A5023329576- Clostridium difficile and Clostridium perfringens research
- Bacterial Identification and Susceptibility Testing
- Viral gastroenteritis research and epidemiology
- Microscopic Colitis
- Nosocomial Infections in ICU
- Urinary Tract Infections Management
- Pneumonia and Respiratory Infections
- SARS-CoV-2 detection and testing
- Respiratory viral infections research
- Pediatric Urology and Nephrology Studies
- Antimicrobial Resistance in Staphylococcus
- Streptococcal Infections and Treatments
- Gut microbiota and health
- Spectroscopy Techniques in Biomedical and Chemical Research
- SARS-CoV-2 and COVID-19 Research
- Bacterial Infections and Vaccines
- Cytomegalovirus and herpesvirus research
- Ocular Infections and Treatments
- Sepsis Diagnosis and Treatment
- Infection Control and Ventilation
- COVID-19 epidemiological studies
- Meta-analysis and systematic reviews
- Neutropenia and Cancer Infections
- Infective Endocarditis Diagnosis and Management
- Spectroscopy and Chemometric Analyses
Duke University
2018-2024
Oregon Medical Research Center
2024
University of Pittsburgh
2024
Communities In Schools of Orange County
2024
New York Proton Center
2024
Lindsay Unified School District
2024
Duke University Health System
2019-2023
Duke Medical Center
2022-2023
Museum of Heilongjiang Province
2021
University of California, Davis
2011-2020
Metagenomic next-generation sequencing (NGS) of cerebrospinal fluid (CSF) has the potential to identify a broad range pathogens in single test.In 1-year, multicenter, prospective study, we investigated usefulness metagenomic NGS CSF for diagnosis infectious meningitis and encephalitis hospitalized patients. All positive tests on were confirmed by orthogonal laboratory testing. Physician feedback was elicited teleconferences with clinical microbial board surveys. Clinical effect evaluated...
Clostridium difficile is a major cause of health care-associated infection, but disagreement between diagnostic tests an ongoing barrier to clinical decision making and public reporting. Molecular are increasingly used diagnose C infection (CDI), many molecular test-positive patients lack toxins that historically defined disease, it unclear if they need treatment.To determine the natural history for treatment who toxin immunoassay negative polymerase chain reaction (PCR) positive (Tox-/PCR+)...
Traditional methods for microbial identification require the recognition of differences in morphology, growth, enzymatic activity, and metabolism to define genera species. Full partial 16S rRNA gene sequencing have emerged as useful tools identifying phenotypically aberrant microorganisms. We report on three bacterial blood isolates from different College American Pathologists-certified laboratories that were referred ARUP Laboratories definitive identification. Because phenotypic suggested...
Bloodstream infection is a serious condition associated with significant morbidity and mortality. The outcome of these infections can be positively affected by the early implementation effective antibiotic therapy based on identification infecting organism genetic markers resistance. In this study, we evaluated microarray-based Verigene Gram-negative blood culture (BC-GN) assay in 8 genus or species targets 6 resistance determinants positive broths. A total 1,847 cultures containing...
INTRODUCTIONIn 2010, we published an initial Point-Counterpoint on the laboratory diagnosis of Clostridium difficile infection (CDI). At that time, nucleic acid amplification tests (NAATs) were just becoming commercially available, and idea algorithmic approaches to CDI was being explored. Now, there are numerous NAATs in marketplace, based recent proficiency test surveys, they have become predominant method used for United States. same is a body literature suggests lack clinical specificity...
On university campuses and in similar congregate environments, surveillance testing of asymptomatic persons is a critical strategy (1,2) for preventing transmission SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). All students at Duke University, private research Durham, North Carolina, signed Compact (3), agreeing to observe mandatory masking, social distancing, participation entry testing. The implemented five-to-one pooled program SARS-CoV-2 using quantitative,...
During April and May 2020, we studied 20 patients hospitalized with coronavirus disease 2019 (COVID-19), their hospital rooms (fomites aerosols), close contacts for molecular culture evidence of severe acute respiratory syndrome 2 (SARS-CoV-2). Among >400 samples, found virus in most sample types, especially the nasopharyngeal (NP), saliva, fecal but prevalence positivity among fomites aerosols was low. The agreement between NP swab saliva high (89.5%; κ = 0.79). Two swabs collected from on...
