10 results on '"Tom Chiller"'
Search Results
2. Emerging Multidrug-Resistant Candida duobushaemulonii Infections in Panama Hospitals: Importance of Laboratory Surveillance and Accurate Identification
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Nestor Sosa, Lockhart, Erika Santiago, Brendan R Jackson, Ramos R, Jovanna Borace, Tom Chiller, Andres Espinosa-Bode, Diego H. Cáceres, Moreno J, Snigdha Vallabhaneni, Elizabeth L. Berkow, Garcia N, Wendy Camelo Castillo, Moran J, de Villarreal G, Lizbeth Hayer, and Perez M
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0301 basic medicine ,Microbiology (medical) ,Antifungal ,medicine.medical_specialty ,Antifungal Agents ,Panama ,medicine.drug_class ,030106 microbiology ,Microbial Sensitivity Tests ,Mycology ,03 medical and health sciences ,0302 clinical medicine ,Drug Resistance, Multiple, Fungal ,Amphotericin B ,Internal medicine ,medicine ,030212 general & internal medicine ,Candida duobushaemulonii ,Candida ,Voriconazole ,business.industry ,Candidiasis ,Candidemia ,Multiple drug resistance ,Candida auris ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,Epidemiological Monitoring ,Christian ministry ,business ,Fluconazole ,medicine.drug - Abstract
Candida duobushaemulonii , a yeast closely related to Candida auris , is thought to cause infections in rare cases and is often misidentified. In October 2016, the Panamanian Ministry of Health implemented laboratory surveillance for C. auris . Suspected C. auris isolates were forwarded to the national reference laboratory for identification by matrix-assisted laser desorption ionization–time of flight mass spectrometry and antifungal susceptibility testing. Between November 2016 and May 2017, 17 of 36 (47%) isolates suspected to be C. auris were identified as C. duobushaemulonii. These 17 isolates were obtained from 14 patients at six hospitals. Ten patients, including three children, had bloodstream infections, and MICs for fluconazole, voriconazole, and amphotericin B were elevated. No resistance to echinocandins was observed. C. duobushaemulonii causes more invasive infections than previously appreciated and poses a substantial problem, given its resistance to multiple antifungals. Expanded laboratory surveillance is an important step in the detection and control of such emerging pathogens.
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- 2018
3. Multicenter Validation of Commercial Antigenuria Reagents To Diagnose Progressive Disseminated Histoplasmosis in People Living with HIV/AIDS in Two Latin American Countries
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Blanca Samayoa, Brenda Guzmán, Beatriz L. Gómez, Narda Medina, Tom Chiller, Danicela Mercado, Diego H. Cáceres, Ángela M. Tobón, Angela Restrepo, and Eduardo Arathoon
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Aids-related opportunistic infections ,Reproducibility of results ,0301 basic medicine ,Latin Americans ,Enzyme linked immunosorbent assay ,Hispanic ,diagnostic ,Reagent kits ,Urine ,Diagnostic accuracy ,Cohort Studies ,Mannans ,chemistry.chemical_compound ,0302 clinical medicine ,Progressive disseminated histoplasmosis ,Mixed infection ,Histoplasmosis ,Diagnostic value ,Priority journal ,medicine.diagnostic_test ,biology ,Coinfection ,Diagnostic test accuracy study ,Validation study ,Hispanic or Latino ,Guatemala ,Mannan ,Reproducibility ,Multicenter study ,Histoplasma capsulatum ,Aids related complex ,Clinical trial ,Retrospective study ,Sensitivity and specificity ,Acquired immune deficiency syndrome ,Antigen ,fungal ,Cohort studies ,Cohort analysis ,Human ,Microbiology (medical) ,medicine.medical_specialty ,Antigens, Fungal ,Histoplasma ,Immunology ,030231 tropical medicine ,030106 microbiology ,Predictive value ,Enzyme-Linked