertinent to infectious diseases (ID) pharmacotherapy published in prominent peer-reviewed journals 2011 are summarized.Pharmacists, physicians, and researchers from the Houston Infectious Diseases Network were asked nominate that they perceived as having a significant impact field of ID pharmacotherapy. The resulting list, comprising 10 related human immunodeficiency virus (HIV) disease or acquired immune deficiency syndrome (AIDS) 38 broad range other...

The direct or indirect interactions that antifungals have with the host immune response may play a significant role in defining their activity vivo. However, impact acquired antifungal resistance has on immunopharmacologic of is not well described. We assessed caspofungin, micafungin, and voriconazole among isolates Candida glabrata without FKS-mediated echinocandin resistance. Clinical bloodstream C. from patients who did (n = 5) 3) develop persistent candidemia 2) 11) harbor FKS gene...

Early treatment of bloodstream infections with appropriate, definitive antimicrobial therapy has proven to reduce mortality, length hospital stay, and healthcare costs. Culture-based testing methods require up five days for final pathogen identification susceptibility reporting, forcing use broad spectrum empiric therapy. Recently, multiple rapid microbiological molecular have been developed that the time identify susceptibility, allowing optimal be prescribed earlier. Real-time polymerase...

Patients with invasive candidiasis (IC) have complex medical and infectious disease problems that often require continued care after discharge. This study aimed to assess echinocandin use at hospital discharge develop a transition of (TOC) model facilitate for patients IC. was mixed method design used epidemiologic assessment better understand TOC. Using grounded theory methodology focused on given echinocandins during their last day hospitalization, TOC IC, the [I Can] developed barriers. A...

Candida auris is an emerging multi-drug-resistant human pathogen. Experimental data on the pathogenicity of C. scarce, especially regarding its virulence compared with albicans. Additionally, studies drug efficacy against rely conventional animal models that are laborious and low throughput; alternative, less cumbersome desirable. To end, we developed a fly infection model. We injected 2-week-old TollI-RXA/Tollr632 female flies needle dipped in solutions (108 yeast cells/mL) dorsal side...

Abstract Background Candida parapsilosis has emerged as an important fungal pathogen with mortality rates up to 30%. Recent studies show no difference in treatment outcomes for patients treated both empirically and definitively either echinocandins or fluconazole. However, the impact of antifungal susceptibility testing opportunities stewardship are less clear this patient population. The purpose study was assess rates, patterns, among C. candidemia. Methods This a single-center,...