Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Modarai F [original query] |
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Cluster and sporadic cases of Herbaspirillum spp. infections in patients with cancer
Chemaly RF , Dantes R , Shah DP , Shah PK , Pascoe N , Ariza-Heredia E , Perego C , Nguyen DB , Nguyen K , Modarai F , Moulton-Meissner H , Noble-Wang J , Tarrand JJ , LiPuma JJ , Guh AY , MacCannell T , Raad I , Mulanovich V . Clin Infect Dis 2014 60 (1) 48-54 OBJECTIVE: Herbaspirillum spp. are gram-negative Betaproteobacteria that inhabit the rhizosphere. We investigated a potential cluster of hospital-based Herbaspirillum spp. Infections. METHODS: Cases were defined as Herbaspirillum spp. isolated from a patient in our comprehensive cancer center between January 1st, 2006 and October 15th, 2013. Case finding was performed by reviewing isolates initially identified as Burkholderia cepacia susceptible to all antibiotics tested, and 16S rDNA sequencing of available isolates to confirm their identity. Pulsed-field gel electrophoresis (PFGE) was performed to test genetic relatedness. Facility observations, infection prevention assessments, and environmental sampling were performed to investigate potential sources of Herbaspirillum spp. RESULTS: Eight cases of Herbaspirillum spp. were identified. Isolates from the first five clustered cases were initially misidentified as B. cepacia, and available isolates from 4 of these cases were indistinguishable. The 3 subsequent cases were identified by prospective surveillance and had different PFGE patterns. All but 1 case-patient had bloodstream infections, and 6 presented with sepsis. Underlying diagnoses included solid tumors (3), leukemia (3), lymphoma (1), and aplastic anemia (1). Herbaspirillum spp. infections were hospital-onset in five and community-onset in three patients. All symptomatic patients were treated with intravenous antibiotics and their infections resolved. No environmental source or common mechanism of acquisition was identified. CONCLUSIONS: This is the first report of hospital-based cluster of Herbaspirillum spp. infections. Herbaspirillum spp. are capable of causing bacteremia and sepsis in immunocompromised patients. Herbaspirillum spp. can be misidentified as Burkholderia cepacia by commercially available microbial identification systems. |
Relationship of opioid prescription sales and overdoses, North Carolina
Modarai F , Mack K , Hicks P , Benoit S , Park S , Jones C , Proescholdbell S , Ising A , Paulozzi L . Drug Alcohol Depend 2013 132 81-6 BACKGROUND: In the United States, fatal drug overdoses have tripled since 1991. This escalation in deaths is believed to be driven primarily by prescription opioid medications. This investigation compared trends and patterns in sales of opioids, opioid drug overdoses treated in emergency departments (EDs), and unintentional overdose deaths in North Carolina (NC). METHODS: Our ecological study compared rates of opioid sales, opioid related ED overdoses, and unintentional drug overdose deaths in NC. Annual sales data, provided by the Drug Enforcement Administration, for select opioids were converted into morphine equivalents and aggregated by zip code. These opioid drug sales rates were trended from 1997 to 2010. In addition, opioid sales were correlated and compared to opioid related ED visits, which came from a Centers for Disease Control and Prevention syndromic surveillance system, and unintentional overdose deaths, which came from NC Vital Statistics, from 2008 to 2010. Finally, spatial cluster analysis was performed and rates were mapped by zip code in 2010. RESULTS: Opioid sales increased substantially from 1997 to 2010. From 2008 to 2010, the quarterly rates of opioid drug overdoses treated in EDs and opioid sales correlated (r=0.68, p=0.02). Specific regions of the state, particularly in the southern and western corners, had both high rates of prescription opioid sales and overdoses. CONCLUSIONS: Temporal trends in sales of prescription opioids correlate with trends in opioid related ED visits. The spatial correlation of opioid sales with ED visit rates shows that opioid sales data may be a timely way to identify high-risk communities in the absence of timely ED data. |
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