Immunosorbent Assay ,Mycology ,Major clinical study ,Elisa ,Colombia ,Sensitivity and Specificity ,Microbiology ,Article ,Aids ,03 medical and health sciences ,Galactomannan ,Enzyme-linked immunosorbent assay ,Acquired immunodeficiency syndrome (AIDS) ,Human immunodeficiency virus infection ,Urine sampling ,Virology ,Internal medicine ,medicine ,South and central america ,Antigens ,Retrospective Studies ,AIDS-Related Opportunistic Infections ,Fungal detection ,business.industry ,Galactose ,Reproducibility of Results ,Hispanic americans ,Nonhuman ,medicine.disease ,biology.organism_classification ,Confidence interval ,Retrospective studies ,Isolation and purification ,chemistry ,Immunoassay ,Fungus antigen ,Diagnostic kit ,Fungus isolation ,Reagent Kits, Diagnostic ,business ,Controlled study ,Complication - Abstract
Histoplasmosis is an important cause of mortality in patients with AIDS, especially in countries with limited access to antiretroviral therapies and diagnostic tests. However, many disseminated infections in Latin America go undiagnosed. A simple, rapid method to detect Histoplasma capsulatum infection in regions where histoplasmosis is endemic would dramatically decrease the time to diagnosis and treatment, reducing morbidity and mortality. The aim of this study was to validate a commercial monoclonal Histoplasma galactomannan (HGM) enzyme-linked immunosorbent assay (Immuno-Mycologics [IMMY], Norman, OK, USA) in two cohorts of people living with HIV/AIDS (PLHIV). We analyzed urine samples from 589 people (466 from Guatemala and 123 from Colombia), including 546 from PLHIV and 43 from non-PLHIV controls. Sixty-three of these people (35 from Guatemala and 28 from Colombia) had confirmed histoplasmosis by isolation of H. capsulatum . Using the standard curve provided by the quantitative commercial test, the sensitivity was 98% (95% confidence interval [CI], 95 to 100%) and the specificity was 97% (95% CI, 96 to 99%) (cutoff = 0.5 ng/ml). Semiquantitative results, using a calibrator of 12.5 ng/ml of Histoplasma galactomannan to calculate an enzyme immunoassay index value (EIV) for the samples, showed a sensitivity of 95% (95% CI, 89 to 100%) and a specificity of 98% (95% CI, 96 to 99%) (cutoff ≥ 2.6 EIV). This relatively simple-to-perform commercial antigenuria test showed a high performance with reproducible results in both countries, suggesting that it can be used to detect progressive disseminated histoplasmosis in PLHIV in a wide range of clinical laboratories in countries where histoplasmosis is endemic.
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- 2018
4. Pseudo-Outbreak of Lecanicillium and Acremonium Species in Orthopedic Surgery Patients
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Heather M. Gilmartin, S. A. Balajee, M. Imanishi, C. O. S. Neal, Mary E. Brandt, Connie S. Price, Lalitha Gade, Tom Chiller, L. S. Chang, and E. Deak
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Microbiology (medical) ,Lecanicillium ,biology ,Acremonium ,Hypocreales ,Acremonium species ,Human pathogen ,Mycology ,biology.organism_classification ,Isolation (microbiology) ,Disease Outbreaks ,Pseudo outbreak ,Microbiology ,Orthopedics ,Postoperative Complications ,Molecular Diagnostic Techniques ,Mycoses ,Environmental Microbiology ,Humans ,Molecular diagnostic techniques - Abstract
Acremonium species cause a variety of human infections, while Lecanicillium species have not been reported as human pathogens. We describe a pseudo-outbreak involving both organisms, highlighting the role and limitations of molecular methods in the characterization of rare fungal isolates. Repeated isolation of these fungi from patient tissue samples raises concerns about exogenous contamination in the hospital environment.
