TAG: "Infectious disease"

UC Irvine Health-led study earns Top 10 Clinical Research Achievement

MRSA study honored by Clinical Research Forum.

Susan Huang, UC Irvine

A study on antibiotic-resistant bacteria in hospitals led by UC Irvine Health infectious disease expert Dr. Susan Huang earned a “Top 10 Clinical Research Achievement Award” for 2013 from the Clinical Research Forum.

Huang, medical director of epidemiology and infection prevention for UC Irvine Health, is an associate professor of medicine. Winning projects represent the outstanding examples of research projects that benefit the health and well being of the general public.

The study showed that using germ-killing soap and ointment in hospitals on all intensive-care unit patients can reduce bloodstream infections by up to 44 percent and significantly reduce the presence of methicillin-resistant Staphylococcus aureus (MRSA). Patients who have MRSA present on their bodies are at increased risk of developing a MRSA infection and can spread the germ to other patients.

In the study, which was designed to test three MRSA prevention strategies, researchers found that treating all ICU patients with germ-killing soap and ointment was more effective than strategies that relied on screening patients for MRSA first, then applying prevention strategies only to those who carry the germ. This approach was also effective for preventing infections caused by germs other than MRSA. Study results appeared in the New England Journal of Medicine.

“Clinical research culminates years of basic and translational science to bring new treatments to patients, and I’m always excited to see the groundbreaking clinical research recognized every year by the Clinical Research Forum,” said National Institutes of Health Director Francis S. Collins, M.D., Ph.D. “This is just the tip of the iceberg of the incredible work coming out in the field, much of it funded by the NIH.”

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Dr. Elliot Goldstein, former UC Davis infectious diseases chief, dies

He was 79.

Dr. Elliot Goldstein, professor emeritus and former chief of the UC Davis Division of Infectious Diseases, died on March 31, in Woodland.

Dr. Goldstein was born in New York on Dec. 29, 1934, the eldest son of Joseph and Frieda Goldstein. He graduated from Stuyvesant High School and received a bachelor’s degree from Cornell University in 1956 and his medical degree from Cornell Medical College in 1960.

Dr. Goldstein trained at UC San Francisco; Bellevue Hospital, Columbia Division; and Channing Laboratories, Harvard University. He was an instructor at Harvard; a professor and chief of infectious disease at UC Davis; and professor and director of infectious disease at Kansas University Medical College. He was twice selected as a Fulbright research scholar to the Netherlands and lectured around the world.

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Scientists generate 3-D structure for malaria parasite genome

UC Riverside-led research could help identify new anti-malaria strategies.

3-D modeling of the human malaria parasite genome at one of the stages of its life cycle. Each color represents one of the 14 chromosomes of the parasite genome, the exception being purple (indicates genes known to be involved in virulence).

A research team led by a cell biologist at UC Riverside has generated a 3-D model of the human malaria parasite genome at three different stages in the parasite’s life cycle — the first time such 3-D architecture has been generated during the progression of the life cycle of a parasite.

The parasite that causes malaria in humans is Plasmodium falciparum. The female Anopheles mosquito transmits P. falciparum from an infected human to healthy individuals, spreading malaria in the process.  According to the World Health Organization, an estimated 207 million people were infected with malaria in 2012, leading to 627,000 deaths.

“Understanding the spatial organization of chromosomes is essential to comprehend the regulation of gene expression in any eukaryotic cell,” said Karine Le Roch, an associate professor of cell biology and neuroscience, who led the study.

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New program offers parents medical guidance for international adoptions

UCLA pediatric infectious disease specialists seek to help adoptive parents, children.

The Wilson family

With thousands of internationally adopted children arriving in the United States each year, there is a growing demand for a specialized health care support system that helps adoptive parents and children navigate through the international adoption process.

Now, Dr. Yvonne Bryson and Dr. Nava Yeganeh, pediatric infectious disease specialists at Mattel Children’s Hospital UCLA, have created a new program to meet this need.

The goal of the hospital’s new International Adoption and Travel Clinic is to provide parents with a medical-based support system as they embark on their adoption journey.

“Children adopted internationally, many from developing countries, may have spent months to years in orphanages and other state-run institutions; their medical histories may be incomplete, and many need specific infectious disease–related attention,” said Bryson, professor and chief of pediatric infectious diseases at Mattel. We also help families prepare for international travel, with guidance on recommended vaccines and other medical preparations.”

