6 results on '"Kathryn L Meagley"'
Search Results
2. Incidence, Etiology, and Severity of Acute Gastroenteritis Among Prospectively Enrolled Patients in 4 Veterans Affairs Hospitals and Outpatient Centers, 2016–2018
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Aron J. Hall, Neha Balachandran, Rashi Gautam, Rebecca M. Dahl, Jan Vinjé, Mark Holodniy, David O. Beenhouwer, Sheldon T. Brown, Cynthia Lucero-Obusan, Umesh D. Parashar, Adrienne Perea, Blanca Vargas, Karen V. Evangelista, Michael D. Bowen, Anita Kambhampati, Cristina V. Cardemil, Scott Grytdal, Kathryn L Meagley, Maria C. Rodriguez-Barradas, Hannah Browne, and Vincent C. Marconi
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0301 basic medicine ,Microbiology (medical) ,Adult ,Rotavirus ,medicine.medical_specialty ,Hospitals, Veterans ,030106 microbiology ,Population ,medicine.disease_cause ,Article ,law.invention ,03 medical and health sciences ,Feces ,0302 clinical medicine ,fluids and secretions ,law ,Internal medicine ,Outpatients ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,education ,Veterans Affairs ,Aged ,Caliciviridae Infections ,Veterans ,education.field_of_study ,business.industry ,Clostridioides difficile ,Incidence (epidemiology) ,Incidence ,virus diseases ,Infant ,Clostridium difficile ,Intensive care unit ,United States ,Gastroenteritis ,Infectious Diseases ,Norovirus ,Etiology ,business - Abstract
Background Acute gastroenteritis (AGE) burden, etiology, and severity in adults is not well characterized. We implemented a multisite AGE surveillance platform in 4 Veterans Affairs Medical Centers (Atlanta, Georgia; Bronx, New York; Houston, Texas; and Los Angeles, California), collectively serving >320 000 patients annually. Methods From 1 July 2016 to 30 June 2018, we actively identified inpatient AGE case patients and non-AGE inpatient controls through prospective screening of admitted patients and passively identified outpatients with AGE through stool samples submitted for clinical diagnostics. We abstracted medical charts and tested stool samples for 22 pathogens by means of multiplex gastrointestinal polymerase chain reaction panel followed by genotyping of norovirus- and rotavirus-positive samples. We determined pathogen-specific prevalence, incidence, and modified Vesikari severity scores. Results We enrolled 724 inpatients with AGE, 394 non-AGE inpatient controls, and 506 outpatients with AGE. Clostridioides difficile and norovirus were most frequently detected among inpatients (for AGE case patients vs controls: C. difficile, 18.8% vs 8.4%; norovirus, 5.1% vs 1.5%; P < .01 for both) and outpatients (norovirus, 10.7%; C. difficile, 10.5%). The incidence per 100 000 population was highest among outpatients (AGE, 2715; C. difficile, 285; norovirus, 291) and inpatients ≥65 years old (AGE, 459; C. difficile, 91; norovirus, 26). Clinical severity scores were highest for inpatient norovirus, rotavirus, and Shigella/enteroinvasive Escherichia coli cases. Overall, 12% of inpatients with AGE had intensive care unit stays, and 2% died; 3 deaths were associated with C. difficile and 1 with norovirus. C. difficile and norovirus were detected year-round with a fall/winter predominance. Conclusions C. difficile and norovirus were leading AGE pathogens in outpatient and hospitalized US veterans, resulting in severe disease. Clinicians should remain vigilant for bacterial and viral causes of AGE year-round.