- Published
- 2012
5. Comparison of In Vitro Susceptibility Characteristics of Candida Species from Cases of Invasive Candidiasis in Solid Organ and Stem Cell Transplant Recipients: Transplant-Associated Infections Surveillance Network (TRANSNET), 2001 to 2006
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Naureen Iqbal, Tom Chiller, John W. Baddley, Carol A. Kauffman, Randall C. Walker, Peter G. Pappas, Benjamin J. Park, Susan Hadley, David R. Andes, Debra Wagner, Shawn R. Lockhart, Lisa Brumble, and James I. Ito
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Microbiology (medical) ,Voriconazole ,medicine.medical_specialty ,Posaconazole ,Itraconazole ,Biology ,medicine.disease ,Transplantation ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Amphotericin B ,Immunology ,medicine ,Caspofungin ,Mycosis ,Fluconazole ,medicine.drug - Abstract
Invasive fungal infections (IFI) are a major cause of morbidity and mortality among both solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Candida is the most common cause of IFI in SOT recipients and the second most common cause of IFI in HSCT recipients. We determined susceptibilities to fluconazole, voriconazole, itraconazole, posaconazole, amphotericin B, and caspofungin for 383 invasive Candida sp. isolates from SOT and HSCT recipients enrolled in the Transplant-Associated Infection Surveillance Network and correlated these results to clinical data. Fluconazole resistance in C. albicans , C. tropicalis , and C. parapsilosis isolates was low (1%), but the high percentage of C. glabrata and C. krusei isolates within this group of patients increased the overall percentage of fluconazole resistance to 16%. Voriconazole resistance was 3% overall but was 8% among C. glabrata isolates. On multivariable analysis, among HSCT recipients fluconazole nonsusceptibility was independently associated with C. glabrata , non-Hodgkin's lymphoma, cytomegalovirus (CMV) antigenemia, diabetes active at the time of the IFI, and any prior amphotericin B use; among SOT recipients, fluconazole nonsusceptibility was independently associated with any fluconazole use in the 3 months prior to the IFI, C. glabrata , ganciclovir use in the 3 months prior to the IFI, diabetes acquired since the transplant, and gender.
- Published
- 2011
6. Correlation of Genotype and In Vitro Susceptibilities of Cryptococcus gattii Strains from the Pacific Northwest of the United States
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Shawn R. Lockhart, Ben Sun, Tom Chiller, Angela M. Ahlquist, Randall J. Nett, Naureen Iqbal, Ron Wohrle, and Emilio DeBess
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Microbiology (medical) ,Antifungal ,Susceptibility testing ,Antifungal Agents ,Northwestern United States ,Genotype ,medicine.drug_class ,Molecular Sequence Data ,Zoology ,Mycology ,Microbial Sensitivity Tests ,Microbiology ,Drug Resistance, Fungal ,medicine ,Animals ,Humans ,DNA, Fungal ,Mycological Typing Techniques ,Cryptococcus gattii ,biology ,Cryptococcosis ,Sequence Analysis, DNA ,Drug susceptibility ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,DNA Fingerprinting ,DNA profiling ,Multilocus sequence typing - Abstract
Cryptococcus gattii emerged in North America in 1999 as a human and veterinary pathogen on Vancouver Island, British Columbia. The emergent subtype, VGIIa, and the closely related subtype VGIIb can now be found in the United States in Washington, Oregon, and California. We performed multilocus sequence typing and antifungal susceptibility testing on 43 isolates of C. gattii from human patients in Oregon, Washington, California, and Idaho. In contrast to Vancouver Island, VGIIa was the most frequent but not the predominant subtype in the northwest United States. Antifungal susceptibility testing showed statistically significant differences in MICs between the subtypes. This is the first study to apply antifungal susceptibility testing to C. gattii isolates from the Pacific Northwest and the first to make direct comparisons between subtypes.
- Published
- 2010
7. Molecular Identification of Aspergillus Species Collected for the Transplant-Associated Infection Surveillance Network
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Stephen A. Moser, Giancarlo Perrone, Kieren A. Marr, Tom Chiller, Stephen W. Peterson, Barbara D. Alexander, John W. Baddley, S. Arunmozhi Balajee, Dimitrios P. Kontoyiannis, David R. Andes, Peter G. Pappas, Mary E. Brandt, and Rui Kano
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Microbiology (medical) ,Antifungal Agents ,Microbial Sensitivity Tests ,Mycology ,Aspergillosis ,Aspergillus fumigatus ,Microbiology ,Immunocompromised Host ,Tubulin ,DNA, Ribosomal Spacer ,medicine ,Humans ,DNA, Fungal ,Transplantation ,Aspergillus ,Aspergillus calidoustus ,biology ,Fungal genetics ,Sequence Analysis, DNA ,biology.organism_classification ,medicine.disease ,Aspergillus tubingensis ,Aspergillus lentulus - Abstract
A large aggregate collection of clinical isolates of aspergilli ( n = 218) from transplant patients with proven or probable invasive aspergillosis was available from the Transplant-Associated Infection Surveillance Network, a 6-year prospective surveillance study. To determine the Aspergillus species distribution in this collection, isolates were subjected to comparative sequence analyses by use of the internal transcribed spacer and β-tubulin regions. Aspergillus fumigatus was the predominant species recovered, followed by A. flavus and A. niger . Several newly described species were identified, including A. lentulus and A. calidoustus ; both species had high in vitro MICs to multiple antifungal drugs. Aspergillus tubingensis , a member of the A. niger species complex, is described from clinical specimens; all A. tubingensis isolates had low in vitro MICs to antifungal drugs.
