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Lim J, Zaw C, Abramson S, Lichtenberger PN, John BV, Cuebas-Rosado L. Clostridium difficile Bacteremia as a Rare Presentation of Polymicrobial Pyogenic Liver Abscesses and Its Management Challenges. Case Rep Gastroenterol 2023; 17:264-268. [PMID: 37928967 PMCID: PMC10624945 DOI: 10.1159/000531892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/27/2023] [Indexed: 11/07/2023] Open
Abstract
Extracolonic manifestations of Clostridium difficile have been rarely reported. We herein report a case of a 60-year-old immunocompetent man presenting with fever, nausea, abdominal pain, and loose stools for 2 weeks. Triple-phase liver computed tomography demonstrated pyogenic liver abscesses and portal pylephlebitis. Blood cultures grew C. difficile and Bacteroides fragilis, and liver abscess cultures grew Proteus mirabilis, Escherichia coli, and the viridans group Streptococci. Antibiotics coverage was selected to direct at all identified organisms. This demonstrates an unusual case of C. difficile bacteremia in a patient with polymicrobial pyogenic liver abscesses and pylephlebitis.
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Affiliation(s)
- Junghyun Lim
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Catherine Zaw
- Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Simon Abramson
- Veterans Health Affairs National Teleradiology Program, Menlo Park, CA, USA
| | | | - Binu V. John
- Division of Hepatology, Bruce W. Carter VA Medical Center, Miami, FL, USA
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2
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Lau HL, De Lima Corvino DF, Guerra FM, Malik AM, Lichtenberger PN, Gultekin SH, Ritter JM, Roy S, Ali IKM, Cope JR, Post MJD, Gonzales Zamora JA. Granulomatous amoebic encephalitis caused by Acanthamoeba in a patient with AIDS: a challenging diagnosis. Acta Clin Belg 2021; 76:127-131. [PMID: 31455179 DOI: 10.1080/17843286.2019.1660023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Acanthamoeba spp. is a ubiquitous free-living amoeba that causes human infections affecting predominantly the cornea and central nervous system. The diagnosis and treatment of Acanthamoeba encephalitis is very challenging. CASE SUMMARY A 53-year-old male with HIV/AIDS was admitted for altered mental status and fever. On initial examination, he had left hemianopia with left-sided weakness and numbness. MRI revealed an inflammatory and enhancing parenchymal mass associated with leptomeningeal enhancement in the occipitoparietal lobe containing multiple punctate hemorrhages. He was treated with empiric antibiotics for presumptive toxoplasmosis, brain abscess, fungal infection and tuberculosis with an unremarkable lymphoma work up. Initial brain biopsy studies were unremarkable except for non-specific granulomas and adjacent necrotic tissue. The patient passed away 2.5 months after initial presentation with no diagnosis. Post-mortem testing by the Centers for Disease Control and Prevention (CDC) confirmed the diagnosis of granulomatous amoebic encephalitis (GAE) by visualization with immunohistochemistry staining and PCR. Recovery is rare from GAE likely due to delay in diagnosis. CONCLUSIONS This case illustrates the importance of including GAE into the differential diagnosis of brain mass. We advocate early molecular testing of tissue specimen by the CDC to achieve an appropriate diagnosis, and a multidisciplinary approach for the management of this condition.
