A5011857175- Respiratory viral infections research
- Pneumonia and Respiratory Infections
- Streptococcal Infections and Treatments
- Bacterial Identification and Susceptibility Testing
- Viral gastroenteritis research and epidemiology
- Bacterial Infections and Vaccines
- Antimicrobial Resistance in Staphylococcus
- Infective Endocarditis Diagnosis and Management
- Clostridium difficile and Clostridium perfringens research
- Influenza Virus Research Studies
- Pleural and Pulmonary Diseases
- Antibiotic Resistance in Bacteria
- Neonatal and Maternal Infections
- Data-Driven Disease Surveillance
- Viral Infections and Immunology Research
- Escherichia coli research studies
- Microbial infections and disease research
- Parvovirus B19 Infection Studies
- Antibiotics Pharmacokinetics and Efficacy
- Salmonella and Campylobacter epidemiology
- Antibiotic Use and Resistance
- Diphtheria, Corynebacterium, and Tetanus
- Pneumocystis jirovecii pneumonia detection and treatment
- Orthopedic Infections and Treatments
- Otolaryngology and Infectious Diseases
University of Utah
2012-2023
Primary Children's Hospital
2013-2023
Intermountain Healthcare
2005-2018
Czech Academy of Sciences, Institute of Microbiology
2006
National Institute of Allergy and Infectious Diseases
2002
National Institutes of Health
2002
Children's Medical Center
1997
LDS Hospital
1989
Pediatrics and Genetics
1985
University of Nebraska–Lincoln
1984
We describe an outbreak of acute rheumatic fever that occurred in the intermountain area centered Salt Lake City, Utah. Seventy-four children meeting modified Jones criteria for diagnosis were evaluated by staff at Primary Children's Medical Center, from January 1985 through June 1986. This represents eightfold increase over average annual incidence this hospital during past decade. Carditis, a dominant feature outbreak, was confirmed auscultation 53 patients (72 percent). An additional 14...
Rapid diagnosis and treatment of infectious meningitis encephalitis are critical to minimize morbidity mortality. Comprehensive testing cerebrospinal fluid (CSF) often includes Gram stain, culture, antigen detection, molecular methods, paired with chemical cellular analyses. These methods may lack sensitivity or specificity, can take several days, require significant volume for complete analysis. The FilmArray Meningitis/Encephalitis (ME) Panel is a multiplexed in vitro diagnostic test the...
Acute rheumatic fever (ARF), a sequelae of group A Streptococcus (GAS) infection, is the most common cause preventable childhood heart disease worldwide. The molecular basis ARF and subsequent are poorly understood. Serotype M18 GAS strains have been associated for decades with outbreaks in U.S. As first step toward gaining new insight into pathogenesis, we sequenced genome strain MGAS8232, serotype organism isolated from patient ARF. circular chromosome 1,895,017 bp, it shares 1.7 Mb...
We investigated the increasing incidence of pediatric empyema during 1990s at Primary Children's Medical Center in Salt Lake City. Of 540 children hospitalized with community-acquired bacterial pneumonia (CAP) who were discharged from 1 July 1993 through 1999, 153 (28.3%) had empyema. The annual population increased study period to 5 cases per 100,000 aged <19 years. Streptococcus pneumoniae was identified as most common cause CAP or without empyema; serotype accounted for 50% pneumococcal...
The ideal clinical diagnostic system should deliver rapid, sensitive, specific and reproducible results while minimizing the requirements for specialized laboratory facilities skilled technicians. We describe an integrated platform, “FilmArray”, which fully automates detection identification of multiple organisms from a single sample in about one hour. An unprocessed biologic/clinical is subjected to nucleic acid purification, reverse transcription, high-order nested multiplex polymerase...