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- 2021
3. 652. What Is Blood Got to Do with It? Genetic Susceptibility to Norovirus and Rotavirus Infection: Results From the SUPERNOVA Network
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Vincent C. Marconi, Anita Kambhampati, Frederick H. Neill, Aleksandra Poteshkina, Cristina V. Cardemil, Adrienne Perea, Kathryn L Meagley, Scott Grytdal, David O. Beenhouwer, Michael D. Bowen, Sheldon T. Brown, Jan Vinjé, Aron J. Hall, Blanca Vargas, Robert L. Atmar, Umesh D. Parashar, Maria C. Rodriguez-Barradas, Hannah Browne, and Rashi Gautam
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business.industry ,viruses ,Rotavirus Infections ,virus diseases ,Stool specimen ,medicine.disease_cause ,Virology ,Rotavirus infection ,Abstracts ,Infectious Diseases ,fluids and secretions ,Oncology ,B. Poster Abstracts ,Rotavirus ,Genotype ,medicine ,Norovirus ,Genetic predisposition ,business - Abstract
Background Histo-blood group antigens (HBGAs), whose expression is controlled in part by fucosyltransferase 2 (FUT2) and 3 (FUT3) genes, serve as receptors for norovirus and rotavirus. Individuals without functional FUT2 (nonsecretors) or FUT3 (Lewis-negative) genes may have decreased susceptibility to norovirus and rotavirus infections. As the prevalence of secretor and Lewis status can vary by race and ethnicity, we assessed this association in a US Veteran population. Methods Stool and saliva specimens were collected from acute gastroenteritis (AGE) cases and age- and time-matched controls through a multisite, active surveillance platform at four Veterans Affairs hospitals (Atlanta, Bronx, Houston, Los Angeles). Stool specimens were tested with the FilmArray Gastrointestinal Panel; norovirus and rotavirus positive specimens were genotyped. Saliva specimens were analyzed for HBGA expression by EIA using glycan-specific monoclonal antibodies and lectins. Chi-squared and Fisher’s exact tests were conducted to evaluate associations between secretor and Lewis status and infection with norovirus or rotavirus. Results From November 4, 2015–December 30, 2017, 670 AGE cases and 319 controls provided both stool and saliva specimens. Norovirus (21 GII.4 Sydney, 13 GII non-4, 7 GI, 10 untyped) and rotavirus (13 G12P[8], 1 G2P[4], 1 untyped) positive cases were more likely to be secretor positive (90% and 100%, respectively) compared with controls (76%) (P = 0.03 for both). Infections with GII.4 Sydney norovirus (P < 0.01) and G12P[8] rotavirus (P < 0.05) were significantly associated with secretor status. This association was not observed with other norovirus or rotavirus genotypes. No association was observed between Lewis status, race, or ethnicity and infection with norovirus or rotavirus. Conclusion Norovirus and rotavirus infections among a US Veteran population were associated with secretor status in a genotype-dependent manner, and with GII.4 Sydney norovirus and G12P[8] rotavirus, the most common strains. These associations are consistent with previously reported results, and suggest that the efficacy of interventions, such as vaccines, should include consideration of secretor status and predominantly circulating virus strains. Disclosures R. L. Atmar, Takeda Vaccines, Inc.: Investigator, Research grant. V. C. Marconi, ViiV: Investigator, Research support and Salary. Gilead: Investigator, Research support. Bayer: Investigator, Research support.
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- 2018
4. 2322. Etiology, Severity of Illness, and Risk Factors for Patients Hospitalized with Acute Gastroenteritis from Multi-Site Veteran’s Affairs (VA) Surveillance, 2016–2018: Results from SUPERNOVA
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Neha Balachandran, Sheldon T. Brown, Anita Kambhampati, Jan Vinjé, Karen V. Evangelista, Scott Grytdal, Mark Holodniy, Cristina V. Cardemil, Kathryn L Meagley, Blanca Vargas, Cynthia Lucero-Obusan, Adrienne Perea, David O. Beenhouwer, Aron J. Hall, Vincent C. Marconi, Michael D. Bowen, Maria C. Rodriguez-Barradas, Hannah Browne, Umesh D. Parashar, and Rashi Gautam
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Pediatrics ,medicine.medical_specialty ,business.industry ,Multi site ,Acute gastroenteritis ,medicine.disease_cause ,Hiv seropositivity ,Causality ,Intensive care unit ,law.invention ,Abstracts ,Infectious Diseases ,Oncology ,law ,Severity of illness ,Poster Abstracts ,Norovirus ,medicine ,Etiology ,business - Abstract
Background The severity of acute gastroenteritis (AGE) in adult populations and the relative contribution of specific pathogens is not well characterized. In 2016, we implemented a multisite AGE surveillance platform in 4 VA hospitals (Atlanta, Bronx, Houston and Los Angeles), collectively serving > 320,000 patients annually. Methods Inpatient AGE cases and age- and time-matched non-AGE controls were identified through prospective screening of admissions using standardized case definitions. Stool samples were tested for 22 pathogens using the FilmArray® Gastrointestinal Panel. Medical conditions were analyzed as risk factors for AGE by multivariate logistic regression. Results From July 2016 to June 2018, 731 cases and 399 controls were enrolled. Risk factors for AGE cases included HIV-positive status (adjusted odds ratio [aOR] 4.6; 95% confidence interval [CI] 1.6–12.9; P < 0.01), severe kidney disease (aOR 4.5; 95% CI 2.0–9.8; P < 0.01), and immunosuppressive therapy (aOR 4.0; 95% CI 1.2–13.3]; P = 0.02). Clostridioides difficile and norovirus were the most commonly detected pathogens in cases (18% and 5%, respectively); detection of these pathogens in cases was significantly higher than detection in controls (8% and 2%, respectively; P < 0.01 for both). The median duration of hospital stay was longer for C. difficile compared with norovirus cases (5 vs. 3 days; P < 0.01), and cases with both pathogens had intensive care unit (ICU) stays (C. difficile: 18%; norovirus: 8%; P = 0.2). Fourteen deaths occurred among AGE cases; 2 were associated with C. difficile and 1 with norovirus; the remainder did not have a clear etiology or pathogen detected. C. difficile and norovirus were detected year-round with a fall and winter predominance; C. difficile prevalence was highest in October, while norovirus prevalence was six times higher in December than in summer months. Conclusion This surveillance platform captured cases of severe AGE, including ICU stays and deaths, among hospitalized US Veterans. C. difficile and norovirus were leading pathogens in AGE cases. These findings can help guide appropriate clinical management of AGE patients and inform public health efforts to quantify and address the associated burden of disease through targeted interventions. Disclosures All authors: No reported disclosures.
