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  • Detecting Bacteremia Pathogens

    Abstract Full Text
    JAMA. 2017; 317(13):1308-1308. doi: 10.1001/jama.2017.2683
  • Association of RNA Biosignatures With Bacterial Infections in Febrile Infants Aged 60 Days or Younger

    Abstract Full Text
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    JAMA. 2016; 316(8):846-857. doi: 10.1001/jama.2016.9207

    This study describes the development and diagnostic accuracy of a host response RNA signature for distinguishing bacterial from nonbacterial infection in infants aged 60 days or younger.

  • JAMA August 23, 2016

    Figure 1: Flow Diagram of Enrollment and Allocation to Different Groups for Microarray Analyses

    The same 19 healthy controls were used for both the bacterial and without bacteria biosignatures analyses. KNN indicates κ–nearest neighbors; UTI, urinary tract infection.aRNA samples selection strategy is described in detail in the Methods section.bTwo patients with bacteremia also had bacterial meningitis, one each in the training and test sets. cHealthy afebrile control infants enrolled during routine primary care visits or at the time of elective surgery were also included as comparators for the analyses.
  • JAMA August 23, 2016

    Figure 5: Discrimination of Febrile Infants With and Without Bacterial Infections by Classifier Genes

    The rectangles located on the top of the heat maps represent the patient’s classification according to standard bacterial cultures in dark colors (red for patients with bacterial infections and green for patients without bacterial infections) and below according to the κ–nearest neighbors (KNN) algorithm in light colors (white represents the patients not classified by the KNN algorithm). The arrows located at the bottom of the heat maps indicate the transcriptional profiles of 3 patients (2 in panel C and 1 panel D) with positive blood cultures for viridans streptococcus. The profiles of these 3 patients appear visually different from those of most other patients with bacteremia.A, Application of the KNN algorithm to the training set composed of febrile infants with and without bacterial infections identified classifier genes (listed in eTable 3 in the Supplement) that best discriminated the 2 groups. B. The accuracy of the classifier genes was confirmed in an independent test set of patients with and without bacterial infections. The heat maps represent the expression levels of the classifier genes in the training and test sets. Overexpressed transcripts are shown in red and underexpressed transcripts in blue. Genes are ordered in the heat map from top to bottom according to their ability to discriminate between the groups. A similar approach was followed to identify classifier genes to discriminate infants with bacteremia and those without bacterial infections. C, The KNN algorithm identified the classifier genes (listed in eTable 4 in the Supplement) in the training set composed of infants with bacteremia and those without bacterial infections that best discriminated the 2 groups. D, The accuracy of the classifier genes was confirmed in an independent test set of patients with bacteremia and without bacterial infections. The heat maps represent the expression levels of the classifier genes in the training and test sets.
  • Association Between Vancomycin Minimum Inhibitory Concentration and Mortality Among Patients With Staphylococcus aureus Bloodstream Infections: A Systematic Review and Meta-analysis

    Abstract Full Text
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    JAMA. 2014; 312(15):1552-1564. doi: 10.1001/jama.2014.6364

    This systematic review and meta-analysis found no statistically significant differences in the risk of death when comparing patients with S aureus exhibiting high-vancomycin minimum inhibitory concentration (MIC) (≥1.5 mg/L) vs those with low-vancomycin MIC (<1.5 mg/L), although the findings cannot definitely exclude an increased mortality risk.

  • Effects of Decontamination of the Oropharynx and Intestinal Tract on Antibiotic Resistance in ICUs: A Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2014; 312(14):1429-1437. doi: 10.1001/jama.2014.7247

    This randomized crossover trial reports that selective oropharyngeal decontamination, vs selective decontamination of the digestive tract, was associated with lower prevalence of antibiotic-resistant gram-negative bacteria.

  • Clinical Management of Staphylococcus aureus Bacteremia: A Review

    Abstract Full Text
    JAMA. 2014; 312(13):1330-1341. doi: 10.1001/jama.2014.9743

    This review summarizes evidence on the clinical management of Staphylococcus aureus bacteremia and offers treatment recommendations for specialists and generalists.

  • JAMA July 4, 2012

    Figure 1:Staphylococcus aureus Bacteremia and Skin and Soft Tissue Infections (SSTIs) for Overall Population, 2005-2010

    Error bars indicate 95% confidence intervals; MRSA, methicillin-resistant S aureus.aFor comparison with community-onset SSTIs, the P value was less than .001; for comparison with hospital-onset bacteremia, the P value was less than .001 (both calculated using the χ2 test).bFor comparison with hospital-onset SSTIs, the P value was .02 (calculated using the χ2 test).cFor comparison with hospital-onset SSTIs, the P value was .62 (calculated using the χ2 test).
  • JAMA July 4, 2012

    Figure 2:Staphylococcus aureus Bacteremia and Skin and Soft Tissue Infections by Onset Setting, 2005-2010

    Error bars indicate 95% confidence intervals; MRSA, methicillin-resistant S aureus. The P values were calculated using Mantel-Haenszel χ2 for linear trend for 2005-2010.
  • Epidemiology of Staphylococcus aureus Blood and Skin and Soft Tissue Infections in the US Military Health System, 2005-2010

    Abstract Full Text
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    JAMA. 2012; 308(1):50-59. doi: 10.1001/jama.2012.7139
    Dr Landrum and coauthors reported on the epidemiology of Staphylococcus aureus blood and skin and soft tissue infections in the US military health system from 2005 through 2010.
  • Staphylococcus aureus Endocarditis: A Consequence of Medical Progress

    Abstract Full Text
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    JAMA. 2005; 293(24):3012-3021. doi: 10.1001/jama.293.24.3012
  • JAMA November 10, 2004

    Figure 2: Transmission of Ehrlichia chaffeensis by Tick Vector (Amblyomma americanum)

    Noninfected larvae obtain blood from a bacteremic vertebrate reservoir host (eg, white-tailed deer), become infected, and maintain ehrlichiae when the tick molts into the nymphal stage (trans-stadial [stage-to-stage] transmission). Infected nymphs may transmit E chaffeensis to susceptible reservoir hosts or incidentally to humans during acquisition of blood. Infected adult ticks, having acquired ehrlichiae either by trans-stadial transmission from the infected nymphal stage or during blood meal as noninfected nymphs on infected deer, may also pass E chaffeensis to other susceptible reservoirs or humans. Transovarial transmission (transmission to the eggs and into larvae) has not been demonstrated, and eggs and unfed larvae are presumably not infected. White-tailed deer (Odocoileus virginianus) are the predominant reservoir for E chaffeensis, although canids (eg, foxes, coyotes) are alternate reservoirs. White-tailed deer can maintain a subclinical E chaffeensis bacteremia for months and are hosts of all 3 stages of Lone Star ticks, its predominant vector. Photo provided by James Gathany/Centers for Disease Control and Prevention.
  • Management and Outcomes of Care of Fever in Early Infancy

    Abstract Full Text
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    JAMA. 2004; 291(10):1203-1212. doi: 10.1001/jama.291.10.1203
  • Serogroup Y Meningococcal Disease in Chicago, 1991-1997

    Abstract Full Text
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    JAMA. 1998; 280(24):2094-2098. doi: 10.1001/jama.280.24.2094
  • JAMA April 4, 2017

    Figure: Detecting Bacteremia Pathogens