- Published
- 2009
8. Preliminary laboratory report of fungal infections associated with contaminated methylprednisolone injections
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Naureen Iqbal, Anastasia P. Litvintseva, Lalitha Gade, Cau D. Pham, Mary E. Brandt, Angela A. Cleveland, Benjamin J. Park, Judith Noble-Wang, Shawn R. Lockhart, Tom Chiller, Anne M. Whitney, and Christina M. Scheel
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Microbiology (medical) ,Adult ,Male ,Posaconazole ,Pathology ,medicine.medical_specialty ,Antifungal Agents ,Adolescent ,Itraconazole ,Microbial Sensitivity Tests ,Mycology ,Vial ,Methylprednisolone ,Aspergillus fumigatus ,Microbiology ,Disease Outbreaks ,Injections ,Young Adult ,Ascomycota ,Amphotericin B ,medicine ,Humans ,Aged ,Voriconazole ,Aged, 80 and over ,biology ,Outbreak ,Methylprednisolone acetate ,Middle Aged ,biology.organism_classification ,United States ,Mycoses ,Female ,Drug Contamination ,medicine.drug - Abstract
In September 2012, the Centers for Disease Control and Prevention (CDC) initiated an outbreak investigation of fungal infections linked to injection of contaminated methylprednisolone acetate (MPA). Between 2 October 2012 and 14 February 2013, the CDC laboratory received 799 fungal isolates or human specimens, including cerebrospinal fluid (CSF), synovial fluid, and abscess tissue, from 469 case patients in 19 states. A novel broad-range PCR assay and DNA sequencing were used to evaluate these specimens. Although Aspergillus fumigatus was recovered from the index case, Exserohilum rostratum was the primary pathogen in this outbreak and was also confirmed from unopened MPA vials. Exserohilum rostratum was detected or confirmed in 191 specimens or isolates from 150 case patients, primarily from Michigan ( n = 67 patients), Tennessee ( n = 26), Virginia ( n = 20), and Indiana ( n = 16). Positive specimens from Michigan were primarily abscess tissues, while positive specimens from Tennessee, Virginia, and Indiana were primarily CSF. E. rostratum antifungal susceptibility MIC 50 and MIC 90 values were determined for voriconazole (1 and 2 μg/ml, respectively), itraconazole (0.5 and 1 μg/ml), posaconazole (0.5 and 1 μg/ml), isavuconazole (4 and 4 μg/ml), and amphotericin B (0.25 and 0.5 μg/ml). Thirteen other mold species were identified among case patients, and four other fungal genera were isolated from the implicated MPA vials. The clinical significance of these other fungal species remains under investigation. The laboratory response provided significant support to case confirmation, enabled linkage between clinical isolates and injected vials of MPA, and described significant features of the fungal agents involved in this large multistate outbreak.
