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  1. Article ; Online: Decolonization of Staphylococcus aureus.

    Sharara, Sima L / Maragakis, Lisa L / Cosgrove, Sara E

    Infectious disease clinics of North America

    2020  Volume 35, Issue 1, Page(s) 107–133

    Abstract: Staphylococcus aureus infections are associated with increased morbidity, mortality, hospital stay, and health care costs. S aureus colonization has been shown to increase risk for invasive and noninvasive infections. Decolonization of S aureus has been ... ...

    Abstract Staphylococcus aureus infections are associated with increased morbidity, mortality, hospital stay, and health care costs. S aureus colonization has been shown to increase risk for invasive and noninvasive infections. Decolonization of S aureus has been evaluated in multiple patient settings as a possible strategy to decrease the risk of S aureus transmission and infection. In this article, we review the recent literature on S aureus decolonization in surgical patients, patients with recurrent skin and soft tissue infections, critically ill patients, hospitalized non-critically ill patients, dialysis patients, and nursing home residents to inform clinical practice.
    MeSH term(s) Adult ; Anti-Bacterial Agents/administration & dosage ; Anti-Infective Agents, Local/administration & dosage ; Chlorhexidine/administration & dosage ; Critical Illness ; Cross Infection/prevention & control ; Dialysis/methods ; Drug Administration Routes ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Methicillin-Resistant Staphylococcus aureus/pathogenicity ; Mupirocin/administration & dosage ; Nursing Homes ; Soft Tissue Infections/prevention & control ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/microbiology ; Staphylococcus aureus/isolation & purification ; Surgical Wound Infection/prevention & control
    Chemical Substances Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Mupirocin (D0GX863OA5) ; Chlorhexidine (R4KO0DY52L)
    Language English
    Publishing date 2020-12-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1077676-x
    ISSN 1557-9824 ; 0891-5520
    ISSN (online) 1557-9824
    ISSN 0891-5520
    DOI 10.1016/j.idc.2020.10.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Reply to Wang and Lai, and to Woerther et al.

    Sharara, Sima L / Cosgrove, Sara E / Tamma, Pranita D

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 71, Issue 9, Page(s) 2540–2541

    MeSH term(s) Humans ; Piperacillin, Tazobactam Drug Combination ; Pyelonephritis ; beta-Lactamases
    Chemical Substances Piperacillin, Tazobactam Drug Combination (157044-21-8) ; beta-Lactamases (EC 3.5.2.6)
    Language English
    Publishing date 2020-02-04
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa118
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Treatment of multidrug-resistant Gram-negative skin and soft tissue infections.

    Jabbour, Jean-Francois / Sharara, Sima L / Kanj, Souha S

    Current opinion in infectious diseases

    2020  Volume 33, Issue 2, Page(s) 146–154

    Abstract: Purpose of review: The increase in skin and soft tissue infections (SSTI) because of multidrug-resistant (MDR) pathogens is a global concern. Although MDR Gram-negative bacteria (GNB) are often overlooked as a cause of SSTIs, their burden on the ... ...

