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Bohan J, Goetz MB, Graber CJ, Jones M, McClain S, Spivak E, Jahng M, Samore M, Glassman P, Madaras-Kelly K. National Healthcare Safety Network Standardized Antimicrobial Administration Ratios Assessment Using Visual Analytics: Tools to Improve Population Antimicrobial Use. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Matthew Bidwell Goetz
- Infectious Diseases, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Christopher J. Graber
- Infectious Diseases Section, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Makoto Jones
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Sarah McClain
- Pharmacy, Boise Veterans Affairs Medical Center, Boise, Idaho
| | - Emily Spivak
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Maximillian Jahng
- Pharmacy, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Matthew Samore
- University of Utah School of Medicine, Division of Epidemiology, Salt Lake City, Utah
| | - Peter Glassman
- VA Greater Los Angeles Health Care System, Los Angeles, California, Los Angeles, California
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Gornick W, Khong C, Rogers R, Jahng M, Singh J. Measles Exposures at a Children's Hospital—Not the “Happiest Place on Earth". Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.1288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chavez-Dozal AA, Jahng M, Rane HS, Asare K, Kulkarny VV, Bernardo SM, Lee SA. In vitro analysis of flufenamic acid activity against Candida albicans biofilms. Int J Antimicrob Agents 2013; 43:86-91. [PMID: 24156913 DOI: 10.1016/j.ijantimicag.2013.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 08/25/2013] [Accepted: 08/28/2013] [Indexed: 11/25/2022]
Abstract
In a recent high-throughput screen against specific Candida albicans drug targets, several compounds that exhibited non-specific antifungal activity were identified, including the non-steroidal anti-inflammatory drug flufenamic acid (FFA). This study sought to determine the effect of different doses of FFA, alone or in combination with fixed concentrations of the standard antifungal agents amphotericin B (AmB), caspofungin (CAS) or fluconazole (FLU), for the prevention and treatment of C. albicans biofilms. Biofilms were formed in a 96-well microplate followed by evaluation of antifungal activity using the XTT assay. FFA concentrations of ≥512mg/L demonstrated >80% prevention of biofilm formation. FFA concentrations of 1024mg/L demonstrated >85% reduction of mature biofilms. When FFA (≥8mg/L) was used in combination with FLU (32mg/L), antifungal activity increased to 99% for the prevention of biofilm formation. Similarly, when a FFA concentration of ≥8mg/L was used in combination with either AmB (0.25mg/L) or CAS (0.125mg/L), antifungal activity also increased up to 99% for the prevention of biofilm formation. The inhibitory effect of FFA on C. albicans biofilms has not been reported previously, therefore these findings suggest that FFA in combination with traditional antifungals might be useful for the treatment and prevention of C. albicans biofilms.
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Affiliation(s)
- Alba A Chavez-Dozal
- Section of Infectious Diseases, New Mexico Veterans Healthcare System, Albuquerque, NM, USA; Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Maximillian Jahng
- Section of Infectious Diseases, New Mexico Veterans Healthcare System, Albuquerque, NM, USA
| | - Hallie S Rane
- Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Kingsley Asare
- Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Vibhati V Kulkarny
- Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Stella M Bernardo
- Section of Infectious Diseases, New Mexico Veterans Healthcare System, Albuquerque, NM, USA; Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Samuel A Lee
- Section of Infectious Diseases, New Mexico Veterans Healthcare System, Albuquerque, NM, USA; Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, USA.
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Lin JC, Aung G, Thomas A, Jahng M, Johns S, Fierer J. The use of ceftaroline fosamil in methicillin-resistant Staphylococcus aureus endocarditis and deep-seated MRSA infections: a retrospective case series of 10 patients. J Infect Chemother 2013; 19:42-9. [PMID: 22797874 DOI: 10.1007/s10156-012-0449-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 06/14/2012] [Indexed: 10/28/2022]
Abstract
There are many limitations to the current antibiotics used for the treatment of severe methicillin-resistant Staphylococcus aureus (MRSA) infections. Ceftaroline is a new fifth-generation cephalosporin approved for the treatment of skin and soft tissue infections caused by MRSA and community-acquired pneumonia. We propose that ceftaroline can also be used successfully in more severe MRSA infections, including endocarditis. We conducted a retrospective chart review in a university-affiliated Department of Veterans Affairs hospital in San Diego, California (USA) of ten inpatients treated with ceftaroline for severe MRSA infection, including five cases of probable endocarditis (including two endocardial pacemaker infections), one case of pyomyositis with possible endocarditis, two cases of pneumonia (including one case of empyema), two cases of septic arthritis (including one case of prosthetic joint infection), and two cases of osteomyelitis. Seven of the 10 patients achieved microbiological cure. Six of the 10 patients achieved clinical cure. Seven patients were discharged from the hospital. Three patients were placed on comfort care and expired in the hospital; one achieved microbiological cure before death, and two remained bacteremic at time of death. In most patients, ceftaroline was effective for treatment of MRSA bacteremia and other severe MRSA infections. Adverse effects seen included rash, eosinophilia, pruritus, and Clostridium difficile infection. Ceftaroline can be a safe and effective drug for treatment of severe MRSA infections, and further comparative studies are warranted.