- Published
- 2013
9. Species identification and antifungal susceptibility testing of Candida bloodstream isolates from population-based surveillance studies in two U.S. cities from 2008 to 2011
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Monica M. Farley, Carol B. Bolden, Betsy Stein, Lee H. Harrison, Tom Chiller, Shawn R. Lockhart, Naureen Iqbal, Angela A. Cleveland, Rosemary Hollick, Wendy Baughman, and Benjamin J. Park
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Microbiology (medical) ,Antifungal Agents ,Georgia ,Population ,Microbial Sensitivity Tests ,Mycology ,Candida parapsilosis ,Microbiology ,Candida tropicalis ,chemistry.chemical_compound ,medicine ,Humans ,education ,Candida albicans ,Candida ,education.field_of_study ,Candida glabrata ,biology ,Maryland ,Coinfection ,Candidemia ,biology.organism_classification ,bacterial infections and mycoses ,chemistry ,Anidulafungin ,Caspofungin ,Fluconazole ,medicine.drug - Abstract
Between 2008 and 2011, population-based candidemia surveillance was conducted in Atlanta, GA, and Baltimore, MD. Surveillance had been previously performed in Atlanta in 1992 to 1993 and in Baltimore in 1998 to 2000, making this the first population-based candidemia surveillance conducted over multiple time points in the United States. From 2,675 identified cases of candidemia in the current surveillance, 2,329 Candida isolates were collected. Candida albicans no longer comprised the majority of isolates but remained the most frequently isolated species (38%), followed by Candida glabrata (29%), Candida parapsilosis (17%), and Candida tropicalis (10%). The species distribution has changed over time; in both Atlanta and Baltimore the proportion of C. albicans isolates decreased, and the proportion of C. glabrata isolates increased, while the proportion of C. parapsilosis isolates increased in Baltimore only. There were 98 multispecies episodes, with C. albicans and C. glabrata the most frequently encountered combination. The new species-specific CLSI Candida MIC breakpoints were applied to these data. With the exception of C. glabrata (11.9% resistant), resistance to fluconazole was very low (2.3% of isolates for C. albicans , 6.2% for C. tropicalis , and 4.1% for C. parapsilosis ). There was no change in the proportion of fluconazole resistance between surveillance periods. Overall echinocandin resistance was low (1% of isolates) but was higher for C. glabrata isolates, ranging from 2.1% isolates resistant to caspofungin in Baltimore to 3.1% isolates resistant to anidulafungin in Atlanta. Given the increase at both sites and the higher echinocandin resistance, C. glabrata should be closely monitored in future surveillance.
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- 2012
10. Comparison of in vitro susceptibility characteristics of Candida species from cases of invasive candidiasis in solid organ and stem cell transplant recipients: Transplant-Associated Infections Surveillance Network (TRANSNET), 2001 to 2006
- Author
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Shawn R, Lockhart, Debra, Wagner, Naureen, Iqbal, Peter G, Pappas, David R, Andes, Carol A, Kauffman, Lisa M, Brumble, Susan, Hadley, Randall, Walker, James I, Ito, John W, Baddley, Tom, Chiller, and Benjamin J, Park
- Subjects
Transplantation ,surgical procedures, operative ,Antifungal Agents ,Drug Resistance, Fungal ,Humans ,Candidiasis, Invasive ,Microbial Sensitivity Tests ,Organ Transplantation ,Mycology ,bacterial infections and mycoses ,Candida ,Stem Cell Transplantation - Abstract
Invasive fungal infections (IFI) are a major cause of morbidity and mortality among both solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Candida is the most common cause of IFI in SOT recipients and the second most common cause of IFI in HSCT recipients. We determined susceptibilities to fluconazole, voriconazole, itraconazole, posaconazole, amphotericin B, and caspofungin for 383 invasive Candida sp. isolates from SOT and HSCT recipients enrolled in the Transplant-Associated Infection Surveillance Network and correlated these results to clinical data. Fluconazole resistance in C. albicans, C. tropicalis, and C. parapsilosis isolates was low (1%), but the high percentage of C. glabrata and C. krusei isolates within this group of patients increased the overall percentage of fluconazole resistance to 16%. Voriconazole resistance was 3% overall but was 8% among C. glabrata isolates. On multivariable analysis, among HSCT recipients fluconazole nonsusceptibility was independently associated with C. glabrata, non-Hodgkin's lymphoma, cytomegalovirus (CMV) antigenemia, diabetes active at the time of the IFI, and any prior amphotericin B use; among SOT recipients, fluconazole nonsusceptibility was independently associated with any fluconazole use in the 3 months prior to the IFI, C. glabrata, ganciclovir use in the 3 months prior to the IFI, diabetes acquired since the transplant, and gender.
- Published
- 2011
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