Try a new search

Format these results:

Searched for:

person:mazod01

in-biosketch:true

Total Results:

9


Mpox in Children: 3 Cases

Frantzis, Irene; Ungar, Stephanie P; Soma, Vijaya L; Knutsen, Dorothy; Mazo, Dana; Zucker, Jason
Although the 2022 mpox outbreak mostly affected adults, its effect on children and adolescents was also substantial. In this report, we describe the clinical course and treatment of the first 3 known cases of mpox in children in New York City. These cases are instructive because they illustrate various routes of transmission, clinical presentations, and diagnostic challenges that differ from previous reports of mpox in endemic countries and previous mpox outbreaks. Of note is that each of the 3 patients received treatment with tecovirimat under an US Food and Drug Administration expanded access investigational new drug application and improved without exhibiting adverse reactions.
PMID: 38239109
ISSN: 1098-4275
CID: 5627642

Utility of incorporation of beta-D-glucan and T2Candida testing for diagnosis and treatment of candidemia

Zacharioudakis, Ioannis M; Zervou, Fainareti N; Marsh, Kassandra; Siegfried, Justin; Yang, Jenny; Decano, Arnold; Dubrovskaya, Yanina; Mazo, Dana; Aguero-Rosenfeld, Maria
The additive role of non-culture-based methods for the diagnosis of candidemia remains unknown. We evaluated 2 clinical practices followed in our hospitals for the diagnosis of candidemia, namely practice#1 including a combination of blood cultures and T2Candida, and practice#2 that also included Beta-D-glucan (BDG). Three out of 96 patients testing positive with practice#1 received a complete antifungal course. Of the 120 patients evaluated with practice#2, 29 were positive. Only 55.2% of those received a complete course. We observed significant differences in antifungal utilization, with 268.5 antifungal days/1000 patient-days for practice#1, as opposed to 371.9 days for practice#2, a nearly 40% difference. However, we found similar rates of antifungal discontinuation among negative patients at 3 days of testing (36.8% and 37.0% respectively). No differences were detected in death and/or subsequent diagnosis of candidemia. In summary, addition of BDG was interpreted variably by clinicians, was associated with an increase in antifungal utilization, and did not correlate with measurable clinical benefits for patients.
PMID: 38071859
ISSN: 1879-0070
CID: 5589412

Implementation and early outcomes of a telehealth visit model to deliver tecovirimat for mpox infection in New York City

Chan, Justin; DiTullio, David J; Pagan Pirallo, Patricia; Foote, Mary; Knutsen, Dorothy; Kottkamp, Angelica Cifuentes; McPherson, Tristan D; Mukherjee, Vikramjit; Pitts, Robert; Wallach, Andrew; Wong, Marcia; Mazo, Dana; Mgbako, Ofole
The 2022 mpox outbreak in New York City posed challenges to rapidly scaling up treatment capacity. We describe a telehealth treatment model launched during this outbreak that facilitated healthcare provider treatment capacity, and was able to adhere to a Centers for Disease Control and Prevention (CDC)-sponsored expanded access investigational new drug (EA-IND) protocol for tecovirimat. Sixty-nine patients were evaluated and prescribed tecovirimat for mpox through telehealth visits at NYC Health + Hospitals/Bellevue and NYU Langone Health from June to August 2022. Thirty-two (46.4%) were previously diagnosed with HIV. Forty-four (63.8%) reported full recovery, with the remainder lost to follow-up. Most patients (n = 60, 87.0%) attended at least one follow-up visit (either in person or through telehealth) after starting treatment. We observed favorable treatment outcomes, with no serious adverse events, hospitalizations, or deaths related to mpox. While equitable access to telehealth remains a limitation that needs to be addressed, this telehealth model enabled a rapid scale-up of tecovirimat prescription during the mpox outbreak, and should be considered as an important tool used to respond to future infectious disease outbreaks.
PMID: 37632124
ISSN: 1758-1109
CID: 5598892

Navigating the expanded access investigational new drug protocol for tecovirimat: Lessons learned from a public-private hospital partnership during the 2022 NYC mpox outbreak

Mgbako, Ofole; Chan, Justin; Pitts, Robert A.; Dilorenzo, Madeline A.; Knutsen, Dorothy; Mazo, Dana
During the 2022 mpox outbreak, tecovirimat was accessed through an expanded access investigational new drug (EA-IND) protocol. We leveraged a unique public/private hospital partnership in New York City to create a novel infrastructure to navigate the EA-IND's regulatory requirements and rapidly provide tecovirimat to patients.
SCOPUS:85164425420
ISSN: 2732-494x
CID: 5548652

Treatment of Piperacillin-Tazobactam-Nonsusceptible/Ceftriaxone-Susceptible Infections With Carbapenem Versus Carbapenem-Sparing Antimicrobials

Cao, John; Dubrovskaya, Yanina; Siegfried, Justin; Decano, Arnold; Mazo, Dana; Hochman, Sarah; Zacharioudakis, Ioannis M; So, Jonathan; Solomon, Sadie; Papadopoulos, John; Marsh, Kassandra
BACKGROUND/UNASSIGNED: METHODS/UNASSIGNED:infections. The primary composite endpoint included escalation to intensive care unit, infection- or treatment-related readmission, mortality, and infection recurrence. Outcomes were compared between groups who received carbapenem (CG) versus carbapenem-sparing agents (CSG) as targeted gram-negative therapy. RESULTS/UNASSIGNED:= .001), while treatment with carbapenem-sparing therapy was not. CONCLUSIONS/UNASSIGNED:Our study did not find improved clinical outcomes with targeted carbapenem therapy for TZP-NS/CRO-S infections. Carbapenem-sparing agents may be considered to spare carbapenems in noncritically ill patients similar to those included in our cohort.
PMCID:10249260
PMID: 37305841
ISSN: 2328-8957
CID: 5522322