ABSTRACT Sepsis is a major cause of morbidity, mortality, and increased medical expense. Rapid diagnosis improves outcomes reduces costs. The FilmArray blood culture identification panel (BioFire Diagnostics LLC, Salt Lake City, UT), highly multiplexed PCR assay, can identify 24 etiologic agents sepsis (8 Gram-positive, 11 Gram-negative, 5 yeast species) three antimicrobial resistance genes ( mecA , vanA / B bla KPC ) from positive bottles. It provides results in about 1 h with 2 min for...
The FilmArray Respiratory Panel 2 (RP2) is a multiplex in vitro diagnostic test for the simultaneous and rapid (∼45-min) detection of 22 pathogens directly from nasopharyngeal swab (NPS) samples. It contains updated (and some instances redesigned) assays that improve upon (RP; version 1.7), with faster run time. organisms identified are adenovirus, coronavirus 229E, HKU1, NL63, OC43, human metapneumovirus, rhinovirus/enterovirus, influenza virus A, A H1, H1-2009, H3, B, parainfluenza 1, 2,...
Pediatric pneumococcal parapneumonic empyema (PPE) has become increasingly common. In the last decade, Utah had one of highest rates PPE in United States, 14/100,000 children, attributed primarily to Streptococcus pneumoniae serotype 1. Our objective was describe temporal trends before and after availability 7-valent conjugate vaccine (PCV-7).The Intermountain Health Care (IHC) data warehouse queried for all cases children younger than 18 years, defined as International Classification...
Use of the heptavalent pneumococcal conjugate vaccine (PCV-7 [Prevnar]) has been associated with decreased a incidence invasive disease (IPD) among children in United States.Cases IPD < 18 years age insured by or receiving health care from Intermountain Health Care during 1996-2003 were identified. Isolates S. pneumoniae treated at Primary Children's Medical Center (PCMC; Salt Lake City, UT) 1997-2003 serogrouped. Temporal trends IPD, serogroup distribution pneumococci, and antibiotic...
BACKGROUND. Influenza causes significant morbidity among children. Previous studies used indirect case ascertainment methods with little cost data. We sought to measure the burden of laboratory-confirmed influenza from hospitalized METHODS. conducted a retrospective cohort study during 3 viral seasons at Primary Children's Medical Center (Salt Lake City, UT). Children ≤18 years age who were infection included. Outcomes included hospitalization rates, complications including intensive care...
Febrile infants in the first 90 days may have life-threatening serious bacterial infection (SBI). Well-appearing febrile with SBI cannot be distinguished from those without by examination alone. Variation care resulting both undertreatment and overtreatment is common.We developed implemented an evidence-based process model (EB-CPM) for management of well-appearing Intermountain Healthcare System. We report observational study describing changes (1) delivery, (2) outcomes infants, (3) costs...
Our objective was to demonstrate correlations between invasive pneumococcal disease in children and circulating respiratory viruses.This retrospective study included 6 winter viral seasons (2001-2007) Intermountain Healthcare, an integrated health system the West, including Primary Children's Medical Center Salt Lake City, Utah. Children <18 years of age who were hospitalized with either any Healthcare facility or culture-confirmed at included. We analyzed correlation viruses.A total 435 203...
Streptococcus pneumoniae is the most common cause of bacterial pneumonia in children. Despite use 7-valent pneumococcal conjugate vaccine, incidence necrotizing (PNP) has been increasing. Our objectives were to describe temporal trends PNP and evaluate serotypes associated with Utah.We performed a retrospective review all children <18 years age who cared for at tertiary care children's hospital had blood, lung tissue, broncheoalveolar lavage, or pleural fluid cultures that grew S....
Parapneumonic empyema (PPE) is an increasingly common complication of bacterial pneumonia. Epidemiologic study complicated by the low frequency positive cultures. We sought to describe epidemiology PPE in children using molecular analysis pleural fluid.We performed testing for pathogens archived fluid from hospitalized 2009 with PPE. Real-time polymerase chain reaction (PCR) detect Streptococcus pneumoniae, Staphylococcus aureus (including methicillin-resistant), pyogenes, Haemophilus...