    Abstract Purpose of review: The increase in skin and soft tissue infections (SSTI) because of multidrug-resistant (MDR) pathogens is a global concern. Although MDR Gram-negative bacteria (GNB) are often overlooked as a cause of SSTIs, their burden on the morbidity of many subgroups of patients is high. There is a paucity in the available treatment options and guidelines on how to treat these pathogens. This manuscript reviews the management of SSTIs caused by carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa (CRPA), Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia. We also highlight a few novel antibiotics that show promise in the future management of MDR-GNB SSTIs.
    Recent findings: Studies on treatment options of MDR-GNB SSTIs are scarce. Most clinical trials investigating new antibiotics have addressed conditions such as complicated intraabdominal infections, complicated urinary infections, and respiratory infections. CREs are a heterogenous group of pathogens with various mechanisms of resistance dictating susceptibility to different antimicrobial agents. Ceftazidime--avibactam, and meropenem--vaborbactam have potent activity against some of the CREs, especially Klebsiella pneumoniae carbapenemase (KPC) producers. Several novel antibiotics have potent activity against CRPA SSTIs, such as ceftazidime--avibactam, ceftolozane--tazobactam, cefiderocol, delafloxacin, finafloxacin, and murepavadin. Cefiderocol may also play an important role in the management of CRAB SSTIs, along with plazomicin and eravacycline.
    Summary: MDR-GNB play a major role in SSTIs in patients with underlying immunodeficiency, as well as burn or trauma-related injuries. With the alarming global rise in MDR-GNB resistance, antibiotic therapy for SSTIs is challenging and must be guided by in-vitro susceptibility results. Currently, data extrapolated from other indications and combination therapy can be used empirically pending microbiological data and susceptibilities. Novel antibiotics are currently under development. It is hoped that future clinical trials will be designed to address MDR-GNB SSTIs.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Drug Resistance, Multiple, Bacterial ; Gram-Negative Bacteria/drug effects ; Gram-Negative Bacterial Infections/drug therapy ; Gram-Negative Bacterial Infections/microbiology ; Humans ; Skin Diseases, Bacterial/drug therapy ; Skin Diseases, Bacterial/microbiology ; Soft Tissue Infections/drug therapy ; Soft Tissue Infections/microbiology
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2020-02-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645085-4
    ISSN 1473-6527 ; 1535-3877 ; 0951-7375 ; 1355-834X
    ISSN (online) 1473-6527 ; 1535-3877
    ISSN 0951-7375 ; 1355-834X
    DOI 10.1097/QCO.0000000000000635
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Antimicrobial Treatment of

    Zakhour, Johnny / Sharara, Sima L / Hindy, Joya-Rita / Haddad, Sara F / Kanj, Souha S

    Antibiotics (Basel, Switzerland)

    2022  Volume 11, Issue 10

    Abstract: Pseudomonas ... ...

    Abstract Pseudomonas aeruginosa
    Language English
    Publishing date 2022-10-18
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics11101432
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Mycobacterium simiae: Harmless colonizer or deadly pathogen?

    Jabbour, Jean-Francois / Hamieh, Amal / Sharara, Sima L / Kanj, Souha S

    PLoS pathogens

    2020  Volume 16, Issue 4, Page(s) e1008418

    MeSH term(s) Animals ; Antitubercular Agents/administration & dosage ; Humans ; Mycobacterium/genetics ; Mycobacterium/growth & development ; Mycobacterium/isolation & purification ; Mycobacterium/physiology ; Mycobacterium Infections/diagnosis ; Mycobacterium Infections/drug therapy ; Mycobacterium Infections/epidemiology ; Mycobacterium Infections/microbiology
    Chemical Substances Antitubercular Agents
    Language English
    Publishing date 2020-04-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2205412-1
    ISSN 1553-7374 ; 1553-7366
    ISSN (online) 1553-7374
    ISSN 1553-7366
    DOI 10.1371/journal.ppat.1008418
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: War and infectious diseases: challenges of the Syrian civil war.

    Sharara, Sima L / Kanj, Souha S

    PLoS pathogens

    2014  Volume 10, Issue 10, Page(s) e1004438

    MeSH term(s) Epidemics ; Humans ; Leishmaniasis, Cutaneous/epidemiology ; Measles/epidemiology ; Poliomyelitis/epidemiology ; Syria/epidemiology ; Warfare
    Language English
    Publishing date 2014-11-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2205412-1
    ISSN 1553-7374 ; 1553-7366
    ISSN (online) 1553-7374
    ISSN 1553-7366
    DOI 10.1371/journal.ppat.1004438
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Does This Patient Need Blood Cultures? A Scoping Review of Indications for Blood Cultures in Adult Nonneutropenic Inpatients.

    Fabre, Valeria / Sharara, Sima L / Salinas, Alejandra B / Carroll, Karen C / Desai, Sanjay / Cosgrove, Sara E

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 71, Issue 5, Page(s) 1339–1347

    Abstract: Guidance regarding indications for initial or follow-up blood cultures is limited. We conducted a scoping review of articles published between January 2004 and June 2019 that reported the yield of blood cultures and/or their impact in the clinical ... ...

