A5033236946- Pneumonia and Respiratory Infections
- Bacterial Infections and Vaccines
- Antibiotic Resistance in Bacteria
- Antimicrobial Resistance in Staphylococcus
- Clostridium difficile and Clostridium perfringens research
- Bacterial Identification and Susceptibility Testing
- Infective Endocarditis Diagnosis and Management
- Streptococcal Infections and Treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- Microscopic Colitis
- Mycobacterium research and diagnosis
- Antibiotics Pharmacokinetics and Efficacy
- Influenza Virus Research Studies
- HIV Research and Treatment
- HIV/AIDS drug development and treatment
- Viral gastroenteritis research and epidemiology
- Neonatal and Maternal Infections
- Urinary Tract Infections Management
- HIV/AIDS Research and Interventions
- Antibiotic Use and Resistance
- Fungal Infections and Studies
- Antifungal resistance and susceptibility
- Escherichia coli research studies
- Viral Infections and Vectors
- Respiratory viral infections research
University of Pittsburgh
2012-2021
University of Pittsburgh Medical Center
2007-2021
Center for Genomic Science
2020
Biology of Infection
2017-2019
Engineering Associates (United States)
2017-2019
Presbyterian Hospital
2015
Immunosciences Lab (United States)
2015
UPMC Presbyterian
2015
UPMC Health System
2015
New Mexico Department of Health
2009
Abstract Background and Objective: Fluoroquinolones have not been frequently implicated as a cause of Clostridium difficile outbreaks. Nosocomial C. infections increased from 2.7 to 6.8 cases per 1,000 discharges ( P < .001). During the first 2 years outbreak, there were 253 nosocomial infections; these, 26 resulted in colectomy 18 death. We conducted an investigation large outbreak our hospital identify risk factors characterize outbreak. Methods: A retrospective case-control study...
Invasive pneumococcal disease declined among children and adults after the introduction of pediatric heptavalent conjugate vaccine (PCV7) in 2000, but its effect on meningitis is unclear.We examined trends from 1998 through 2005 using active, population-based surveillance data eight sites United States. Isolates were grouped into PCV7 serotypes (4, 6B, 9V, 14, 18C, 19F, 23F), PCV7-related (6A, 9A, 9L, 9N, 18A, 18B, 18F, 19B, 19C, 23A, 23B), non-PCV7 (all others). Changes incidence assessed...
New meningococcal vaccines are undergoing clinical trials, and changes in the epidemiologic features of disease will affect their use. Active laboratory-based, population-based US surveillance for during 1992–1996 was used to project that 2400 cases occurred annually. Incidence highest infants; however, 32% persons ⩾30 years age. Serogroup C caused 35% cases; serogroup B, 32%; Y, 26%. Increasing age (relative risk [RR], 1.01 per year), having an isolate obtained from blood (RR, 4.5), 1.6)...
Group B streptococcal disease is one of the most common infections in first week after birth. In 2002, national guidelines recommended universal late antenatal screening pregnant women for colonization with group streptococcus to identify candidates intrapartum chemoprophylaxis.
Risk factors for Nocardia infection in organ transplant recipients have not been formally assessed the current era of transplantation. We performed a matched case-control study (1:2 ratio) between January 1995 and December 2005. Control subjects were type timing. Univariate odds ratios determined conditional logistic regression was to identify independent risk factors. Clinical microbiological characteristics all case patients reviewed. Among 5126 recipients, 35 (0.6%) identified as having...
In January 2005, a quadrivalent (serogroups A, C , Y, and W-135) meningococcal conjugate vaccine was licensed for use in adolescents. This report describes the epidemiologic features of disease United States from 1998 through December 2007, before during implementation adolescent vaccination.Data were collected active surveillance invasive Neisseria meningitidis conducted Active Bacterial Core (ABCs) sites 1998-2007. Isolates cases serogrouped at ABCs site confirmed Centers Disease Control...
Background. The occurrence of community-associated infections due to extended-spectrum β-lactamase (ESBL)–producing Escherichia coli has been recognized as a major clinical problem in Europe and other regions.
Background. Previous studies have suggested that asymptomatic carriers of toxigenic Clostridium difficile are a source hospital-associated (HA) infections. Multilocus variable number tandem repeats analysis (MLVA) is highly discriminatory molecular subtyping tool helps to determine possible transmission sources. Methods. isolates were recovered from perirectal swabs collected for vancomycin-resistant Enterococcus (VRE) surveillance as well clinical C. toxin–positive stool samples July...
We investigated an outbreak of leptospirosis among athletes and community residents after a triathlon was held in Springfield, Illinois. A telephone survey conducted to collect clinical information data on possible risk factors, surveillance established, animal specimens lake water samples were collected determine the source leptospiral contamination. total 834 876 triathletes contacted; 98 (12%) reported being ill. Serum obtained from 474 tested; 52 these (11%) tested positive for...
Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from United States 26 other countries. Eighty (42%) met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming Segama River (relative...
Background. Alemtuzumab is being increasingly used for the prevention and/or treatment of acute allograft rejection in organ transplant recipients. We assessed risks infection in, to our knowledge, largest cohort and broadest range recipients yet reported have received alemtuzumab. Methods. All patients who alemtuzumab from September 2002 through March 2004, either as induction therapy at time transplantation or rejection, were evaluated development an opportunistic (OI) until death 12...
In June 2000, the hospital-acquired Clostridium difficile (CD) infection rate in our hospital (University of Pittsburgh Medical Center-Presbyterian, Pittsburgh, PA) increased to 10.4 infections per 1000 discharges (HDs); annual from 2.7 HDs 7.2 and was accompanied by an increase frequency severe outcomes. Forty-seven (51%) 92 HA CD isolates 2001 were identified as "epidemic BI strain." A comprehensive control "bundle" implemented outbreak infection.The bundle consisted education, early case...