Background. Adenovirus (ADV) infections were difficult to diagnose in the past, and many unrecognized. Direct fluorescent assay (DFA) for rapid diagnosis of ADV infection, as part a viral respiratory panel, became available at Primary Children’s Medical Center (Salt Lake City, UT) December 2000. Objective. To describe children with infection diagnosed by DFA culture document impact testing on patient care. Methods. viruses including was performed nasal wash specimens parallel culture. Chart...
Background. Intrapartum antibiotic prophylaxis against group B Streptococcus (GBS) has reduced the occurrence of serious bacterial infections (SBI) in young infants caused by GBS. Recommendations for initial therapy febrile infant 1 to 90 days old were developed when with GBS common and resistance was rare. Objective. To document pathogens responsible SBI recent years susceptibility these organisms. Methods. The results cultures from evaluated fever at Primary Children’s Medical Center Salt...
<h3>Background</h3> Acute viral respiratory disease is the most common reason for pediatric hospitalization in United States. Viral illnesses may be mistaken bacterial infection, and antibiotic therapy prescribed. Overprescribing of antimicrobials illness a factor contributing to increasing antimicrobial resistance among pathogens encountered pediatrics. <h3>Objective</h3> To determine if availability rapid diagnostic test viruses would affect use children's hospital. <h3>Design</h3>...
Utah had a high rate of pediatric pneumococcal empyema (PPE) prior to licensure the conjugate vaccine (PCV-7) in 2000. The majority (62%) PPE cases was due nonvaccine serotypes, primarily Streptococcus pneumoniae serotype 1, multilocus sequence type (MLST) 227. children has increased over last decade. It is unclear whether increase replacement or switch. In this study, we describe incidence and molecular epidemiology by MLST after PCV-7. Empyema rates from 8.5/100,000 state 2001 12.5/100,000...
ABSTRACT We evaluated a multiplexed PCR panel for the detection of 16 bacterial, viral, and fungal pathogens in cerebrospinal fluid. Panel results were compared to routine testing, discrepancies resolved by additional nucleic acid amplification tests or sequencing. Overall, positive negative agreements across methods 92.9% 91.9%, respectively.
Diarrheal diseases are a major cause of ambulatory care visits and hospitalizations among children. Because overlapping signs symptoms expensive inefficient testing methods, the etiology pediatric diarrhea is rarely established. We identified children <18 years age who were evaluated for at Primary Children's Hospital in Salt Lake City, Utah, between October 2010 September 2012. Stool specimens submitted by using FilmArray gastrointestinal diagnostic system, which rapid multiplex polymerase...
Diagnostic tools that can rapidly identify and characterize microbes growing in blood cultures are important components of clinical microbiology practice because they help to provide timely information be used optimize patient management. This publication describes the bioMérieux BIOFIRE Blood Culture Identification 2 (BCID2) Panel study was submitted U.S. Food & Drug Administration. Results obtained with BCID2 were compared standard-of-care (SoC) results, sequencing PCR reference laboratory...
The bioMérieux BIOFIRE Joint Infection (JI) Panel is a multiplex
Gordonia species are emerging pathogens that often misidentified as Rhodococcus or Nocardia but reliably distinguished by 16S ribosomal RNA gene sequencing. We present a case series of 6 episodes catheter-associated infection caused in 5 patients seen at tertiary care pediatric hospital and describe the management outcomes this adults children.
Background: During previous influenza pandemics, many deaths were associated with secondary bacterial infection. In April 2009, a previously unknown 2009 A virus (2009 H1N1) emerged, causing global pandemic. We examined the relationship between circulating H1N1 and occurrence of parapneumonic empyema in children. Methods: Children hospitalized from August 2004 to July including period when circulated Utah, identified using International Classification Diseases, Ninth Revision codes. compared...