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- 2019
5. 1648. Incidence of Norovirus and Rotavirus From Multisite Active Surveillance in Veteran’s Affairs Hospitals, December 2016–February 2018: Results From the SUPERNOVA Network
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Scott Grytdal, Maria C. Rodriguez-Barradas, Cynthia A. Lucero, Mark Holodniy, Hannah Browne, Vincent Marconi, Karen V. Evangelista, Aron J. Hall, Michael D. Bowen, Rashi Gautam, Blanca Vargas, David O. Beenhouwer, Adrienne Perea, Umesh D. Parashar, Jan Vinjé, Anita Kambhampati, Cristina V. Cardemil, Kathryn L Meagley, and Sheldon T. Brown
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0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,viruses ,medicine.medical_treatment ,030106 microbiology ,Stool specimen ,medicine.disease_cause ,Abstracts ,03 medical and health sciences ,fluids and secretions ,0302 clinical medicine ,A. Oral Abstracts ,Rotavirus ,Genotype ,Cost of illness ,Medicine ,030212 general & internal medicine ,Genotype determination ,business.industry ,Incidence (epidemiology) ,virus diseases ,Infectious Diseases ,Oncology ,Norovirus ,business ,Watchful waiting - Abstract
Background Viruses are frequently implicated in acute gastroenteritis (AGE) outbreaks, yet the endemic burden of norovirus and rotavirus disease in adult populations is not well characterized. In 2016, we implemented a multisite AGE surveillance platform capturing cases and controls in 4 VA hospitals (Atlanta, Bronx, Houston, and Los Angeles), collectively serving >320,000 patients annually. Methods Inpatient AGE cases and age- and time-matched controls were identified through prospective screening of admissions via standardized case definitions. Outpatient cases were passively identified using stool samples submitted for routine clinical microbiological diagnostics. Samples were tested with the FilmArray Gastrointestinal Panel, followed by genotyping of virus positives. Incidence was estimated using population denominators of unique patients served annually by site. Results From December 1, 2016 to February 28, 2018, 875 cases (496 inpatients, 379 outpatients), and 374 controls were enrolled. Norovirus and rotavirus prevalence was highest among outpatient AGE cases (11.6% and 2.9%, respectively) followed by inpatient cases (3.4% and 1.6%, respectively); few controls were positive (norovirus, 1.3%; rotavirus, 0%). Norovirus-associated inpatient incidence was 15.2 per 100,000 population (range by site: 10.7–19.9/100,000) and rotavirus-associated inpatient incidence was 7.5 per 100,000 population (range by site: 0–12.8/100,000). The predominant norovirus genotype was GII.P16-GII.4 Sydney (50%), and rotavirus genotype was G12P[8] (83%). Norovirus was detected every calendar month and peaked in December–January, while rotavirus peaked in April. Nine deaths were documented among AGE inpatient cases, including one norovirus-associated death. Conclusion Implementation of a multisite AGE surveillance platform captured a wide spectrum of illness for norovirus and rotavirus in US Veterans including outpatient visits, inpatient hospitalizations, and one norovirus-associated death. Norovirus was the leading viral pathogen and was detected year-round. Ongoing surveillance using this platform will allow for further characterization of the pathogen distribution and associated AGE disease burden in adults. Disclosures V. Marconi, ViiV: Investigator, Research support and Salary. Bayer: Investigator, Research support. Gilead: Investigator, Research support.
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- 2018
6. Chemical Control of Crystal Growth with Multidentate Carboxylate Ligands: Effect of Ligand Denticity on Zinc Oxide Crystal Shape
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Kathryn L. Meagley and Simon P. Garcia
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Denticity ,Aqueous solution ,Ligand ,Inorganic chemistry ,chemistry.chemical_element ,Crystal growth ,General Chemistry ,Zinc ,Condensed Matter Physics ,law.invention ,Crystal ,Crystallography ,chemistry.chemical_compound ,chemistry ,law ,General Materials Science ,Carboxylate ,Crystallization - Abstract
Ligand denticity profoundly affects the ability of organic ligands to control crystal shape during aqueous crystallization of zinc oxide. A method is presented for rapidly screening the shape-control activity of organic molecules during zinc oxide crystallization. This method involves the solution-phase growth and isolation of zinc oxide crystals large enough to be quantified by optical microscopy. Crystals grown by this method were hexagonally prismatic with a rod-like morphology, but in the presence of multidentate carboxylate ligands, a platy morphology developed. By quantifying the aspect ratio of crystals as a function of ligand concentration, the shape-control activities of three carboxylate ligands were compared systematically. Shape control was strongest in a tridentate ligand (citrate), weaker in a bidentate ligand (malate), and absent in a monodentate ligand (glycolate). The effect of denticity, coupled with trends in crystal length and width, suggests that ligands alter the deposition rate on s...
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- 2012
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