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Article ; Online: Updates in Prevention of Surgical Site Infection: Reply.

Long, Dustin R / Alverdy, John C / Vavilala, Monica S

2023 Volume 138, Issue 4, Page(s) 447

MeSH term(s)	Humans ; Surgical Wound Infection/prevention & control ; Infection Control
Language	English
Publishing date	2023-01-21
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000004463
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Zs.MO 199: Show issues

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Article ; Online: Emerging Paradigms in the Prevention of Surgical Site Infection: The Patient Microbiome and Antimicrobial Resistance.

Long, Dustin R / Alverdy, John C / Vavilala, Monica S

Anesthesiology

2022 Volume 137, Issue 2, Page(s) 252–262

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Drug Resistance, Bacterial ; Humans ; Microbiota ; Surgical Wound Infection/prevention & control
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-06-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000004267
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Article ; Online: Cell-Free DNA Detects

Long, Dustin R / Holmes, Elizabeth A / Goss, Christopher H / Singh, Pradeep K / Waalkes, Adam / Salipante, Stephen J

American journal of respiratory and critical care medicine

2023 Volume 208, Issue 9, Page(s) 944–947

MeSH term(s)	Humans ; Cystic Fibrosis/complications ; Cystic Fibrosis/drug therapy ; Pseudomonas aeruginosa ; Cell-Free Nucleic Acids ; Pseudomonas Infections/drug therapy ; Anti-Bacterial Agents/therapeutic use ; Lung
Chemical Substances	Cell-Free Nucleic Acids ; Anti-Bacterial Agents
Language	English
Publishing date	2023-08-04
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202305-0844LE
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Article ; Online: Transposon sequencing identifies genes impacting

Lo, Hsin-Yu / Long, Dustin R / Holmes, Elizbeth A / Penewit, Kelsi / Hodgson, Taylor / Lewis, Janessa D / Waalkes, Adam / Salipante, Stephen J

Infection and immunity

2023 Volume 91, Issue 10, Page(s) e0022823

Abstract: Staphylococcus ... ...

Abstract	Staphylococcus aureus
MeSH term(s)	Humans ; Staphylococcus aureus/metabolism ; Staphylococcal Infections/metabolism ; Respiratory System ; Cystic Fibrosis/complications ; Virulence/genetics
Language	English
Publishing date	2023-09-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	218698-6
ISSN	1098-5522 ; 0019-9567
ISSN (online)	1098-5522
ISSN	0019-9567
DOI	10.1128/iai.00228-23
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Zs.A 684: Show issues

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Article ; Online: 2023 Neer Award for Basic Science: Genetics of Cutibacterium acnes in Revision Shoulder Arthroplasty: A Large-Scale Bacterial Whole-Genome Sequencing Study.

Hsu, Jason E / Matsen, Frederick A / Whitson, Anastasia J / Waalkes, Adam / Almazan, Jared / Bourassa, Lori A / Salipante, Stephen J / Long, Dustin R

Journal of shoulder and elbow surgery

2024

Abstract: Background: Cutibacterium acnes is the bacterium most commonly responsible for shoulder periprosthetic joint infection (PJI) and is often cultured from samples obtained at the time of revision for failed shoulder arthroplasty. We sought to determine ... ...

Abstract	Background: Cutibacterium acnes is the bacterium most commonly responsible for shoulder periprosthetic joint infection (PJI) and is often cultured from samples obtained at the time of revision for failed shoulder arthroplasty. We sought to determine whether these bacteria originate from the patient or from exogenous sources. We also sought to identify which C. acnes genetic traits were associated with the development of shoulder PJI. Methods: We performed bacterial whole-genome sequencing of C. acnes from a single-institution repository of cultures obtained before or during primary and revision shoulder arthroplasty and correlated the molecular epidemiology and genetic content of strains with clinical features of infection. Results: A total of 341 isolates collected over a four-year period from 88 patients were sequenced. C. acnes cultured from surgical specimens demonstrated significant similarity to the strains colonizing the skin of the same patient (p<0.001). Infrequently, there was evidence of strains shared across unrelated patients, suggesting that exogenous sources of C. acnes culture-positivity were uncommon. Phylotypes IB and II were modestly associated with clinical features of PJI, but all phylotypes appeared inherently capable of causing disease. Chronic shoulder PJI was associated with the absence of common C. acnes genes involved in bacterial quorum-sensing (luxS, tqsA). Conclusion: C. acnes strains cultured from deep intraoperative sources during revision shoulder arthroplasty demonstrate strong genetic similarity to the strains colonizing a patient's skin. Some phylotypes of C. acnes commonly colonizing human skin are modestly more virulent than others, but all phylotypes have a capacity for PJI. C. acnes cultured from cases of PJI commonly demonstrated genetic hallmarks associated with adaptation from acute to chronic phases of infection. This is the strongest evidence to date supporting the role of the patient's own, cutaneous C. acnes strains in the pathogenesis of shoulder arthroplasty infection. Our findings support the importance of further research focused on perioperative decolonization and management of endogenous bacteria that are likely to be introduced into the arthroplasty wound at the time of skin incision.
Language	English
Publishing date	2024-04-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1170782-3
ISSN	1532-6500 ; 1058-2746
ISSN (online)	1532-6500
ISSN	1058-2746
DOI	10.1016/j.jse.2024.02.039
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Zs.A 3973: Show issues

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Article ; Online: Considerations for Assessing Risk of Provider Exposure to SARS-CoV-2 after a Negative Test.