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Affiliation(s)
- Jennifer C Lin
- Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, CA 92093, USA.
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Asare KA, Jahng M, Pincus JL, Massie L, Lee SA. Sternal osteomyelitis caused by Aspergillus fumigatus following cardiac surgery: Case and review. Med Mycol Case Rep 2012; 2:4-6. [PMID: 24432203 DOI: 10.1016/j.mmcr.2012.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 12/03/2012] [Indexed: 10/27/2022] Open
Abstract
Postsurgical sternal wound infection is a serious post-operative complication of cardiac surgery. Aspergillus infection of the sternum is extremely rare. We describe a case of sternal infection due to Aspergillus in an immunocompetent patient following aortic valve replacement.
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Affiliation(s)
- Kingsley A Asare
- New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA ; Division of Infectious Diseases, The University of New Mexico, Albuquerque, NM, USA
| | - Maximillian Jahng
- New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA
| | - Jennifer L Pincus
- New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA ; Division of Pathology, The University of New Mexico, Albuquerque, NM, USA
| | - Larry Massie
- New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA ; Division of Pathology, The University of New Mexico, Albuquerque, NM, USA
| | - Samuel A Lee
- New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA ; Division of Infectious Diseases, The University of New Mexico, Albuquerque, NM, USA
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Pincus JL, Jahng M, Massie L, Lee SA. Early Aspergillus pacemaker pocket infection: Case and review. Med Mycol Case Rep 2012; 1:32-4. [PMID: 24371732 DOI: 10.1016/j.mmcr.2012.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 05/02/2012] [Accepted: 05/11/2012] [Indexed: 10/28/2022] Open
Abstract
We report the first case to our knowledge of an early pacemaker pocket infection due to Aspergillus fumigatus. Several cases of late pacemaker pocket infection by Aspergillus have been reported, but it remains exceedingly rare. Recognition of Aspergillus infection as a potential early or late complication of placement of pacemakers or implantable cardioverter defibrillator devices may help clinicians diagnose and treat future cases of this potentially devastating infection.
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Affiliation(s)
- Jennifer L Pincus
- New Mexico Veterans Healthcare System, 1501 San Pedro SE, Mail Code 111-J, Albuquerque, NM 87108, USA ; Division of Pathology, The University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Maximillian Jahng
- New Mexico Veterans Healthcare System, 1501 San Pedro SE, Mail Code 111-J, Albuquerque, NM 87108, USA
| | - Larry Massie
- New Mexico Veterans Healthcare System, 1501 San Pedro SE, Mail Code 111-J, Albuquerque, NM 87108, USA ; Division of Pathology, The University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Samuel A Lee
- New Mexico Veterans Healthcare System, 1501 San Pedro SE, Mail Code 111-J, Albuquerque, NM 87108, USA ; Division of Infectious Diseases, The University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA
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McKamy S, Hernandez E, Jahng M, Moriwaki T, Deveikis A, Le J. Incidence and risk factors influencing the development of vancomycin nephrotoxicity in children. J Pediatr 2011; 158:422-6. [PMID: 20888013 DOI: 10.1016/j.jpeds.2010.08.019] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 07/27/2010] [Accepted: 08/17/2010] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To determine the incidence of vancomycin-associated nephrotoxicity in children and to examine potential risk factors for nephrotoxicity, including average serum trough concentrations ≥ 15 mg/L. STUDY DESIGN Patients ≥ 1 week old to ≤ 19 years with normal baseline serum creatinine values who received vancomycin for ≥ 48 hours between December 2007 and April 2009 were retrospectively evaluated. Nephrotoxicity was defined as a serum creatinine increase of ≥ 0.5 mg/dL or ≥ 50% baseline increase over 2 days. Patients with average serum trough concentrations ≥ 15 mg/L were compared with a lower trough group. RESULTS Nephrotoxicity occurred in 14% of 167 patients. More patients who attained high average (≥ 15 mg/L) rather than low average (<15 mg/L) vancomycin troughs had nephrotoxicity (28% versus 7.3%, P = .0001). Using multivariable regression analysis, patients with high troughs and those receiving furosemide in the intensive care unit were more likely to have nephrotoxicity (OR, 3.27 [95% CI, 1.19 to 8.95], P = .021, and odds ratio, 9.45 [95% confidence interval, 3.44 to 26.00], P < .0001, respectively). CONCLUSIONS Renal function and serum troughs in children receiving vancomycin, especially those with targeted troughs of ≥ 15 mg/L, in intensive care, and receiving furosemide, should be closely monitored.
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Affiliation(s)
- Susan McKamy
- Miller Children's Hospital, 2801 Atlantic Avenue, PO Box 1428, Long Beach, CA 90801, USA.
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