The Wilsons of Bakersfield have experienced firsthand some of the challenges of trying to piece together medical expertise on their own. The family includes three biological children, two brothers adopted from Ethiopia in 2011 and two boys adopted from China last year. The Wilsons were referred to the new UCLA clinic when their sons from China needed an infectious disease specialist because of possible tuberculosis exposure. The clinic is now completing other missing tests so that the boys have a complete medical workup.

“Having medical experts from a dedicated international adoption clinic can really help streamline things, whether it’s getting a timely review of the potential child’s health records or having a more comprehensive check list of necessary vaccines and specific tests that need to be performed once the child is home with us,” said the Wilson boys’ mother, Brooke. ”We are starting another adoption in China, and this time, we plan on working with the clinic from the beginning of the process. Having a medical group available to help families before and after their journeys with their children is an incredible asset.”

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Valley fever lecture series to bring attention to ‘silent epidemic’

Series is next step in UC Merced-led effort aimed at combating valley fever.

Valley fever, described as a “silent epidemic” by the Centers for Disease Control, will be explored through a series of wide-ranging talks at the University of California, Merced.

Twelve lectures will be held between March and May. Ten will be presented on the university campus. One will be presented remotely by the founder of valleyfeversurvivor.com and one presentation will be held at the UCSF Fresno Center for Medical Education and Research. All lectures are scheduled from 1 to 3 pm.

“The aim of the lecture series is to raise awareness of a largely silent disease that has a significant impact on the San Joaquin Valley,” said professor Paul Brown, director of the campus’s Health Sciences Research Institute. “Great strides are needed to enhance prevention, detection and treatment. UC Merced is committed to developing a collaborative approach to respond to this regional ailment.”

Researchers estimate that each year, more than 150,000 people are infected by Coccidioides, the fungus that causes valley fever, according to the Centers for Disease Control (CDC). Infection occurs when microscopic fungal spores are inhaled. Most people who are infected do not show symptoms, while others may experience flu-like symptoms that last from weeks to months. Severe cases can even result in death. The fungus is commonly found in the Southwest, particularly Arizona and California, including the San Joaquin Valley.

Friday, March 14
“Clinical Considerations in Coccidioidomycosis”
Nathan Stockamp, M.D., assistant clinical professor, UC San Francisco at UCSF Fresno
UC Merced, Social Sciences and Management Building, Room 317

Wednesday, April 2
“The Impact of Valley Fever on Correctional Health Care Ethics”
Clarence Cryer Jr., Master of Public Health, California Correctional Health Care Services
UC Merced, Classroom and Office Building, Room 322

Friday, April 11
“Ecology of Coccidioides immitis – Challenges to Detect this Fungal Pathogen in its Natural Habitat”
Antje Lauer, Ph.D., assistant professor, California State University, Bakersfield
UC Merced, Social Sciences and Management Building, Room 317

Wednesday, April 16
“Valley Fever Basics,” plus an update from the 2014 Cocci Study Group meeting
Herbert Boro, M.D., Fellow of the American College of Physicians, Cocci Study Group
UC Merced, Classroom and Office Building, Room 322

Friday, April 18
“Inflammasome Activation by the Fungal Pathogen, Aspergillus fumigatus”
David Ojcius, professor, UC Merced
UC Merced, Social Sciences and Management Building, Room 317

Wednesday, April 23
“Public and Medical Misinformation on Valley Fever”
David Filip, founder, valleyfeversurvivor.com
UC Merced, Social Sciences and Management Building, Room 366

Wednesday, April 30
“The Ebb and Flow of Coccidioidomycosis in Kern County”
Kirt Emery, Master of Public Health, County of Kern, Public Health Services Department
UC Merced, Classroom and Office Building, Room 322

Thursday, May 1
“Regulation of Cell Shape and Virulence in Thermally Dimorphic Fungi”
Anita Sil, M.D., associate professor, UC San Francisco
UC Merced, Social Sciences and Management Building, Room 317

Thursday, May 1
“Coccidioides Species Outside a Living Host: Saprophytic or Saprozooic?”
John Taylor, professor, UC Berkeley
UC Merced, Social Sciences and Management Building, Room 317

Wednesday, May 7
“Undocumented Accounts of Valley Fever: Farmworkers in the Central Valley”
Sarah M. Rios, UC Santa Barbara
UC Merced, Classroom and Office Building, Room 322

Wednesday, May 14
“Preliminary Perspectives of Children with Valley Fever”
Erin Gaab, Ph.D., UC Merced
UC Merced, Social Sciences and Management Building, Room 117

Wednesday, May 21
“The Costs Behind California’s Rising Silent Epidemic”
Leslie Wilson, professor, UC San Francisco
UCSF Fresno Center, Room 116

Lectures are free and open to the public. People unable to attend in person can watch as the discussions are streamed online, and will be available online afterward, too.