Long, Dustin R / Sunshine, Jacob E / Van Cleve, Wil

Anesthesiology

2020 Volume 133, Issue 2, Page(s) 483–485

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; False Negative Reactions ; Health Personnel ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/prevention & control ; Reproducibility of Results ; Reverse Transcriptase Polymerase Chain Reaction/methods ; Reverse Transcriptase Polymerase Chain Reaction/standards ; Reverse Transcriptase Polymerase Chain Reaction/statistics & numerical data ; Risk Assessment ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-11
Publishing country	United States
Document type	Letter
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000003392
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Article ; Online: Dynamics of Cutibacterium repopulation onto the skin surface of the shoulder after chlorhexidine application.

Hsu, Jason E / Whitson, Anastasia J / Van Dyke, Rufus / Wu, John C / Matsen, Frederick A / Long, Dustin R

International orthopaedics

2023 Volume 47, Issue 6, Page(s) 1511–1515

Abstract: Purpose: The objective of this study was to characterize the temporal dynamics of Cutibacterium repopulation of the skin surface after application of chlorhexidine to the shoulder.: Methods: Ten shoulders in five male subjects were used. A skin swab ... ...

Abstract	Purpose: The objective of this study was to characterize the temporal dynamics of Cutibacterium repopulation of the skin surface after application of chlorhexidine to the shoulder. Methods: Ten shoulders in five male subjects were used. A skin swab was taken prior to (0 minutes) and then at three, 30, 60, 120, and 240 minutes after skin preparation with 2% chlorhexidine gluconate and 70% isopropyl alcohol. Semi-quantitative bacterial load was measured for each timepoint. Results: From zero minutes (pre-treatment) to three minutes, chlorhexidine-isopropyl alcohol reduced the skin bacterial load in eight out of ten shoulders. Of these eight shoulders, four (50%) had growth by 30 minutes, seven (88%) had growth by 60 minutes, and all eight (100%) had growth by 240 minutes. Compared to the three minutes after chlorhexidine application, bacterial load had significantly increased by 60 minutes but were still significantly lower than the pre-prep bacterial load (0 minutes). Conclusion: Following standard surgical skin preparation with chlorhexidine-isopropyl alcohol, the surface of the shoulder is repopulated with Cutibacterium within one hour, presumably from reservoirs in sebaceous glands not penetrated by topical antiseptic agents. Since these dermal glands are transected by skin incision for shoulder arthroplasty, this study suggests that they may be sources of wound contamination during surgery in spite of skin preparation with chlorhexidine.
MeSH term(s)	Male ; Humans ; Chlorhexidine ; Shoulder ; 2-Propanol ; Surgical Wound Infection ; Anti-Infective Agents, Local ; Skin/microbiology ; Preoperative Care
Chemical Substances	Chlorhexidine (R4KO0DY52L) ; 2-Propanol (ND2M416302) ; Anti-Infective Agents, Local
Language	English
Publishing date	2023-03-29
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80384-4
ISSN	1432-5195 ; 0341-2695
ISSN (online)	1432-5195
ISSN	0341-2695
DOI	10.1007/s00264-023-05786-x
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Zs.A 1324: Show issues

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Article ; Online: Contribution of the patient microbiome to surgical site infection and antibiotic prophylaxis failure in spine surgery.

Long, Dustin R / Bryson-Cahn, Chloe / Waalkes, Adam / Holmes, Elizabeth A / Penewit, Kelsi / Tavolaro, Celeste / Bellabarba, Carlo / Zhang, Fangyi / Chan, Jeannie D / Fang, Ferric C / Lynch, John B / Salipante, Stephen J

Science translational medicine

2024 Volume 16, Issue 742, Page(s) eadk8222

Abstract: Despite modern antiseptic techniques, surgical site infection (SSI) remains a leading complication of surgery. However, the origins of SSI and the high rates of antimicrobial resistance observed in these infections are poorly understood. Using ... ...