    Abstract Guidance regarding indications for initial or follow-up blood cultures is limited. We conducted a scoping review of articles published between January 2004 and June 2019 that reported the yield of blood cultures and/or their impact in the clinical management of fever and common infectious syndromes in nonneutropenic adult inpatients. A total of 2893 articles were screened; 50 were included. Based on the reported incidence of bacteremia, syndromes were categorized into low, moderate, and high pretest probability of bacteremia. Routine blood cultures are recommended in syndromes with a high likelihood of bacteremia (eg, endovascular infections) and those with moderate likelihood when cultures from the primary source of infection are unavailable or when prompt initiation of antibiotics is needed prior to obtaining primary source cultures. In syndromes where blood cultures are low-yield, blood cultures can be considered for patients at risk of adverse events if a bacteremia is missed (eg, patient with pacemaker and severe purulent cellulitis). If a patient has adequate source control and risk factors or concern for endovascular infection are not present, most streptococci or Enterobacterales bacteremias do not require routine follow-up blood cultures.
    MeSH term(s) Adult ; Bacteremia/diagnosis ; Blood Culture ; Cellulitis ; Fever ; Humans ; Inpatients ; Retrospective Studies
    Language English
    Publishing date 2020-01-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa039
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: A healthcare worker and patient-informed approach to oral antibiotic decision making during the hospital-to-home transition.

    Sharara, Sima L / Arbaje, Alicia I / Cosgrove, Sara E / Gurses, Ayse P / Dzintars, Kathryn / Ladikos, Nicholas / Qasba, S Sonia / Keller, Sara C

    Infection control and hospital epidemiology

    2021  Volume 42, Issue 10, Page(s) 1266–1271

    Abstract: In a qualitative study of healthcare workers and patients discharged on oral antibiotics, we identified 5 barriers to antibiotic decision making at hospital discharge: clinician perceptions of patient expectations, diagnostic uncertainty, attending ... ...

    Abstract In a qualitative study of healthcare workers and patients discharged on oral antibiotics, we identified 5 barriers to antibiotic decision making at hospital discharge: clinician perceptions of patient expectations, diagnostic uncertainty, attending physician-led versus multidisciplinary team culture, not accounting for total antibiotic duration, and need for discharge prior to complete data.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Decision Making ; Health Personnel ; Hospitals ; Humans ; Patient Discharge
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-01-21
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 639378-0
    ISSN 1559-6834 ; 0195-9417 ; 0899-823X
    ISSN (online) 1559-6834
    ISSN 0195-9417 ; 0899-823X
    DOI 10.1017/ice.2020.1383
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The Voice of the Patient: Patient Roles in Antibiotic Management at the Hospital-to-Home Transition.

    Sharara, Sima L / Arbaje, Alicia I / Cosgrove, Sara E / Gurses, Ayse P / Dzintars, Kathryn / Ladikos, Nicholas / Qasba, Sarojini Sonjia / Keller, Sara C

    Journal of patient safety

    2021  Volume 18, Issue 3, Page(s) e633–e639

    Abstract: Objective: Our objective was to characterize tasks required for patient-performed antibiotic medication management (MM) at the hospital-to-home transition, as well as barriers to and strategies for patient-led antibiotic MM. Our overall goal was to ... ...

    Abstract Objective: Our objective was to characterize tasks required for patient-performed antibiotic medication management (MM) at the hospital-to-home transition, as well as barriers to and strategies for patient-led antibiotic MM. Our overall goal was to understand patients' role in managing antibiotics at the hospital-to-home transition.
    Methods: We performed a qualitative study including semistructured interviews with health care workers and contextual inquiry with patients discharged home on oral antibiotics. The setting was one academic medical center and one community hospital. Participants included 37 health care workers and 16 patients. We coded interview transcripts and notes from contextual inquiry and developed themes.
    Results: We identified 6 themes involving barriers or strategies for antibiotic MM. We identified dissonance between participant descriptions of the ease of antibiotic MM at the hospital-to-home transition and their experience of barriers. Similarly, patients did not always recognize when they were experiencing side effects. Lack of access to follow-up care led to unnecessarily long antibiotic courses. Instructions about completing antibiotics were not routinely provided. However, patients typically did not question the need for the prescribed antibiotic.
    Conclusions: There are many opportunities to improve patient-led antibiotic MM at the hospital-to-home transition. Mismatches between patient perceptions and patient experiences around antibiotic MM at the hospital-to-home transition provide opportunities for health system improvement.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Hospitals ; Humans ; Patient Discharge ; Qualitative Research ; Transitional Care
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-09-27
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2394324-5
    ISSN 1549-8425 ; 1549-8417
    ISSN (online) 1549-8425
    ISSN 1549-8417
    DOI 10.1097/PTS.0000000000000899
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Modifiable Risk Factors for the Emergence of Ceftolozane-tazobactam Resistance.