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Affiliation(s)
- Hsien Lee Lau
- Departments of Neurology, Miller School of Medicine University of Miami, Miami, FL, USA
| | | | - Francisco M. Guerra
- Infectious Disease, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Amer M. Malik
- Departments of Neurology, Miller School of Medicine University of Miami, Miami, FL, USA
| | | | - Sakir H. Gultekin
- Pathology, Miller School of Medicine University of Miami, Miami, FL, USA
| | - Jana M. Ritter
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shantanu Roy
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ibne Karim M. Ali
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer R. Cope
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M. Judith D. Post
- Pathology and Radiology, Miller School of Medicine University of Miami, Miami, FL, USA
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3
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Morris SR, Natori Y, Salguero D, Mantero A, Ma R, de Lima Corvino DF, Fernandez A, Lazo A, Vu CA, Bjork L, Serota D, Quevedo J, Vega A, Maxam M, DeRonde K, Barreiro P, Raccamarich P, Alvarez MR, Skiada D, Balan S, Ramanathan M, Holt G, Gonzales-Zamora J, Baracco GJ, Doblecki-Lewis S, Abbo LM, Lichtenberger PN, Alcaide ML. Development of a Standardized Data Collection Tool for Evaluation and Management of Coronavirus Disease 2019. Open Forum Infect Dis 2020; 7:ofaa320. [PMID: 32959015 PMCID: PMC7454902 DOI: 10.1093/ofid/ofaa320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/24/2020] [Indexed: 01/08/2023] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 ) is responsible for coronavirus disease 2019 (COVID-19), a disease that had not been previously described and for which clinicians need to rapidly adapt their daily practice. The novelty of SARS-CoV-2 produced significant gaps in harmonization of definitions, data collection, and outcome reporting to identify patients who would benefit from potential interventions. Methods We describe a multicenter collaboration to develop a comprehensive data collection tool for the evaluation and management of COVID-19 in hospitalized patients. The proposed tool was developed by a multidisciplinary working group of infectious disease physicians, intensivists, and infectious diseases/antimicrobial stewardship pharmacists. The working group regularly reviewed literature to select important patient characteristics, diagnostics, and outcomes for inclusion. The data collection tool consisted of spreadsheets developed to collect data from the electronic medical record and track the clinical course after treatments. Results Data collection focused on demographics and exposure epidemiology, prior medical history and medications, signs and symptoms, diagnostic test results, interventions, clinical outcomes, and complications. During the pilot validation phase, there was <10% missing data for most domains and components. Team members noted improved efficiency and decision making by using the tool during interdisciplinary rounds. Conclusions We present the development of a COVID-19 data collection tool and propose its use to effectively assemble harmonized data of hospitalized individuals with COVID-19. This tool can be used by clinicians, researchers, and quality improvement healthcare teams. It has the potential to facilitate interdisciplinary rounds, provide comparisons across different hospitalized populations, and adapt to emerging challenges posed by the pandemic.
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Affiliation(s)
- Stephen R Morris
- Jackson Memorial Hospital/University of Miami, Miami, Florida, USA
| | - Yoichiro Natori
- Miami Transplant Institute, Jackson Health System, Division of infectious Diseases, Department of Medicine, University of Miami, Miami, Florida, USA
| | - Douglas Salguero
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA
| | - Alejandro Mantero
- University of Miami, Department of Public Health Sciences, Division of Biostatistics, Miami, Florida, USA
| | - Ruixuan Ma
- University of Miami, Department of Public Health Sciences, Division of Biostatistics, Miami, Florida, USA
| | | | - Anmary Fernandez
- Jackson Memorial Hospital/University of Miami, Miami, Florida, USA
| | - Alex Lazo
- Jackson Memorial Hospital/University of Miami, Miami, Florida, USA
| | - Christine A Vu
- Jackson Memorial Hospital, Department of Pharmacy, Miami, Florida, USA
| | - Lauren Bjork
- Miami Veterans Affairs Medical Center, Department of Pharmacy, Miami, Florida, USA
| | - David Serota
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA
| | - Jennifer Quevedo
- University of Miami Hospital, Department of Pharmacy, Miami, Florida, USA
| | - Ana Vega
- Jackson Memorial Hospital, Department of Pharmacy, Miami, Florida, USA
| | - Meshell Maxam
- Jackson Memorial Hospital, Department of Pharmacy, Miami, Florida, USA
| | - Kailynn DeRonde
- Jackson Memorial Hospital, Department of Pharmacy, Miami, Florida, USA
| | - Pablo Barreiro
- Hospital Carlos III-La Paz, Unit of Infectious Diseases, European University, Madrid, Spain
| | - Patricia Raccamarich
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA
| | | | - Dimitra Skiada
- Jackson Memorial Hospital/University of Miami, Miami, Florida, USA
| | - Shuba Balan
- Jackson Memorial Hospital/University of Miami, Miami, Florida, USA
| | - Maya Ramanathan
- Jackson Memorial Hospital/University of Miami, Miami, Florida, USA
| | - Gregory Holt
- University of Miami, Department of Medicine, Division of Pulmonary/Critical Care Medicine, Miami, Florida, USA
| | - Jose Gonzales-Zamora
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA
| | - Gio J Baracco
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA.,Miami Veterans Affairs Medical Center, Infectious Disease Section, Miami, Florida, USA
| | - Susanne Doblecki-Lewis
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA
| | - Lilian M Abbo
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA
| | - Paola N Lichtenberger
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA.,Miami Veterans Affairs Medical Center, Infectious Disease Section, Miami, Florida, USA
| | - Maria L Alcaide
- University of Miami, Department of Medicine, Division of Infectious Diseases, Miami, Florida, USA
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4
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Lichtenberger PN, Ricciardi MJ, Solorzano D, Raccamarich P, Leda A, Sharkey M, Watkins DI, El Sahly H, Rouphael N, Mulligan MJ, Doblecki-Lewis S, Stevenson M, Alcaide ML. Occupational Exposure to the Ugandan Research Strain (MR766) of Zika Virus. Open Forum Infect Dis 2019; 6:ofz420. [PMID: 31667199 PMCID: PMC6814281 DOI: 10.1093/ofid/ofz420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/07/2019] [Indexed: 12/22/2022] Open
Abstract
A laboratory worker suffered an accidental needle-stick resulting in an exposure to the Ugandan strain (MR766) of Zika virus, which has rarely been studied in humans. We report the clinical presentation and outcomes, molecular and serological diagnostic results, and antibody response.