Abstract	Despite modern antiseptic techniques, surgical site infection (SSI) remains a leading complication of surgery. However, the origins of SSI and the high rates of antimicrobial resistance observed in these infections are poorly understood. Using instrumented spine surgery as a model of clean (class I) skin incision, we prospectively sampled preoperative microbiomes and postoperative SSI isolates in a cohort of 204 patients. Combining multiple forms of genomic analysis, we correlated the identity, anatomic distribution, and antimicrobial resistance profiles of SSI pathogens with those of preoperative strains obtained from the patient skin microbiome. We found that 86% of SSIs, comprising a broad range of bacterial species, originated endogenously from preoperative strains, with no evidence of common source infection among a superset of 1610 patients. Most SSI isolates (59%) were resistant to the prophylactic antibiotic administered during surgery, and their resistance phenotypes correlated with the patient's preoperative resistome (
MeSH term(s)	Humans ; Surgical Wound Infection/prevention & control ; Surgical Wound Infection/drug therapy ; Surgical Wound Infection/microbiology ; Antibiotic Prophylaxis ; Skin ; Anti-Infective Agents ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use
Chemical Substances	Anti-Infective Agents ; Anti-Bacterial Agents
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2518854-9
ISSN	1946-6242 ; 1946-6234
ISSN (online)	1946-6242
ISSN	1946-6234
DOI	10.1126/scitranslmed.adk8222
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Article ; Online: Relative leg press strength relates to activity energy expenditure in older women: Implications for exercise prescription.

Carter, Stephen J / Singh, Harshvardan / Nabhan, Dustin C / Long, Emily B / Hunter, Gary R

Experimental gerontology

2022 Volume 169, Page(s) 111956

Abstract: Limited work has evaluated how leg press strength (LPS), relative to body mass (i.e., rLPS), affects heart rate (HR) responses during activities of daily living. Such information would prove useful by informing a specific level of rLPS needed to promote ... ...

Abstract	Limited work has evaluated how leg press strength (LPS), relative to body mass (i.e., rLPS), affects heart rate (HR) responses during activities of daily living. Such information would prove useful by informing a specific level of rLPS needed to promote independent mobility and physical activity. Secondary analyses were performed on baseline measures of 76 untrained older (65 ± 4 y) women. After familiarization, one-repetition maximum leg press was converted to rLPS by dividing the external load lifted (kg) by body mass (BM). Participants were stratified according to percentile of age-group norms of rLPS: ≤50 % (low, ≤0.99 kg/BM, n = 15), 51-89 % (middle, 1.0-1.31 kg/BM, n = 31), and ≥90 % (high, ≥1.32 kg/BM, n = 30). HR was measured at rest and during laboratory-based tasks including fixed-speed (0.89 m·s
MeSH term(s)	Humans ; Female ; Aged ; Leg ; Activities of Daily Living ; Lipopolysaccharides ; Energy Metabolism/physiology ; Prescriptions
Chemical Substances	Lipopolysaccharides
Language	English
Publishing date	2022-09-17
Publishing country	England
Document type	Journal Article
ZDB-ID	390992-x
ISSN	1873-6815 ; 0531-5565
ISSN (online)	1873-6815
ISSN	0531-5565
DOI	10.1016/j.exger.2022.111956
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Article ; Online: Practical Tools for Patient-specific Characterization and Dosimetry of Radiopharmaceutical Extravasation.

Wilson, Sean / Osborne, Dustin / Long, Misty / Knowland, Josh / Fisher, Darrell R

Health physics

2022 Volume 123, Issue 5, Page(s) 343–347

Abstract: Abstract: Extravasation during radiopharmaceutical injection may occur with a frequency of more than 10%. In these cases, radioactivity remains within tissue and deposits unintended radiation dose. Characterization of extravasations is a necessary step ... ...

Abstract	Abstract: Extravasation during radiopharmaceutical injection may occur with a frequency of more than 10%. In these cases, radioactivity remains within tissue and deposits unintended radiation dose. Characterization of extravasations is a necessary step in accurate dosimetry, but a lack of free and publicly available tools hampers routine standardized analysis. Our objective was to improve existing extravasation characterization and dosimetry methods and to create and validate tools to facilitate standardized practical dosimetric analysis in clinical settings. Using Monte Carlo simulations, we calculated dosimetric values for sixteen nuclear medicine isotopes: 11 C, 64 Cu, 18 F, 67 Ga, 68 Ga, 123 I, 131 I, 111 In, 177 Lu, 13 N, 15 O, 82 Rb, 153 Sm, 89 Sr, 99m Tc, and 90 Y. We validated our simulation results against five logical alternative dose assessment methods. We then created three new characterization tools: a worksheet, a spreadsheet, and a web application. We assessed each tool by recalculating extravasation dosimetry results found in the literature and used each of the tools for patient cases to show clinical practicality. Average variation between our simulation results and alternative methods was 3.1%. Recalculation of published dosimetry results indicated an average error of 7.9%. Time required to use each characterization tool ranged from 1 to 5 min, and agreement between the three tools was favorable. We improved upon existing methods by creating new tools for characterization and dosimetry of radiopharmaceutical extravasation. These free and publicly available tools will enable standardized routine clinical analysis and benefit patient care, clinical follow-up, documentation, and event reporting.
MeSH term(s)	Computer Simulation ; Humans ; Monte Carlo Method ; Radiometry/methods ; Radiopharmaceuticals/adverse effects ; Software
Chemical Substances	Radiopharmaceuticals
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2406-5
ISSN	1538-5159 ; 0017-9078
ISSN (online)	1538-5159
ISSN	0017-9078
DOI	10.1097/HP.0000000000001600
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