Attendees can register online or contact Erin Gaab at (209) 228-4803 for streaming details and for more information.

The lecture series, funded in part by Sierra Health Foundation, is the next step in an effort led by the UC Merced Health Sciences Research Institute aimed at combating valley fever. In November 2013, UC Merced, UCSF Fresno Medical Education Program and California State University, Fresno’s Central California Center for Health and Human Services held a “Valley Fever Research Day” to determine research priorities and public service needs related to valley fever.

Because valley fever is a rare disease outside the Southwest, it does not attract sufficient research funding. More than 40 percent of people infected with valley fever have symptoms. Many of those infected with valley fever are sick without knowing why or without being diagnosed.

HSRI is developing a consortium to increase awareness about the disease and to improve detection and treatment through research, clinical care and community outreach. Partners include UCSF Fresno, Fresno State, Community Medical Centers, Children’s Hospital Central California, the public health departments in the eight counties that make up the San Joaquin Valley and community organizations serving or working with people most at risk for valley fever.

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New treatment guidelines issued for skin abscesses caused by MRSA

Antibiotic-resistant infection is most common cause of infection seen in U.S.

David Talan

It has been more than 10 years since the clinical battle began with community-acquired methicillin-resistant Staphylococcus aureus (MRSA), and doctors are still grappling with how to diagnose, treat and prevent this virulent form of staph infection, which is immune to many antibiotics.

As MRSA cases have increased dramatically over the decade, so have the number of skin abscesses — generally pus-filled boils or pimples with discharge — that characterize these infections. Now, researchers from UCLA have issued updated guidelines outlining the best ways to treat and manage these abscesses.

The first cases of MRSA were relatively mild and primarily affected high-risk patients in hospitals and long-term care facilities. But beginning the early 2000s, doctors identified a new, highly contagious and hard-to-treat strain known as “community-acquired” MRSA, which had spread to the general public. This more virulent form of the infection can be dangerous and in severe cases cause necrotizing pneumonia, fasciitis and sepsis.

One of the first reports that MRSA infections would become epidemic was published in the New England Journal of Medicine in 2006 by Dr. Gregory Moran, Dr. David A. Talan and colleagues at Olive View–UCLA Medical Center.

Their research showed that community-associated MRSA had become the most common cause of skin infection among patients presenting at emergency departments and other settings in the U.S.

In a new report published March 13 in the New England Journal of Medicine, Talan and Dr. Adam J. Singer of the emergency medicine department at Stony Brook University in New York present updated “best practice” guidelines for managing the skin abscesses associated with community-acquired MRSA.

“MRSA is not going away, so we need to fine-tune ways to treat it,” said Talan, a professor in the division of infectious diseases and chief of the department of emergency medicine at Olive View–UCLA Medical Center. “We hope the information will help guide doctors as to the best ways to address these infection-related skin abscesses.”

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How Staph cells adhere to nanostructures

Berkeley Lab-led research could guide development of bacteria-resistant materials.

This scanning electron microscopy image reveals how Staphylococcus aureus cells physically interact with a nanostructure. A bacterial cell (blue) is embedded inside the hollow nanopillar's hole and several cells cling to the nanopillar's curved walls. (Credit: Mofrad lab and the Nanomechanics Research Institute)

The bacterium Staphylococcus aureus (S. aureus) is a common source of infections that occur after surgeries involving prosthetic joints and artificial heart valves. The grape-shaped microorganism adheres to medical equipment, and if it gets inside the body, it can cause a serious and even life-threatening illness called a Staph infection. The recent discovery of drug-resistant strains of S. aureus makes matters even worse.

A Staph infection can’t start unless Staphylococcus cells first cling to a surface, however, which is why scientists are hard at work exploring bacteria-resistant materials as a line of defense.