    Tamma, Pranita D / Beisken, Stephan / Bergman, Yehudit / Posch, Andreas E / Avdic, Edina / Sharara, Sima L / Cosgrove, Sara E / Simner, Patricia J

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 73, Issue 11, Page(s) e4599–e4606

    Abstract: Background: Ceftolozane-tazobactam (TOL-TAZ) affords broad coverage against Pseudomonas aeruginosa. Regrettably, TOL-TAZ resistance has been reported. We sought to identify modifiable risk factors that may reduce the emergence of TOL-TAZ resistance.: ... ...

    Abstract Background: Ceftolozane-tazobactam (TOL-TAZ) affords broad coverage against Pseudomonas aeruginosa. Regrettably, TOL-TAZ resistance has been reported. We sought to identify modifiable risk factors that may reduce the emergence of TOL-TAZ resistance.
    Methods: Twenty-eight consecutive patients infected with carbapenem-resistant P. aeruginosa isolates susceptible to TOL-TAZ, treated with ≥72 hours of TOL-TAZ , and with P. aeruginosa isolates available both before and after TOL-TAZ exposure between January 2018 and December 2019 in Baltimore, Maryland, were included. Cases were defined as patients with at least a 4-fold increase in P. aeruginosa TOL-TAZ MICs after exposure to TOL-TAZ. Independent risk factors for the emergence of TOL-TAZ resistance comparing cases and controls were investigated using logistic regression. Whole genome sequencing of paired isolates was used to identify mechanisms of resistance that emerged during TOL-TAZ therapy.
    Results: Fourteen patients (50%) had P. aeruginosa isolates which developed at least a 4-fold increase in TOL-TAZ MICs(ie, cases). Cases were more likely to have inadequate source control (29% vs 0%, P = .04) and were less likely to receive TOL-TAZ as an extended 3-hour infusion (0% vs 29%; P = .04). Eighty-six percent of index isolates susceptible to ceftazidime-avibactam (CAZ-AVI) had subsequent P. aeruginosa isolates with high-level resistance to CAZ-AVI, after TOL-TAZ exposure and without any CAZ-AVI exposure. Common mutations identified in TOL-TAZ resistant isolates involved AmpC, a known binding site for both ceftolozane and ceftazidime, and DNA polymerase.
    Conclusions: Due to our small sample size, our results remain exploratory but forewarn of the potential emergence of TOL-TAZ resistance during therapy and suggest extending TOL-TAZ infusions may be protective. Larger studies are needed to investigate this association.
    MeSH term(s) Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Azabicyclo Compounds/pharmacology ; Ceftazidime/pharmacology ; Cephalosporins/pharmacology ; Cephalosporins/therapeutic use ; Drug Combinations ; Drug Resistance, Multiple, Bacterial/genetics ; Humans ; Microbial Sensitivity Tests ; Pseudomonas Infections/drug therapy ; Pseudomonas Infections/epidemiology ; Pseudomonas aeruginosa/genetics ; Risk Factors ; Tazobactam/pharmacology ; Tazobactam/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; Azabicyclo Compounds ; Cephalosporins ; Drug Combinations ; ceftolozane (37A4IES95Q) ; Ceftazidime (9M416Z9QNR) ; Tazobactam (SE10G96M8W)
    Language English
    Publishing date 2020-09-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa1306
    Database MEDical Literature Analysis and Retrieval System OnLINE

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