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Affiliation(s)
- Paola N Lichtenberger
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Michael J Ricciardi
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Dalhila Solorzano
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Patricia Raccamarich
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ana Leda
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mark Sharkey
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David I Watkins
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Hana El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Nadine Rouphael
- Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Mark J Mulligan
- New York University Vaccine Center and Division of Infectious Diseases and Immunology, Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Susanne Doblecki-Lewis
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mario Stevenson
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maria L Alcaide
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
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5
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Munita JM, Aitken SL, Miller WR, Perez F, Rosa R, Shimose LA, Lichtenberger PN, Abbo LM, Jain R, Nigo M, Wanger A, Araos R, Tran TT, Adachi J, Rakita R, Shelburne S, Bonomo RA, Arias CA. Multicenter Evaluation of Ceftolozane/Tazobactam for Serious Infections Caused by Carbapenem-Resistant Pseudomonas aeruginosa. Clin Infect Dis 2017; 65:158-161. [PMID: 28329350 PMCID: PMC5850333 DOI: 10.1093/cid/cix014] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/10/2017] [Indexed: 01/09/2023] Open
Abstract
A multicenter, retrospective study of patients infected with carbapenem-resistant Pseudomonas aeruginosa who were treated with ceftolozane/tazobactam was performed. Among 35 patients, pneumonia was the most common indication and treatment was successful in 26 (74%). Treatment failure was observed in all cases where isolates demonstrated ceftolozane-tazobactam minimum inhibitory concentrations ≥8 μg/mL.
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Affiliation(s)
- Jose M Munita
- Center for Antimicrobial Resistance and Microbial Genomics and Gulf Coast Consortium on Antimicrobial Resistance
- Division of Infectious Diseases, Department of Internal Medicine, and
- Genomics and Resistant Microbes Group, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Samuel L Aitken
- Center for Antimicrobial Resistance and Microbial Genomics and Gulf Coast Consortium on Antimicrobial Resistance
- Division of Pharmacy and
| | - William R Miller
- Center for Antimicrobial Resistance and Microbial Genomics and Gulf Coast Consortium on Antimicrobial Resistance
- Division of Infectious Diseases, Department of Internal Medicine, and
| | - Federico Perez
- Cleveland Veterans Affairs Medical Center Case Western Reserve University, Ohio
| | - Rossana Rosa
- Department of Medicine, Jackson Memorial Hospital and
- Division of Infectious Diseases, University of Miami Miller School of Medicine, Florida
| | - Luis A Shimose
- Department of Medicine, Jackson Memorial Hospital and
- Division of Infectious Diseases, University of Miami Miller School of Medicine, Florida
| | - Paola N Lichtenberger
- Division of Infectious Diseases, University of Miami Miller School of Medicine, Florida
| | - Lilian M Abbo
- Department of Medicine, Jackson Memorial Hospital and
- Division of Infectious Diseases, University of Miami Miller School of Medicine, Florida
| | | | - Masayuki Nigo
- Division of Infectious Diseases, Department of Internal Medicine, and
| | - Audrey Wanger
- Department of Pathology and Laboratory Medicine, University of Texas McGovern Medical School, Houston
| | - Rafael Araos
- Genomics and Resistant Microbes Group, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Truc T Tran
- Center for Antimicrobial Resistance and Microbial Genomics and Gulf Coast Consortium on Antimicrobial Resistance
- Division of Infectious Diseases, Department of Internal Medicine, and
| | - Javier Adachi
- Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston
| | - Robert Rakita
- Division of Allergy and Infectious Diseases, University of Washington, Seattle; and
| | - Samuel Shelburne
- Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston
| | - Robert A Bonomo
- Cleveland Veterans Affairs Medical Center Case Western Reserve University, Ohio
| | - Cesar A Arias
- Center for Antimicrobial Resistance and Microbial Genomics and Gulf Coast Consortium on Antimicrobial Resistance
- Division of Infectious Diseases, Department of Internal Medicine, and
- International Center for Antimicrobial Resistance, Universidad El Bosque, Bogota, Colombia
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6
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Grubaugh ND, Ladner JT, Kraemer MUG, Dudas G, Tan AL, Gangavarapu K, Wiley MR, White S, Thézé J, Magnani DM, Prieto K, Reyes D, Bingham AM, Paul LM, Robles-Sikisaka R, Oliveira G, Pronty D, Barcellona CM, Metsky HC, Baniecki ML, Barnes KG, Chak B, Freije CA, Gladden-Young A, Gnirke A, Luo C, MacInnis B, Matranga CB, Park DJ, Qu J, Schaffner SF, Tomkins-Tinch C, West KL, Winnicki SM, Wohl S, Yozwiak NL, Quick J, Fauver JR, Khan K, Brent SE, Reiner RC, Lichtenberger PN, Ricciardi MJ, Bailey VK, Watkins DI, Cone MR, Kopp EW, Hogan KN, Cannons AC, Jean R, Monaghan AJ, Garry RF, Loman NJ, Faria NR, Porcelli MC, Vasquez C, Nagle ER, Cummings DAT, Stanek D, Rambaut A, Sanchez-Lockhart M, Sabeti PC, Gillis LD, Michael SF, Bedford T, Pybus OG, Isern S, Palacios G, Andersen KG. Genomic epidemiology reveals multiple introductions of Zika virus into the United States. Nature 2017; 546:401-405. [PMID: 28538723 PMCID: PMC5536180 DOI: 10.1038/nature22400] [Citation(s) in RCA: 232] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 04/28/2017] [Indexed: 12/23/2022]