This research has now gone nanoscale, thanks to a team of researchers led by Berkeley Lab scientists. They investigated, for the first time, how individual S. aureus cells glom onto metallic nanostructures of various shapes and sizes that are not much bigger than the cells themselves.

They found that bacterial adhesion and survival rates vary depending on the nanostructure’s shape. Their work could lead to a more nuanced understanding of what makes a surface less inviting to bacteria.

“By understanding the preferences of bacteria during adhesion, medical implant devices can be fabricated to contain surface features immune to bacteria adhesion, without the requirement of any chemical modifications,” says Mohammad Mofrad, a faculty scientist in Berkeley Lab’s Physical Biosciences Division and a professor of bioengineering and mechanical engineering at UC Berkeley.

Mofrad conducted the research with the Physical Biosciences Division’s Zeinab Jahed, the lead author of the study and a graduate student in Mofrad’s UC Berkeley Molecular Cell Biomechanics Laboratory, in collaboration with scientists from Canada’s University of Waterloo.

Their research was recently published online in the journal Biomaterials.

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Is West Nile virus coming to your town?

UCLA releases first risk-assessment predictions.

Ryan Harrigan, UCLA

Since its introduction to the U.S. in 1999, West Nile virus has spread rapidly across North America, threatening wildlife populations and posing a serious health risk to humans. In 2012, there were more than 5,500 human cases of the disease reported in 48 states, the highest number in more than a decade.

Now, a team of researchers from the Center for Tropical Research at UCLA’s Institute of the Environment and Sustainability has created a model to help predict where the disease may occur under future climate change. Their findings were published Feb. 27 in the journal Global Change Biology.

“To our knowledge, this is the first continental risk assessment of West Nile virus based on nearly a decade of data,” said Ryan Harrigan, a postdoctoral researcher at the center who, along with center director Thomas Smith, collaborated with researchers from Germany’s University of Tubingen and Britain’s University of Leeds. “What we are presenting is the first North American predictions of the disease under present and future climate conditions.”

Using the relationship between current climate conditions and cases of West Nile virus, the researchers were able to generate models to predict where this disease may occur under climate conditions in the future. Their results suggest that higher temperatures and lower precipitation lead to a higher probability of West Nile virus cases in humans, birds and mosquitoes and that as a result climate change, the disease will spread northward into previously unaffected areas.

Their analyses also identify current and future hotspots of West Nile virus transmission and present an important new approach for monitoring the risk of this and other vector-borne diseases.

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Update on rare polio-like disease in California

The current illness is extremely rare.

Emmanuelle Waubant, UC San Francisco

Over the past 18 months, physicians in California have observed on rare occasions what may be a new disease, one in which patients, usually children, quickly and permanently lose muscle function in an arm or leg.

In some cases, patients have had infectious respiratory symptoms before the paralysis begins. The illness shares some features with polio, but it is not the same disease.

The cause of the disease is still unknown, but a strong possibility is that it is caused by a virus known as enterovirus-68, which was detected in two of five cases that Emmanuelle Waubant, M.D., Ph.D., of UCSF Benioff Children’s Hospital, and Keith Van Haren, M.D., of Stanford University’s Lucile Packard Children’s Hospital, will present in detail at the annual meeting of the American Academy of Neurology this spring.

A similar type of rare paralysis caused by a virus related to enterovirus-68 has been reported for many years in Asia and Australia.

The current illness is extremely rare, and does not represent an epidemic. Only about 20 cases have been identified in the U.S., all in California, a state with a population of 38.3 million people, of whom 9.3 million are under age 18, according to the U.S. Census Bureau. No “clustering” of these cases within a small geographic area has been observed, nor are there any apparent connections between the children affected.

The polio vaccine does not appear to protect against this possibly new disease, but the UCSF and Stanford physicians are advising that children continue to receive the polio vaccine to protect against polio. They also urge that any child who shows symptoms of paralysis be seen immediately by his or her primary care physician.

Waubant and Van Haren are actively working with the California Department of Public Health (CDPH) to identify and track cases, with the goal of learning the cause of the disease.

The CDPH is taking all reports of this illness very seriously, and Waubant and Van Haren hope their combined efforts will help lead to prevention and treatment strategies in the future.

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Vitamin A may help boost immune system to fight TB

Nutrient lowers intracellular cholesterol used by tuberculosis to sustain infection.

