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Biomedical subjects

Farrin A Manian

Publications and source records attributed to Farrin A Manian.

8 recordsLinked to original sources
PubMed2006

Significant absorption of oral vancomycin in a patient with clostridium difficile colitis and normal renal function.

Orally-administered vancomycin is poorly absorbed in most patients, usually producing minimal or subtherapeutic serum concentrations. Bowel inflammation may enhance absorption of oral vancomycin, particularly in those with renal failure. A 77-year-old female with Clostridium difficile (C difficile) colitis and normal renal function was treated with high doses of oral vancomycin and achieved serum concentrations in the therapeutic range. To our knowledge, this is the first report of a patient with C difficile colitis and normal renal function to develop therapeutic serum concentrations following oral administration of vancomycin.

Absorption↗
PubMed2003

Surgical site infections associated with methicillin-resistant Staphylococcus aureus: do postoperative factors play a role?

Patients with surgical site infections (SSIs) who underwent surgery during the period of September 1997 through December 1999 and January through July 2001 were retrospectively studied to compare patients infected with methicillin-resistant Staphylococcus aureus (MRSA) with those infected with organisms other than MRSA. Of patients with SSI who had known culture results, 77 (28.5%) of 270 had cultures that yielded MRSA. On univariate analysis, age of >or=70 years, duration of surgery of >or=4 h, duration of postoperative antibiotic treatment of >1 day, and discharge to a long-term care facility (LTCF) were significantly associated with MRSA SSI (P<.05 for all). On multivariate analysis, only discharge to an LTCF (odds ratio [OR], 2.3; P=.04) and duration of postoperative antibiotic treatment of >1 day (OR, 2.0; P=.03) were significantly associated with MRSA SSI; there was also a trend toward MRSA SSI being associated with use of a surgical drain for >1 day (P=.078). Postoperative factors may play a more important role in the causation of MRSA SSI than has previously been appreciated.

Aged↗
PubMed2003

Asymptomatic nasal carriage of mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) in a pet dog associated with MRSA infection in household contacts.

Recurrent methicillin-resistant Staphylococcus aureus (MRSA) infection in a patient with diabetes and in his wife is described. Culture of nares samples from the family dog grew mupirocin-resistant (minimum inhibitory concentration >1024 microg/mL) MRSA that had a pulsed-field gel electrophoresis chromosomal pattern identical to the MRSA isolated from the patient's nares and his wife's wound. Further recurrence of MRSA infection and nasal colonization in the couple was prevented only after successful eradication of MRSA from the family dog's nares.

Animals↗
PubMed2003

Vascular and cardiac infections in end-stage renal disease.

Patients with end-stage renal disease (ESRD) receiving hemodialysis (HD) are vulnerable to intravascular and endocardial infections. These include vascular access infections, vascular stent infections, and bacterial endocarditis. Staphylococcus aureus is the most commonly encountered microorganism in these conditions. Prolonged intravenous antibiotic therapy is often indicated in these infections. Surgical removal of the infected vascular access or stent may be required. Infective endocarditis occurs less frequently in renal transplant recipients than in patients on HD. Although bacterial endocarditis may occur, fungal endocarditis with organisms such as Aspergillus and Candida species occurs with disproportionately high frequency among renal transplant recipients because of immunosuppression. Prolonged intravenous antibiotic or antifungal therapy is indicated, and valve replacement is often necessary.

Anti-Bacterial Agents↗
PubMed2002

Routine screening for methicillin-resistant Staphylococcus aureus among patients newly admitted to an acute rehabilitation unit.

BACKGROUND: Following an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in our acute rehabilitation unit in 1987, all patients except in-house transfers (because of their low prevalence of MRSA colonization) underwent MRSA screening cultures on admission. OBJECTIVES: To better characterize the current profile of patients with positive MRSA screening cultures at the time of admission to our acute rehabilitation unit, and to determine the relative yield of nares, perianal, and wound screening cultures in this population. METHODS: Prospective chart review with ongoing active surveillance for infections associated with the acute rehabilitation unit RESULTS: The rate of MRSA isolation from one or more body sites increased significantly from 5% (1987-1988) to 12% (1999-2000) (P = .0009) for newly admitted patients and from 0% to 7% (P < .0001) for in-house transfers. A negative nares culture was highly predictive (98%) of a negative perianal culture. Prior history of MRSA infection or colonization and transfer from outside sources were independently associated with positive MRSA screening cultures. CONCLUSION: The rate of MRSA isolation from screening cultures of newly admitted patients, including in-house transfers, has increased significantly during the past decade in our acute rehabilitation unit. When paired with nares cultures, perianal cultures were of limited value in this patient population.

Acute Disease↗