Abstract
Zika virus (ZIKV) is causing an unprecedented epidemic linked to severe congenital abnormalities. In July 2016, mosquito-borne ZIKV transmission was reported in the continental United States; since then, hundreds of locally acquired infections have been reported in Florida. To gain insights into the timing, source, and likely route(s) of ZIKV introduction, we tracked the virus from its first detection in Florida by sequencing ZIKV genomes from infected patients and Aedes aegypti mosquitoes. We show that at least 4 introductions, but potentially as many as 40, contributed to the outbreak in Florida and that local transmission is likely to have started in the spring of 2016-several months before its initial detection. By analysing surveillance and genetic data, we show that ZIKV moved among transmission zones in Miami. Our analyses show that most introductions were linked to the Caribbean, a finding corroborated by the high incidence rates and traffic volumes from the region into the Miami area. Our study provides an understanding of how ZIKV initiates transmission in new regions.
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Affiliation(s)
- Nathan D Grubaugh
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, California 92037, USA
| | - Jason T Ladner
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702, USA
| | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford OX1 3PS, UK
- Boston Children's Hospital, Boston, Massachusetts 02115, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Gytis Dudas
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - Amanda L Tan
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida 33965, USA
| | - Karthik Gangavarapu
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, California 92037, USA
| | - Michael R Wiley
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702, USA
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
| | - Stephen White
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Miami, Florida 33125, USA
| | - Julien Thézé
- Department of Zoology, University of Oxford, Oxford OX1 3PS, UK
| | - Diogo M Magnani
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Karla Prieto
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702, USA
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
| | - Daniel Reyes
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
| | - Andrea M Bingham
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida 32399, USA
| | - Lauren M Paul
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida 33965, USA
| | - Refugio Robles-Sikisaka
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, California 92037, USA
| | - Glenn Oliveira
- Scripps Translational Science Institute, La Jolla, California 92037, USA
| | - Darryl Pronty
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Miami, Florida 33125, USA
| | - Carolyn M Barcellona
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida 33965, USA
| | - Hayden C Metsky
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Mary Lynn Baniecki
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Kayla G Barnes
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Bridget Chak
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Catherine A Freije
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | | | - Andreas Gnirke
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Cynthia Luo
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Bronwyn MacInnis
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | | | - Daniel J Park
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - James Qu
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | | | | | - Kendra L West
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Sarah M Winnicki
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Shirlee Wohl
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Nathan L Yozwiak
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Joshua Quick
- Institute of Microbiology and Infection, University of Birmingham, Birmingham B15 2TT, UK
| | - Joseph R Fauver
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado 80523, USA
| | - Kamran Khan
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario M5B 1T8, Canada
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Shannon E Brent
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario M5B 1T8, Canada
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA
| | - Paola N Lichtenberger
- Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Michael J Ricciardi
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Varian K Bailey
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - David I Watkins
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Marshall R Cone
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, Florida 33612, USA
| | - Edgar W Kopp
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, Florida 33612, USA
| | - Kelly N Hogan
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, Florida 33612, USA