Lung transplant recipients have one of the highest rates invasive aspergillosis (IA) in solid organ transplantation. We used a single center, nonrandomized, retrospective, sequential study design to evaluate fungal infection lung who were managed with either universal prophylaxis voriconazole (n = 65) or targeted 30) itraconazole +/- inhaled amphotericin patients at high risk (pre- posttransplant Aspergillus colonization [except niger]). The rate IA 1 year was better receiving as compared...
Menstrual toxic shock syndrome (TSS) emerged as a public health threat to women of reproductive age in 1979 80. We reviewed surveillance data for the period 1996, when 5,296 cases were reported, and discuss changes epidemiologic features TSS.
Rifampin is used as adjunctive therapy for Clostridium difficile-associated disease, and the drug's derivative, rifaximin, has emerged an attractive antimicrobial treatment of C. disease. resistance in difficile strains been reported to be uncommon.We examined prevalence rifampin among 470 isolates (51.1% during 2001-2002 48.9% 2005) from a large teaching hospital. sensitivity was performed using E-test. The epidemic BI/NAP1 clone identified by tcdC genotyping multilocus variable number...
Recurrent Clostridium difficile infection (CDI) occurs in up to 35% of patients. Recurrences can be due either relapse with the same strain or reinfection another strain. In this study, multilocus variable-number tandem-repeat analysis (MLVA) was performed on C. isolates from patients recurrent CDI distinguish reinfection. addition, univariate and multivariate analyses were identify risk factors associated relapse. Among a single recurrence, original infecting more prevalent than interval...
Real-time (RT)-PCR increases diagnostic yield for bacterial meningitis and is ideal incorporation into routine surveillance in a developing country. We validated multiplex RT-PCR assay Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae Brazil. Risk factors being culture-negative, positive were determined. The sensitivity of cerebrospinal fluid (CSF) was 100% (95% confidence limits, 96.0%–100%) N. 97.8% (85.5%–99.9%) S. 66.7% (9.4%–99.2%) H. influenzae. Specificity...
Multidrug-resistant bacteria pose a serious health threat, especially in hospitals. Horizontal gene transfer (HGT) of mobile genetic elements (MGEs) facilitates the spread antibiotic resistance, virulence, and environmental persistence genes between nosocomial pathogens. We screened genomes 2173 bacterial isolates from healthcare-associated infections single hospital over 18 months, identified identical nucleotide regions belonging to distinct genera. To further resolve these shared...
The carbapenem class of antibiotics is invaluable for the treatment selected multidrug-resistant Gram-negative pathogens. continued transmission carbapenem-resistant bacteria such as ST258 K. pneumoniae serious global public health concern, options these infections are limited. This genomic epidemiologic investigation traced natural history in a single care setting over nearly decade. We found that distinct subpopulations have caused both device-associated and ward-associated outbreaks, some...
Most hospitals use traditional infection prevention (IP) methods for outbreak detection. We developed the Enhanced Detection System Healthcare-Associated Transmission (EDS-HAT), which combines whole-genome sequencing (WGS) surveillance and machine learning (ML) of electronic health record (EHR) to identify undetected outbreaks responsible transmission routes, respectively.We performed WGS healthcare-associated bacterial pathogens from November 2016 2018. EHR ML was used routes WGS-detected...
Background. The rate of influenza vaccination among healthcare workers (HCWs) is approximately 40%. Differences in rates HCW groups and reasons for accepting or rejecting are poorly understood. Objectives. To determine motivators different during the 2004-2005 season. Design. Cross-sectional survey conducted between July 10 September 30, 2005. Setting. Two tertiary care teaching hospitals an urban center. Participants. Physicians, nurses, nursing aides, other staff. Surveys were collected...
ABSTRACT Clostridium difficile is a major cause of antibiotic-associated gastrointestinal illness. Recently, an increased incidence hospital-acquired infections with severe outcomes has been reported in North America and Europe. Current molecular-typing methods for detection outbreaks nosocomial transmission are labor-intensive, subjective, or insufficiently discriminatory to differentiate between closely related strains. This report describes the development multilocus variable-number...
The incidence of serogroup C and Y meningococcal disease increased in the United States during 1990s. cyclical nature endemic remains unexplained. purpose this study was to investigate mechanisms associated with increase disease.We characterized an increasing invasive using population-based surveillance from 1992 through 2001. Isolates were by multilocus sequence typing antigen 3 outer membrane protein (OMP) genes: porA variable regions (VRs) 1 2, porB, fetA VR.For both serogroups, OMP...
ABSTRACT For commonly encountered gram-negative bacilli, a MIC of cefepime 8 μg/ml or less was defined by the Clinical and Laboratory Standards Institute as “susceptible” prior to commercial release antibiotic. We assessed 204 episodes bacteremia caused organisms for which patients received (typically 1 2 g every 12 h) primary mode therapy. The breakpoint derived classification regression tree (CART) software analysis delineate risk 28-day mortality μg/ml. Patients infected with treated at...
Background. A quadrivalent meningococcal conjugate vaccine (MCV4) was licensed in the United States 2005; no serogroup B is available. Neisseria meningitidis changes its capsular phenotype through switching, which has implications for vaccines that do not protect against all serogroups. Methods. Meningococcal isolates from 10 Active Bacterial Core surveillance sites 2000 2005 were analyzed to identify occurring after MCV4 licensure. Isolates characterized by multilocus sequence typing (MLST)...