Abstract Background: Clinicians and laboratories routinely use urinalysis (UA) parameters to determine whether antimicrobial treatment and/or urine cultures are needed. Yet the performance of individual UA common thresholds for action not well defined may vary across different patient populations. Methods: In this retrospective cohort study, we included all encounters with UAs ordered 24 hours prior a culture between 2015 2020 at 3 North Carolina hospitals. We evaluated relevant as potential...
Laser tweezers Raman spectroscopy (LTRS) was used to characterize the fingerprints of metabolic states Escherichia coli (E. coli) cells and determine spectral changes associated with cellular response antibiotic Cefazolin. The spectra E. sampled at different time points in bacterial growth curve exhibited several features that enabled direct identification phase bacteria. Four groups peaks were identified based on similarities time-dependent behavior their intensities over course curve....
The use of culture-independent diagnostic tests (CIDTs), such as stool antigen tests, standalone for the detection Campylobacter in is increasing. We conducted a prospective, multicenter study to evaluate performance CIDTs compared culture and PCR detection. Between July October 2010, we tested 2,767 specimens from patients with gastrointestinal illness following methods: four types selective media, commercial assays, assay. Illnesses which were positive by one or more media at least CIDT...
Clinical diagnosis of infectious diseases in Africa has been associated with increased misdiagnosis and mortality, but when laboratory testing is available, it remains underused. We retrospectively compared diagnoses, test results, anti-microbial use, patient cost physician surveys at a teaching hospital Ghana to evaluate the potential barriers use financial impact for patients. Laboratory capacity was high, survey results objective data indicated reliance on clinical judgment empirical...
Laser tweezers Raman spectroscopy was used to detect the cellular response of Escherichia coli cells penicillin G-streptomycin and cefazolin. Time-dependent intensity changes several peaks at 729, 1,245, 1,660 cm(-1) enabled untreated treated with different antibiotic drugs be distinguished.
Importance Despite modest reductions in the incidence of hospital-onset Clostridioides difficile infection (HO-CDI), CDI remains a leading cause health care–associated infection. As no single intervention has proven highly effective on its own, multifaceted approach to controlling HO-CDI is needed. Objective To assess effectiveness Centers for Disease Control and Prevention’s Strategies Prevent Infection Acute Care Facilities Framework (hereafter, Framework) reducing incidence. Design,...
The natural history of C. difficile progression in nucleic acid amplification test (NAAT) positive, toxin enzyme immunoassay-negative patients remains poorly described. Better understanding risk for subsequent disease may improve prevention strategies. Describe the NAAT+/toxin- adults. A cohort adults (≥18 years) tested within Duke University Health System between 15 March 2020 and 31 December 2023 were classified as NAAT-, NAAT+/toxin-, or NAAT+/toxin+ followed up to 90 days. Three...
Nucleic acid amplification testing is the preferred method to detect enteroviruses and Herpesviridae in cerebrospinal fluid, but clinicians still request viral culture. Review of 22,394 cultures fluid samples found that <0.1% recovered nonenterovirus, non-Herpesviridae species, suggesting that, when nucleic performed, culture may have no additional benefit.
Abstract The extensive use of the urinalysis for screening and monitoring in diverse clinical settings usually identifies abnormal parameters patients with no suspicion urinary tract infection, which turn triggers urine cultures, inappropriate antimicrobial use, associated harms like Clostridioides difficile infection. We highlight how is misused, suggest deconstructing it to better align evolving patterns differential diagnosis being targeted. Reclassifying components into infectious...
Abstract Urinary tract infections (UTIs) are among the most common bacterial in United States and a major driver of antibiotic use, both appropriate inappropriate, across healthcare settings. Novel UTI diagnostics strategy that might enable better treatment. Members Antibacterial Resistance Leadership Group Laboratory Center Infectious Diseases Society America Diagnostics Committee convened to envision ideal future diagnostics, with view towards improving delivery healthcare, patient...