| | - Andrew C Cannons
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Tampa, Florida 33612, USA
| | - Reynald Jean
- Florida Department of Health in Miami-Dade County, Miami, Florida 33125, USA
| | - Andrew J Monaghan
- National Center for Atmospheric Research, Boulder, Colorado 80307, USA
| | - Robert F Garry
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA
| | - Nicholas J Loman
- Institute of Microbiology and Infection, University of Birmingham, Birmingham B15 2TT, UK
| | - Nuno R Faria
- Department of Zoology, University of Oxford, Oxford OX1 3PS, UK
| | | | | | - Elyse R Nagle
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
| | - Derek A T Cummings
- Department of Biology and Emerging Pathogens Institute, University of Florida, Gainesville, Florida 32610, USA
| | - Danielle Stanek
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, Florida 32399, USA
| | - Andrew Rambaut
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh EH9 3FL, UK
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Mariano Sanchez-Lockhart
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
| | - Pardis C Sabeti
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Center for Systems Biology, Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, Massachusetts 02138, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA
- Howard Hughes Medical Institute, Chevy Chase, Maryland 20815, USA
| | - Leah D Gillis
- Bureau of Public Health Laboratories, Division of Disease Control and Health Protection, Florida Department of Health, Miami, Florida 33125, USA
| | - Scott F Michael
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida 33965, USA
| | - Trevor Bedford
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - Oliver G Pybus
- Department of Zoology, University of Oxford, Oxford OX1 3PS, UK
| | - Sharon Isern
- Department of Biological Sciences, College of Arts and Sciences, Florida Gulf Coast University, Fort Myers, Florida 33965, USA
| | - Gustavo Palacios
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland 21702, USA
| | - Kristian G Andersen
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, California 92037, USA
- Scripps Translational Science Institute, La Jolla, California 92037, USA
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, California 92037, USA
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7
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Campo RE, Rosa I, Lichtenberger PN, Suarez G, Rivera FA, Jayaweera DT, Rodriguez AE, Wahlay NA, Kolber MA. Effect of class-specific therapy interruption on persistence of HIV type 1 antiretroviral resistance. AIDS Res Hum Retroviruses 2003; 19:653-6. [PMID: 13678466 DOI: 10.1089/088922203322280865] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Interruption of all antiretroviral therapy for HIV-1 infection when therapy is failing and antiretroviral resistance has emerged is frequently associated with the disappearance of detectable resistance-associated protease and reverse transcriptase substitutions. However, the effect that discontinuation of treatment with a particular antiretroviral class has on resistance to that class when other antiretroviral therapy is continued is unknown. We investigated differences in detectable genotypic resistance to protease inhibitors (PI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) among two populations: patients undergoing testing at the moment class-specific treatment failed (Group 1) and patients undergoing testing for varying periods after class-specific treatment failed and was discontinued but therapy with other antiretroviral classes continued with incomplete viral suppression (Group 2). We found that the prevalence of detectable resistance to the PI and NNRTI classes was similar in both groups despite the absence of class-specific selective pressure for lengthy periods of time in Group 2. We hypothesize that this finding may be due to nonspecific selective pressure (i.e., to nucleoside reverse transcriptase inhibitors) selecting out PI- and, to a lesser extent, NNRTI-resistant viral variants.
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Affiliation(s)
- Rafael E Campo
- Division of Infectious Diseases, University of Miami School of Medicine, 1500 NW 12th Avenue, 8th Floor West, Miami, FL 33136, USA.
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Campo RE, Lichtenberger PN, Rosa I, Suarez G, Rivera FA, Rodriguez AE, Jayaweera DT, Wahlay NA, Kolber MA. Differences in the frequency of resistance to antiretroviral drug classes among human immunodeficiency virus type 1 clinical isolates. J Clin Microbiol 2003; 41:3376-8. [PMID: 12843097 PMCID: PMC165347 DOI: 10.1128/jcm.41.7.3376-3378.2003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Genotypic resistance to all antiretroviral classes was widespread among human immunodeficiency virus type 1 isolates failing therapy. Resistance to nonnucleoside reverse transcriptase inhibitors was found most frequently and resistance to protease inhibitors was found least frequently, most likely due to differences in the number of enzymatic amino acid substitutions leading to resistance to each particular drug class.
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Affiliation(s)
- Rafael E Campo
- Division of Infectious Diseases, University of Miami School of Medicine, Miami, Florida, USA.
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