(From left) UCLA's Elliott Kim, Philip Liu and Avelino De Leon

Tuberculosis is a major global problem, affecting 2 billion people worldwide and causing an estimated 2 million deaths annually. Western countries are once again tackling the disease, with recent outbreaks in Los Angeles and London.

The rise of drug-resistant TB, called a “ticking time bomb” by the World Health Organization, and the high cost of fighting the disease highlight the need for new approaches to treatment.

In findings published in the March 1 issue of the Journal of Immunology, UCLA researchers investigating the role of nutrients in helping the immune system fight against major infections show that vitamin A may play an important role combating TB.

The UCLA team describes for the first time the mechanism by which vitamin A and a specific gene assist the immune system by reducing the level of cholesterol in cells infected with TB. This is important because cholesterol can be used by TB bacteria for nutrition and other needs, the researchers said.

“If we can reduce the amount of cholesterol in a cell infected with tuberculosis, we may be able to aid the immune system in better responding to the infection,” said senior author Philip Liu, an assistant professor of medicine in the divisions of dermatology and orthopedic surgery at UCLA’s David Geffen School of Medicine and Orthopaedic Hospital Research Center. “Understanding how nutrients like vitamin A are utilized by our immune system to fight infections may provide new treatment approaches.”

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Why parents should immunize their children

The importance of getting vaccinated against the measles.

Behnoosh Afghani, UC Irvine

Nearly half a century after the measles vaccine became routine for U.S. children, few people remember how dangerous the disease can be. But each year, the virus — which is spread when an infected person coughs or sneezes — still kills more than 120,000 people around the globe who haven’t been immunized.

Given today’s interconnected world of international travelers, it is vital for parents to get their children vaccinated against the measles, to ensure their health and everyone else’s, said UC Irvine Health pediatric infectious disease specialist Dr. Behnoosh Afghani.

“Measles is a deadly disease and one of the most contagious,” said Afghani, “It’s associated with serious complications. In addition to rash, diarrhea and high fevers, dehydration is very common.” About one patient in 20  who contract measles develop pneumonia; one in 1,000 measles patients develop encephalitis and one or two in 1,000 patients die, she added.

When at least 95 percent of a given population is immunized, the risk of measles spreading is very low. However, in recent years, unfounded fear that autism is linked to the measles vaccine or to combination vaccines has led to lower immunization rates in parts of the United States.

“Because of the decrease in vaccination rates, we are seeing more cases of the measles,” Afghani said. “Parents should look at the scientific evidence and sources rather than listen to hearsay. By not vaccinating, parents put their own child and other children at risk of getting the disease.”

Read a Q&A with Afghani

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Grant will fund research in use of wireless technologies to manage health

Sensors to remotely monitor TB treatment.

Sara Browne, UC San Diego

Sara Browne, UC San Diego

The Alliance Healthcare Foundation has awarded the University of California, San Diego School of Medicine a $1 million Innovation Initiative (i2) Grant to support the work of Dr. Sara Browne, associate professor in the School of Medicine’s Division of Infectious Diseases. The grant is funding groundbreaking research in the use of wireless technologies in the management of personal and public health.

Browne is collaborating with colleagues at UC San Diego’s Anti-Viral Research Center, using technology developed by Proteus Digital Health, which has developed a system to track how and when individuals take medications. The system utilizes an ingestible and wearable sensor platform.

The ingestible sensor records time of medication ingestion and transmits the data to the wearable sensor in the form of a patch worn on the patient’s torso. The patch also collects activity and rest patterns and sends the information to a secure mobile application.

“The power of such a technology for physicians is that it reveals regular information on patients’ medication taking behavior and daily health patterns, enabling them to make better informed treatment decisions and to provide tailored support to their patients,” said Browne.

Browne and colleagues are using this technology to remotely monitor TB treatment, comparing it to directly observed therapy (DOT), where a health care worker personally witnesses the ingestion of medication by the patient. While DOT is the current gold standard for TB treatment monitoring, it is very time- and resource-intensive, making it unattainable for many developing countries, as well as too expensive for many domestic TB programs. Poor adherence to medication for TB is a major problem, one that exacerbates infection rates and boosts drug resistance.

“Wireless technologies have the potential to positively impact public health in San Diego and Imperial counties,” said Browne. “This technology can ultimately impact TB treatment globally, providing new methods of TB therapy monitoring and support to many more patients. This would mean better treatment completion rates, less drug resistance and, consequently, fewer cases of TB.”

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