Utility of Incorporation of Beta-D-glucan Testing in Algorithms for Diagnosis and Treatment of Candidemia [Meeting Abstract]

Zacharioudakis, I; Zervou, F; Marsh, K L; Siegfried, J; Yang, J; Decano, A; Dubrovskaya, Y; Mazo, D; Aguero-Rosenfeld, M E
Background. Candidemia is a common hospital acquired infection that is associated with significant morbidity and mortality. The optimal strategy for diagnosis remains unknown. Methods. We evaluated 2 distinct diagnostic strategies in hospitalized patients with suspicion of Candida bloodstream infection, namely strategy #1 that included simultaneous blood cultures and T2Candida and strategy #2 that included blood cultures, T2Candida testing and Beta-D-glucan (BDG). We examined the consistency with which each diagnostic algorithm led to changes in antifungal prescribing, the overall rate of antifungal utilization and patients' clinical outcomes. Flow Chart. Results. Among 96 patients tested with strategy #1, 3 had a positive result. Of those 100% completed a 14-day antifungal course for candidemia or were on antifungals until hospital discharge. Of the 29 out 120 patients that tested positive with strategy #2, 55.2% received a complete 14-day course or were on antifungals until hospital discharge. The percentage of completed treatment increased to 75.0% and 80.0% when the threshold for BDG positivity was increased at 200 pg/ml and 500 pg/ml respectively. We observed a significant difference in the overall antifungal utilization with 268.5 days of antifungals per 1,000 patient days for strategy #1, as opposed to 371.9 days of antifungals for strategy #2, a 38.5% increase. Negative tests at both diagnostic strategies led to a similar rate of antifungal discontinuation 3 days after testing (36.8% and 37.0% for strategy #1 and #2 respectively). We did not find significant benefits in death and/or subsequent diagnosis of candidemia between the 2 diagnostic strategies. Sensitivity analyses performed based on indication for testing and severity of illness did not significantly alter results. Conclusion. In summary, the addition of BDG in diagnostic algorithms for candidemia was interpreted variably by clinicians, was associated with a significant increase in antifungal utilization, and it did not appear to lead to measured clinical benefits for patients. Diagnostic strategies of common and serious infections that incorporate non-culture diagnostics need to be evaluated for added benefit. (Figure Presented)
EMBASE:640022141
ISSN: 2328-8957
CID: 5513402

Staphylococcus aureus Bacteremia in Patients Infected With COVID-19: A Case Series

Cusumano, Jaclyn A; Dupper, Amy C; Malik, Yesha; Gavioli, Elizabeth M; Banga, Jaspreet; Berbel Caban, Ana; Nadkarni, Devika; Obla, Ajay; Vasa, Chirag V; Mazo, Dana; Altman, Deena R
Background/UNASSIGNED:bacteremia on mortality in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown. Methods/UNASSIGNED:bacteremia. Results/UNASSIGNED:= .003, respectively). Conclusions/UNASSIGNED:bacteremia.
PMCID:7686656
PMID: 33269299
ISSN: 2328-8957
CID: 4995672

Bartonella infection in immunocompromised hosts: immunology of vascular infection and vasoproliferation

Mosepele, Mosepele; Mazo, Dana; Cohn, Jennifer
Most infections by genus Bartonella in immunocompromised patients are caused by B. henselae and B. quintana. Unlike immunocompetent hosts who usually develop milder diseases such as cat scratch disease and trench fever, immunocompromised patients, including those living with HIV/AIDS and posttransplant patients, are more likely to develop different and severe life-threatening disease. This paper will discuss Bartonella's manifestations in immunosuppressed patients and will examine Bartonella's interaction with the immune system including its mechanisms of establishing infection and immune escape. Gaps in current understanding of the immunology of Bartonella infection in immunocompromised hosts will be highlighted.
PMCID:3227422
PMID: 22162717
ISSN: 1740-2530
CID: 4995662

Risk factors for relapse and acquired rifamycin resistance after directly observed tuberculosis treatment: a comparison by HIV serostatus and rifamycin use

Nettles, Richard E; Mazo, Dana; Alwood, Karla; Gachuhi, Regina; Maltas, Gina; Wendel, Karen; Cronin, Wendy; Hooper, Nancy; Bishai, William; Sterling, Timothy R
We sought to determine the risk of acquired rifamycin resistant (ARR) tuberculosis associated with rifampin- versus rifabutin-based directly observed therapy and to assess the risk factors for relapse of tuberculosis. This observational cohort study included patients with culture-confirmed rifamycin-susceptible tuberculosis reported to the Baltimore City Health Department (Baltimore, MD) during the period of January 1993 through December 2001. Of the 407 patients, 108 (27%) were human immunodeficiency virus (HIV) seropositive, 161 (40%) were HIV seronegative, and 138 (34%) had an unknown serostatus. Three (2.8%) of 108 HIV-seropositive persons had ARR tuberculosis, compared with 0 of 299 persons with negative or unknown HIV serostatus (P=.02). Among HIV-seropositive patients, 3 (3.7%) of 81 who were treated with rifampin and 0 of 27 who were treated with rifabutin had ARR tuberculosis (P=.57). Among HIV-seropositive patients, the only risk factor for recurrent tuberculosis was a low median initial CD4+ T lymphocyte count (51 vs. 138 cells/mm3; P=.02). The median CD4+ T lymphocyte count among patients with ARR tuberculosis was 51 cells/mm3. ARR tuberculosis can occur with rifampin-based regimens, but in this study, the risk was not significantly higher than that for a rifabutin-based regimen.
PMID: 14986259
ISSN: 1537-6591
CID: 4995652